bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real world data on immunotherapeutic outcomes in solid tumours.
Authors: Srinivasalu Vijay Kumar , Patnaik Ravi Sekhar , bin Raden Mas Ismail Raden Mas Jeffri , Bin Haji Mohamad Haji Zulkhairi , Lu Dr. Shir Kiong , Sukumaran Dato Seri Laila Jasa Dr. Babu 
Published: June 2023

e18785 Background: Defined as “the new kid on the blocks” in the field of medical oncology, Immunotherapy has paved the way in the armamentarium of cancer therapeutics literally in every cancer subtype. There are various biomarkers approved for considering immunotherapy, but none have been reliable. We aim to assess the response rate, PFS, OS, and clinical characteristics of patients who received immunotherapy for treatment in advanced or metastatic solid tumours. Methods: A retrospective study of all patients who were treated with immunotherapy at The Brunei Cancer Center, PJSC between December 2019 – February 2022 was included with a median follow-up of 6 months from the last dose of immunotherapy. Results: A total of 212 patients were included with Pembrolizumab 66% (n = 140), Nivolumab 24% (n = 51), Atezolizumab 8.4% (n = 18), Durvalumab 0.9% (n = 2), and Ipilimumab + Nivolumab 0.4% (n = 1). The median age was 46 years (range 31-78 years) with a female preponderance of 62%. The median number of cycles were 4.5 per patient (range 0-41). Lung cancer 29.7% (n = 63, adenoca-40, squamous-10, adenosquamous-2, SCLC-11), GI tumours 19.3 (n = 41, HCC-17, Stomach-15, MCRC-7, Pancreas-2), GU tumours 12.7% (n = 27, RCC-19, Bladder-7, Penis-1) and Head and neck tumours 9.9% (n = 21, HNSCC-13, NPC-8). On biomarker analysis for initiation of immunotherapy, PDL-1 + on IHC (either by CPS or TPS) was noted in 88 patients, TMB > 10 in 22, and MSI-H in 4 patients. The ORR in this study was 35.3% (CR-10, PR-29, and SD-36). Sixty patients received less than 3 cycles and were not included in the analysis. Disease progression (27), worsening ECOG performance status (14), and IRAEs (19) were the common reasons for discontinuation of these drugs. On ITT analysis, the ORR was 51.3%. The median duration of response is 12.5 months in responders (range 6-31 months). The Median PFS was 4.9 months (95% CI: 1.78-8.21) and the median OS was 7.1 months (95% CI: 8.14-17.85). On univariate analysis for determinants of better PFS, pretreatment NLR > 4 was associated with improved survival (p = 0.001) and presence of co-mutations, low TMB < 5 and younger age < 45 was associated with inferior survival. Conclusions: Pretreatment NLR > 4 can be used as an indicator of response to immunotherapy in the clinics. Benefits of immunotherapy are not universal, best responses were noted in NSCLC, Bladder, and RCC. Identification of novel predictive biomarkers would improve clinical outcomes in solid tumours.
Experience of a stem cell transplant in multiple myeloma: The patient and care partner perspective.
Authors: Hansen Doris K. , Bixby Todd , Fixler Karen , Shea Lisa , Brittle Christine , Brunisholz Kimberly , Liu Yi-Hsuan , Huo Jinhai 
Published: June 2023

e18790 Background: Understanding patient experiences of their multiple myeloma (MM) disease journey, particularly related to the burden of autologous stem cell transplant (ASCT) and treatment recovery process, helps characterize unmet needs and quality of life of patients and their caregivers. A qualitative study of the experience of patients with MM who received ASCT and perspectives of caregivers was conducted. Methods: Recruited participants with MM were ≥18 years of age and received ASCT within the past 5 years or caregivers of patients who met these criteria. Two virtual focus group interviews were conducted, in which patients and caregivers were asked separately to narrate their disease journey starting with first symptoms and diagnosis, then focusing on the ASCT and recovery period. Results: A total of 16 participants, including 12 MM patients and 4 caregivers, were included. Nine participants (56.25%) were less than 60 years old, and eleven (68.75%) participants were female. Study participants were diverse in race/ethnicity; one-third of participants were Black and one-third comprised other minorities (Hispanic, Native Hawaiian, Asian, and Multiracial). Pain, weakness, and fractured bones (femur, hip, or spinal fractures) were common first symptoms. Other common patient-reported symptoms included high blood pressure, blurred vision, more frequent illnesses, unsteady gait, and anemia. The patients in the study were first diagnosed with MM in a variety of ways, mostly by a primary care physician and some in urgent care settings. The diagnosis process could take up to six months for some patients and commonly a community oncologist referred patients to a bone marrow transplant specialist, who was the primary driver in making ASCT decisions. Eight patients received their ASCT in an inpatient setting and four patients in an outpatient setting, with three eventually being hospitalized due to complications. Only one patient stayed in an outpatient setting the entire time. Initial recovery time after ASCT ranged from 2 weeks to 4 months; complete recovery took from 30 days to “never.” The most patient-reported difficulties during recovery time included nausea, loss of appetite, weakness, fatigue, and pain. Caregivers played an important role in the recovery process and often with negative financial impact related to missing work and travel expenses. Conclusions: Patients with MM who received ASCT and their caregivers perceived various unmet needs throughout their transplant journey. Post–stem cell transplant symptoms had a substantial impact on patients’ quality of life, especially with lengthy and challenging recovery. Innovative therapies are needed for newly diagnosed MM to reduce the burden of disease and enhance the quality of life for both patients and their caregivers.
Clinicopathological features and treatment patterns of patients with cancer of unknown primary site (CUP): Mayo Clinic experience.
Authors: Algarin Perneth Sandra , Suleiman Riham , Duran Mayra , Loor Torres Ricardo , Soto Jacome Cristian , Gile Jennifer , Leon-Ferre Roberto Antonio , Villasboas Jose Caetano , Graham Rondell P. , Thome Stephan , Halfdanarson Thorvardur Ragnar , Fuentes Bayne Harry E 
Published: June 2023

e18803 Background: CUPs are a heterogeneous group of metastatic cancers for which a standardized diagnostic work-up fails to identify the site of origin at the time of diagnosis. CUP accounts for 3%-5% of all cancer diagnoses worldwide, and the natural history of patient with CUP differs from that of patients (pts) with cancer with known primary tumor. Here we report and summarize the clinical features of patients with CUP treated at Mayo Clinic. Methods: Retrospective study of patients treated at Mayo Clinic Rochester MN from 2010 to 2021. Patient demographics, tumor-related variables, treatment-related variables, and clinical data were extracted. Descriptive statistics were used, and all data were analyzed by the SPSS version 22.0 software (SPSS, Chicago, IL, United States). Results: From a total of 214 pts, 207 pts were included, as primary tumor site was identified in 7 patients after initial evaluation. The pts in this study were predominantly white (87%) of female (50.2%) gender with a mean age of 63 (SD: 13) without history of smoking (51%) and either private or public insurance (82.6%). The predominant histology was adenocarcinoma (30%), followed by neuroendocrine neoplasms (27%), and carcinoma NOS (not otherwise specified) (25%). The most prevalent grade in this cohort was grade III with poorly differentiated tumor cells. All pts had diagnostic imaging and the most used imaging modalities included CT (81.2%), and PET-CT (43.5%). In our cohort, the 3 most common sites of metastases included lymph nodes (57.5%), liver (37.8%), lung (34.3%), and bone (23.7%); and in 64% of pts, there was a specific presentation pattern including liver-predominant (24.6%), lymph node-predominant (24.6%), bone-predominant (7.7%), and peritoneal carcinomatosis (7.7%). The majority of pts received systemic therapy (69%) as first line of therapy and the most frequent first line regimens included platinum-doublet (26.5%), gemcitabine-based regimen (20.7%), 5FU-based regimens (18%) and somatostatin analogs (16.7%); whereas salvage radiation and ablation were offered to 11% of pts and surgery to 17%. The median follow-up time was 22 months (IQR: 45) with a median survival time of 23 months and the 3-year cumulative survival rate was 30%. Conclusions: The heterogenous nature of CUPs and lack of specific immunohistochemical signature prevents primary tissue of origin diagnoses in CUP pts. Without the identification of a primary origin site, treatment is restricted to generic chemotherapy with limited benefit as demonstrated in this cohort.
Characteristics of SARSCOV2 infection in vaccinated patients with cancer in one Latin American country: Real world evidence from ACHOCC19-VAC study.
Authors: Ospina Serrano Aylen Vanessa , Bruges Maya Ricardo Elias , Munevar Isabel , Jimenez Paola , Mantilla William Armando , Ramos Pedro , Rivas Tafurt Giovanna Patricia , Caicedo Mirian , Aruachan Sandra , Avendaño Ana Cristina , Manneh Kopp Ray , Triana Ivan , Barrero Angela 
Published: June 2023

e18806 Background: According to results of previous ACHOC-C19 study, mortality in patients with cancer and COVID 19 infection in Colombia is 26%. The impact of vaccination was not evaluated prior to the implementation of this strategy worldwide in patients with cancer. We aimed to characterize SARSCOV 2 infection in a local cohort of vaccinated oncologic patients. Methods: The ACHOCC-19 VAC registry is a national multi-center observational cohort study. Data were collected between April 2021 and March 2022. Inclusion criteria were: age more than 18 years, confirmed diagnosis of cancer (solid tumors), be receiving treatment or being followed-up and have received at least one dose of COVID-19 vaccine. 11 oncologists from 10 health institutions participated. The primary outcome was 30 days mortality due to COVID 19 infection. Secondary outcome was to describe adverse effects related to vaccination. A descriptive univariate and inferential analysis were performed. Results: 720 patients were included, average age was 60 years, 91% lived in urban areas, 12% had low income. 73% (525) were women. The most frequent diagnosis were: breast cancer 47% (338), prostate cancer 7% (50) and lung cancer 4.6% (36). ECOG 0-1 and 2 in 91.7% and 6.1% of population respectively. 41.40% had no comorbidities and 59.4% had 1 or more comorbidity. 29.1% presented metastatic cancer, 59.3% were receiving oncological treatment of which, 32.7% were neoadjuvant or adjuvant and 28.6% palliative. 31.66% were being followed up without treatment. 32.6% had stable disease and 5.9% had cancer in progression. Administered vaccines were CoronaVac (40%), BNT162b2 (35%) others 25%, in accordance with initial availability of vaccines for oncologic population in Colombia. 93.9% of population received 2 doses. COVID19 infection was acquired by 35.9% of the population, 30 days mortality due to infection was 3%. Table 1. Frequency of adverse effects with first and second dose were 14.8% and 12.2%, mild intensity in 93% and 100% respectively, being myalgias (5%), arthralgias (2-3%) and fever (3.5%) the most frequent. Conclusions: In our population, the efficacy of the vaccine against COVID 19 is consistent with available reports in the scientific literature. The incidence of 30 days mortality due to SARCOV 2 infection is very low. Vaccine-related adverse effects had frequency of less than 15% and mild intensity. These findings reinforce the need to promote and intensify vaccination in the oncologic patients. [Table: see text] [Table: see text]
The incidence and risk factors predictive of bone metastases at initial diagnosis of malignancy.
Authors: Knapp Brendan , Flanagan Mary Ellen , Grandhi Nikhil , Ganesh Bharath , Cittolin Santos Giordano Fabricio , Gao Feng , Samson Pamela P. , Govindan Ramaswamy , Morgensztern Daniel 
Published: June 2023

e18816 Background: Bone metastases are associated with increased morbidity and decreased quality of life in patients with solid tumors. We report here the incidence and predictive factors for bone metastases at initial diagnosis in a large population-based dataset. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients 18 years-old or older and with solid cancers of all stages diagnosed from 2010 to 2019. We calculated the incidence and predictive factors for bone metastases according to demographic and tumor characteristics. Results: Among the 1,132,154 patients identified, 1,075,069 (94.96%) had known bone metastasis status and were eligible for the study. Bone metastases were detected in 55,903 (4.9%) patients. Among patients with bone metastases, the most common primary tumors were lung (44.4%), prostate (19.3%), breast (12.4%), kidney (4.0%), colorectal (2.24%) and pancreas (2.23%). The percentage of bone metastases in patients with non-small cell lung cancer (NSCLC), prostate adenocarcinoma, infiltrating ductal carcinoma of the breast (IDC), and colorectal adenocarcinoma (CRC) was 18.04% (18,123 out of 100,447), 5.92% (9,071 out of 153,325), 2.9% (4,490 out of 154,626), and 1.17% (1,043 out of 89,510) respectively. In addition to T and N stage, independent risk factors by multivariable analysis for bone metastases included female sex and non-squamous histology in NSCLC, black race, hormonal and HER2 status in breast cancer, Gleason score and PSA in prostate cancer, male sex, black race, rectal location, liver metastases and lung metastases in CRC. In univariate analysis, the strongest predictors for bone metastases were N2/3 (28.3%) and T3/4 (24.9%) in NSCLC, T3/4 (15.8%), N2/3 (10.6%), N1 (5.9%) and HER2 positive (4.9%) in IDC, N1 (38.1%), Gleason score 9/10 (22.8%), PSA 98 or higher (19.5%) and PSA 20-97 (16.8%) in prostate cancer, and rectal or rectosigmoid location (1.43% vs 1.05% in colon cancer, p < 0.001) in CRC. Conclusions: Approximately 5% of patients with solid tumors have bone metastases at presentation. In addition to T and N stage, there are several risk factors for bone metastases according to the primary tumor site.
Outcomes of venous thromboembolism among cancer patients admitted with COVID-19: A nationwide inpatient sample analysis.
Authors: Ibrahim Muhammad Bilal , Litvin Rafaella , Noor Hiba , Khan Ali Husnain , Shah Mihir , Kanemo Philip Onyekaoso , Cuartas Mesa Maria Cristina , Turk Ekrem , Olafimihan Ayobami Gbenga , Vakil Jay , Deenadayalan Vaishali , Batra Kunnal 
Published: June 2023

e18823 Background: Cancer patients are at a higher risk of venous thromboembolism and fatal pulmonary embolism due to inflammatory cytokines, reduced coagulation inhibitors, microparticles, and other molecular mechanisms. COVID-19 leads to endothelial inflammation and microthrombi formation, further aggravating the baseline profound risk among cancer patients, with subsequent worsened mortality and morbidity. We sought to explore the outcomes of COVID-19-associated VTE in cancer patients. Methods: National Inpatient Sample 2020 was used to identify hospitalizations of cancer patients with COVID-19 with a secondary diagnosis of venous thromboembolism. All cancer patients with COVID-19 were stratified into two cohorts based on the presence of venous thromboembolism. The primary outcomes examined were In-patient mortality, the average length of stay (LOS), and total hospital charge (THC). Multivariate analysis was performed to obtain the odds ratio. All weighted analysis was conducted through STATA 17. Results: Using NIS 2020, 36,285 hospitalizations were identified with cancer and a primary diagnosis of COVID-19. Among cancer patients with COVID-19, the presence of any type of venous thromboembolism was associated with increased mortality(aOR: 1.7 CI: 1.36- 2.11),length of stay(11.62 vs. 7.73 days p < 0.01) and total charges($141,049 vs. $79,238 p < 0.01). Pulmonary embolism was similarly associated with increased mortality (aOR: 1.42 CI: 1.08- 1.88), LOS(9.27 vs. 7.92 days p = 0.015), and total charges($107,111 vs. $82,180 p < 0.01). Venous thromboembolism other than PE was associated with increased mortality at a higher adjusted odds ratio (aOR: 2.12 CI: 1.52- 2.96), as well as longer LOS(15.71 vs. 7.79 days p < 0.01) and higher total charges($200,999 vs. $80,406 p < 0.01). Conclusions: This study shows that venous thromboembolism among cancer patients with COVID-19 leads is associated with increased mortality and economic costs. VTE other than PE appears to be associated with less favorable odds than PE. Physicians should maintain a higher degree of suspicion for venous thromboembolism when treating cancer patients with COVID-19. Optimum thrombotic prophylaxis, timely diagnosis, and treatment of venous thromboembolism are critical to reducing the deleterious outcomes. [Table: see text]
Real-world treatment patterns of triple-class refractory (TCR) multiple myeloma (MM) across the United States (US), Canada, and western Europe: A retrospective chart study.
Authors: Guillaume Xavier , Horchi Dahbia , Gomez Jorge , Hlavacek Patrick , Ren Jinma , Schepart Alex , Aydin Didem , DiBonaventura Marco 
Published: June 2023

e18826 Background: Many patients with MM relapse or become refractory to various therapeutic approaches and typically cycle through many lines of treatment. The present study sought to understand how patients with TCR MM (ie, refractory to ≥1 PI, ≥1 IMiD, and ≥1 anti-CD38 therapy) are managed across various countries. Methods: A non-interventional, retrospective chart review study was conducted across the US, Canada (CA), the UK, France (FR), Germany (DE), Italy (IT), and Spain (ES). Oncologists/hematologists were recruited to abstract medical chart information into an electronic case report form from eligible MM patients (eg, refractory to ≥1 IMiD, ≥1 PI, and ≥1 anti-CD38 antibody treatment, ECOG≤2, and initiated their first therapy after their TCR status [ie, their index therapy] between 1/1/2018 and 12/31/2020 to ensure at least 1 year of follow-up). Abstractions were performed from January through April 2022. Demographics, clinical characteristics, and treatment patterns were descriptively analyzed and reported here. Results: N = 314 patients with TCR MM were included (56.7% male; median age = 70). Clinical characteristics were similar to other TCR MM studies (eg, 26.1% had an ECOG score of 2, 25.8% had high cytogenetic risk (ie, t(4:14), t(14:16), and/or del(17p), and 10.2% had extramedullary disease). Patients received a median of 3 treatment lines prior to their index therapy, with 70 unique treatment regimens reported as part of their index therapy line (Table 1). The most common regimens (> 10%) were Pd and Kd. Conclusions: This global chart review across the US, Canada, and Western Europe highlights the consistent lack of a standard of care for the management of MM among patients who are refractory to the three main classes of therapies. [Table: see text]
Real-world data of early-onset colorectal cancer (EOCRC) in private health system in Brazil.
Authors: Mathias Maria Cecilia , Gil Mariana , Passarini Thais , Canedo Jorge Alexandre , Moraes Eduardo Dias de , Pereira Sabrina , Amorim Larissa Costa , Prolla Gabriel , Freitas Laura , Costa e Silva Matheus , Ferreira Carlos Gil , Ferrari Bruno Lemos , Garicochea Bernardo , Dienstmann Rodrigo , Gil Roberto Almeida , Peixoto Renata D'Alpino , Jácome Alexandre A. 
Published: June 2023

e18830 Background: Incidence of EOCRC has been sharply rising in the past decades in the US and present distinct clinical features when compared to late-onset CRC (LOCRC). Data from other countries are scarce. We compared clinical characteristics and treatment outcomes between patients ≤45y (EOCRC) and ≥60y (LOCRC). Methods: Retrospective study evaluating 510 patients with metastatic CRC treated at 5 Oncoclinicas centers in Brazil from January 2011 to December 2019. Demographic and clinical data were retrieved from electronic medical records. The median OS was calculated by Kaplan-Meier method and prognostic factors were evaluated via multivariate Cox Regression. Results: After excluding patients with ages between 46 and 59, 326 patients were identified. EOCRC was represented by 72 (22%) patients (median age 39) and LOCRC by 254 patients (median age 69). Median follow-up was 39.5m, with 231 deaths (71%). Median OS was 33.2m and 40.9m (p = 0.971), respectively. Likewise, stage IV at presentation was similar between the groups (68% vs 58%, p = 0.215), as well as the rate of dMMR status (4% vs 6%, p = 0.655). Clinical and treatment characteristics that were statistically different between the groups are described in Table 1. In multivariate analysis, presence of RAS mutations (HR:1.83), and undergoing triplet chemotherapy (HR:3.24), primary tumor resection (HR:0.40), and metastasectomy (HR:0.45) were the variables with prognostic effect on OS. Conclusions: In this real-world analysis of mCRC, EOCRC patients presented similar clinical presentation and OS, but they were more aggressively treated compared to the older patients. There is no evidence that more intensive treatments translate into superior clinical outcomes in young patients. Real-world data have been progressively adopted in clinical practice and should be considered before clinical decision making in order to offer treatments with minimal toxicity burden to the patients. Future studies with larger population are needed and may bring additional data. [Table: see text]
Tolerability of capecitabine in difference racial/ethnic groups.
Authors: Dower Joshua , Salei Yana , Dumas Brett , Schlam Ilana 
Published: June 2023

e18833 Background: Capecitabine (cap) is an oral chemotherapy agent used for treatment of solid malignancies. The recommended dose of cap generally ranges from 1000mg/m2 to 1250mg/m2 twice daily, but many patients require a dose reduction during treatment due to AE. It is unclear whether patients of different race have better tolerability of cap than others. In Asian populations for example, potential differences in tolerance have been attributed to low dietary folate intake. Race is a social construct; however it has been used to identify groups of patients within a population. We aimed to understand the tolerability of cap among patients of different racial/ethnic groups. Methods: In this retrospective chart review, we studied patients treated with cap at Tufts Medicine (three centers in MA, USA) between 2017-2021. Patients treated with cap alone, concurrent with other chemo, or concurrent with radiation for solid tumors were included. Patients were excluded if race/ethnicity data was not available. We collected demographic information, cap dose, AE, and dose reductions during the treatment period. Dose intensity (DI) was calculated (Total administered cap dose during treatment period (mg)/Recommended cap dose (mg/m2) * BSA (m2)). ANOVA was used to determine difference between groups. Results: 202 patients were included: 134 (66.3%) White, 35 (17.3%) Asian, 22 (10.9%) African American/Black, and 11 (5.4%) other race. 10 (5%) identified as Hispanic ethnicity. Most common cancer types treated were 46 (22.8%) breast, 44 (21.8%) colon, and 39 (19.3%) rectal. Average DI by race/ethnicity is outlined in Table 1. There was no statistically significant difference in DI among patients of different racial groups (p = 0.232). AEs leading to dose reduction or cap discontinuation occurred in 93 (46%) of patients, the most common outlined in Table 1. Conclusions: We found no significant difference in cap DI or toxicity among patients of different racial groups. The study is limited by the small sample size and that it is retrospective. The patients presented are racially diverse but live in one geographic area, which could impact environmental factors such as dietary folate intake. Our findings suggest that there is no difference in tolerated DI among all patients. Clinicians should not empirically reduce the dose of cap based on race and should assess tolerance on an individual basis. [Table: see text]