bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of genetic ancestry in endometrial cancers: Understanding disparities in black women.
Authors: Lee Michelle Jeung-Eun , Shah Manan , Kollepara Sri Lakshmi Sudha , Jain Sanjay R. 
Published: June 2022

e17631 Background: Endometrial cancer is the most common gynecological malignancy in the United States. Endometrial cancer disproportionately affects black women in terms of incidence and survival despite advancement in treatment, and preventive strategies. Identifying distinct tumor markers in patients with African ancestry will help distinguish biological determinants underlying the disparities in endometrial cancer. In this study, we investigated the genetic alterations in endometrial cancer in individuals of African (AFR) ancestry using The Cancer Genome Atlas (TCGA). Methods: The genomic and clinical data of TCGA PanCancer Atlas uterine corpus endometrial carcinoma (UCEC) were explored using CBioportal (http://www.cbioportal.org/). We utilized The Cancer Genome Ancestry Atlas (TCGAA) and LAMP for estimates of genetic ancestry and quantitative ancestral composition. This dataset contains 529 patients, including 357 self-reported whites and 107 blacks. For each case the proportion of European, West African, East Asian, Native American ancestry was estimated. The dominant ancestry was defined as ≥50% of admixture from one reference population. Differences in gene mutation frequency were analyzed based on AFR ancestry proportion. The Kaplan-Meier curves were generated, and Cox regression analyses were performed. Results: Global genetic ancestry analysis identified 115 AFR ancestry cases with mean ancestry of 80.4%. The dominant AFR ancestry subject matched the self-reported race with 94% accuracy. We identified 23 subjects with ≥90% AFR ancestry, 43 subjects with 80-90% AFR ancestry, 34 subjects with 70-80% AFR ancestry, and 15 subjects with 50-70% AFR ancestry. TP53 was the most frequently mutated gene in patients with AFR ancestry(49.5%). ≥90% AFR ancestry had the highest rate of TP53 mutations (52.2%) compared with 80-90% AFR ancestry (51.2%), 70-80% AFR ancestry (43.8%), and 50-70% AFR ancestry (41.7%). PTEN was less commonly mutated in patients with higher proportion of AFR ancestry (47.8% in ≥90% AFR ancestry, 39.0% in 80-90% AFR ancestry, 59.4% in 70-80% AFR ancestry, and 66.7% in 50-70% AFR ancestry). PIK3CA mutation frequency was almost identical in all AFR ancestry groups studied. No significant differences in overall survival was observed between AFR ancestry groups. Conclusions: We aimed to investigate the etiology of endometrial cancer disparities by analyzing the effect of ancestry on genetic alterations in endometrial cancer. This study demonstrated differences in the mutation frequency among patients with AFR ancestry. We have shown that TP53 mutations were seen more frequently in patients with higher AFR ancestry, which may confer a poorer prognosis. Nonetheless, to validate the findings of this study, future studies should be conducted with larger sample sizes and more diverse ancestral groups to explore how genetic ancestry impacts tumorigenesis and cancer progression.
Molecular aberrations in late-stage dedifferentiated/undifferentiated endometrial carcinoma: A review of current literature.
Authors: Landry Ian , Sumbly Vikram , Vest Mallorie , Reed Mary K Smith 
Published: June 2022

e17632 Background: Uterine cancer remains the fourth most common cancer diagnosed and seventh most common cause of cancer death in American women. Four molecular subtypes have been created to categorize and prognosticate endometrial carcinoma based on their molecular aberrations, but are often based on initial tumor presentation and are associated with high cost to the healthcare system. Methods: A comprehensive literature search was performed on PubMed, ClinicalTrials.gov, Embase, and WebofScience. Abstracts and publications from ASCO/ASH were also included. Results: 32 articles were included in our systematic review. A total of 388 women were analyzed in the main group analysis and nearly half of the patients were diagnosed as stage III or IV (n = 178, 46%). MSI was present in 66% of all tumors tested and PD-L1 was overexpressed in 78%. Eighty-four percent (84%) of the tumors were negative for ER, up to 44% had loss in SWI/SNF complex, and 64% lost expression of e-cadherin. Pax-8 and fascin proteins were over expressed in 29% and 88% of patients tested, respectively. In a sub-group analysis, evidence of progression and use of adjuvant radiotherapy were significantly associated with a later stage of diagnosis ( p = 0.052, 0.044). Conclusions: We found no statistically significant association between stage of diagnosis and unique mutation. Patients with evidence of progression or recurrence were found to have disease in atypical locations. Unique mutations which categorize patients at time of diagnosis may be different upon progression or recurrence of the tumor. While a novel classification system has been produced to assist with prognosis and treatment guidelines, these tests are not widely available in the community hospital setting.[Table: see text]
Neoadjuvent chemotherapy in rare sinonasal teratocarcinosarcoma: Long-term result from tertiary center.
Authors: Sharma Abhishek , Patil Vijay Maruti , Rai Rahul Kumar , Saha Saswata , Noronha Vanita , Menon Nandini Sharrel , Joshi Amit , Prabhash Kumar 
Published: June 2022

e18005 Background: Sinonasal teratocarcinosarcoma (SNTCS) is a rare and highly aggressive disease entity having poor outcomes with available treatment modalities. Surgery followed by radiation or radical chemoradiation are considered standard therapy. However, in very locally advanced diseases surgery or radiation is not feasible and such patients are subjected to palliative therapy and have dismal outcomes. Methods: We identified 21 patients with very locally advanced SNTCS in our prospectively maintained head and neck cancer database over the last 8 years. All patients were seen in a multidisciplinary clinic prior to the start of therapy and were deemed unfit for local therapy. They were planned for 2 – 3 cycles of Neoadjuvant chemotherapy (NACT). They were then assessed in the multidisciplinary clinic for local therapy. Depending upon the response and performance status further therapy was planned. SPSS version 20 was used for the analysis. Descriptive statistics were performed and the Kaplan Meier method was used to evaluate overall survival(OS) and progression-free survival(PFS). Results: Median age was 50 years (range 27-80 Years) with male to female ratio being 6:1. ECOG PS was 0 in 3(14%), PS 1 in 14(67%) and PS 2 in 2 (9%) patients. 14 (67%) patients had Kadish C and the rest (33%) had Kadish D stage at presentation. Cisplatin & Etoposide was the chemotherapy of choice for the majority of patients (14/21 patients, 67%) with Docetaxel – Cisplatin (5/21 patients,19%), and Ifosfamide – Adriamycin (2/21 patients, 9%) being the other regimens. After NACT 14/21(66%) patients underwent surgery,1/21(4%) underwent radical Chemoradiation,1/21(4%) for palliative radiation therapy and rest for best supportive care. R0 resection was achieved in 11 out of 14 (78.6%) patients. The median PFS of the study was 17.5 months (95% CI 8.2 – 26.7) and the median OS was 19 months (95% CI = 0 -47). Those who underwent surgery after NACT have achieved a median OS of 37.3 months(95% CI 0-77.7) in comparison to 6.3 months (95% CI 0.3 -12.2) for those without surgery (p value 0.02). Conclusions: NACT in very locally advanced SNTCS achieves resectability in ⅔ patients who were unresectable upfront and would have received palliative therapy. This is important as patients who undergo surgery have prolonged overall survival.
Long-term outcomes of a randomized controlled clinical trial comparing the efficacy of cabazitaxel versus docetaxel as second-line or above therapy in recurrent head and neck cancer.
Authors: Nawale Kavita Prakash , Patil Vijay Maruti , Noronha Vanita , Menon Nandini Sharrel , Dhumal Sachin Babanrao , Bhattacharjee Atanu , Prabhash Kumar 
Published: June 2022

e18008 Background: Long term outcomes (> 2 years or above) are rarely reported in studies with second line or beyond systemic therapies in head and neck squmouas cell carcinoma (HNSCC). Methods: Recurrent or relapsed adult HNSCC, with ECOG PS 0-2 who have been exposed to at least one line of chemotherapy were 1:1 randomized between Docetaxel (75 mg/m2) and Cabazitaxel (20 mg/m2). The chemotherapy was given till progression or development of intolerable side effects. The outcomes reported are long term overall survival(OS) and progression free survival (PFS) and factors impacting overall survival. Results: On the intention to treat analysis (n = 92), at the time of data censoring, 92 patients had died. The median overall survival was 112 days (95% CI 81 to 178 days) in the cabazitaxel arm versus 192 days (95% CI 153 to 259 days) in the Docetaxel arm (P = 0.048). In cabazitaxel arm, the one year OS was 6.5% (95% CI 1.6-16.06), 2 year OS was 2.17% (95% CI 0.17-9.95) and 3 years was 2.17% (95% CI 0.17-9.95). While the corresponding figures in the docetaxel arm were 21.7% (95% CI 11.23-34.46), 0% and 0%. The median progression-free survival was 21.0 days (95% CI 16.0-42.0 days) in the Cabazitaxel arm versus 57.5 days (95% CI 26.0-85.0 days) in the Docetaxel arm (P = 0.02). Among the tested factors age (p = 0.037) and site of primary(p = 0.023) had an impact on OS. Conclusions: In this phase 2 randomised study, cabazitaxel has inferior PFS and OS than docetaxel. Hence docetaxel remains the option of choice when cytotoxic chemotherapy needs to be used as second line or beyond setting in HNSCC. Clinical trial information: CTRI/2015/06/005848.
Real world data of neoadjuvant and adjuvant chemotherapy in head neck osteosarcoma: Experience from a tertiary care center in India.
Authors: Tongaonkar Arnav , Patil Vijay Maruti , Noronha Vanita , Menon Nandini Sharrel , Jogdhankar Shweta , Prabhash Kumar 
Published: June 2022

e18012 Background: The head and neck (HN) region is a rare sub-site of osteosarcoma(OGS), with less than 10% of all cases of osteosarcoma and < 1% of all the head and neck malignancies . The evidence pertaining to the treatment of OGS of the head & neck region is limited. The role of adjuvant chemotherapy is evolving and research in this field is limited by the rarity of this tumour. However, in multiple small series, adjuvant or neoadjuvant chemotherapy has been found to be beneficial in head and neck OGS. To this end, we have audited our practice of the last 10 years to see the pattern of care, outcomes and advancements in the chemotherapy of HN OGS. Methods: We maintain a record at our outpatient department of patients receiving neoadjuvant and adjuvant chemotherapy. We conducted a database search spanning the data from 2010 to 2020, using the keywords: osteosarcoma, osteogenic sarcoma, OGS and head neck region, maxilla, skull base. Any adult patients who received chemotherapy in the adjuvant or neoadjuvant setting were selected for this study. The baseline demographics, patterns of chemotherapy administration and outcomes were documented. We analysed the data using SPSS descriptive statistical analysis. Survival analysis for progression-free survival and overall survival was done using the Kaplan-Meyer method. Results: 30 patients of HN OGS were treated with neoadjuvant chemotherapy (NACT) or adjuvant chemotherapy (ACT) at our centre from 2010 to 2020. The median age was 25 years, with a male preponderance (n = 21, 70%). The sites of disease were maxilla- 15(50%), mandible- 11 (37%), alveolus- 2 (6.6 %), orbit- 1 (3.3%), masticator space - 1 (3.3%). Out of the study population, 18 patients (60%) received NACT, 17 patients (56%) received ACT, 5(16%) patients received both NACT and ACT. 23 patients (76.6 %) underwent surgical resection, with R0 resection achieved in 17 (56.6%) and R1 in 3 patients(10%). 16 patients (53.3%) received adjuvant radiotherapy. Median progression-free survival was 16.10 months (95% CI: 10.30-21.89). Median overall survival (OS) was 22.56 months (95%CI: 11.16-33.96). 2 years OS was 49.1% (standard error 9.6). Conclusions: The patterns of use of neoadjuatnt and adjuvant chemotherapy in HN OGS are variable. Overall, the outcomes of HN OGS remain unsatisfactory. Further efforts are warranted in this direction to standardise an algorithm for chemotherapy. Further intensification of therapy may be required to improve patient outcomes.
Mitoxantrone hydrochloride liposome injection in the treatment of recurrent/metastatic head and neck cancers: A multicenter, open-label, single-arm, phase Ⅰb study.
Authors: Yang Hang , Wang Xicheng , Zhang Hong , Peng Jiyong , Li Weidong , Liu Yanyan , Hu Jianbing , Zhou Hui , Zhang Bing , Liu Jixiang , Lin Shunhuan , Luo Hao , Hu Jie , Li Zhiming 
Published: June 2022

e18028 Background: Mitoxantrone is an anthraquinone antibiotic antitumor agent, and mitoxantrone hydrochloride liposomes have been approved for the treatment of relapsed or refractory peripheral T-cell lymphoma (PTCL) in China. The current study aimed to evaluate the safety and efficacy of mitoxantrone hydrochloride liposome in patients (pts) with recurrent/metastatic head and neck cancers. Methods: This study is a multicenter, open-label, single-arm, phase Ⅰb study. The pts with histologically confirmed diagnosis of head and neck squamous cell carcinoma (including nasopharyngeal carcinoma) were enrolled. Mitoxantrone hydrochloride liposome was administered at 20 mg/m2 by an intravenous infusion, every 21 days (q3w, 1 cycle) until disease progression, intolerable toxic reaction, death, or withdrawal by investigator or patient decision (a maximum of 8 cycles). The primary objective was to determine the safety of mitoxantrone hydrochloride liposome. Secondary objective was to assess the efficacy of mitoxantrone hydrochloride liposome in the treatment of recurrent/metastatic head and neck squamous cell carcinoma. Efficacy assessment was performed every 2 cycles after dosing as per RECIST v1.1. Results: From July 8, 2021 through November 5, 2021, 34 pts with median age of 48 years (range 20-69 years) were enrolled, including 23 with nasopharyngeal cancer and 11 with non-nasopharyngeal cancer (5 with tongue cancer, 2 with hypopharynx, 2 with tonsil cancer, and 1 each with larynx and gum cancer). The most common treatment-emergent adverse events (TEAEs) were white blood cell decreased (41.2%), anemia (41.2%) and lymphocyte count decreased (29.4%). TEAEs were generally Grade (G) 1-2; 13 pts reported G3 TEAE. The summary of all-grade TEAEs (≥ 10%) are shown in the table below. Nineteen pts had undergone at least 1 efficacy evaluation (including 18 pts with nasopharyngeal cancer and 1 with non-nasopharyngeal cancer). The overall objective response rate (ORR) was 42.1% (8/19) and disease control rate (DCR) was 78.9% (15/19). ORR for nasopharyngeal cancer was 38.9% (7/18) and DCR was 77.8% (14/18). One case of hypopharyngeal cancer was evaluated as partial remission (PR). Conclusions: The preliminary data of mitoxantrone hydrochloride liposome has showed manageable safety and evidence of efficacy in pts with recurrent/metastatic head and neck squamous cell carcinoma. An expanded sample size is still needed for further validation in the future study. Clinical trial information: NCT04902027. [Table: see text]
Survivorship profile and post-treatment quality of life of oral cancer survivors in comparison with caregivers: An analysis of a real-world cohort of a developing country.
Authors: Thaduri Abhinav , Malhotra Manu , Garg Pankaj Kumar , Singh Mahendra Pal , Poonia Dharma Ram , Sharma Pankaj , Gupta Ravi , Gupta Manoj kumar 
Published: June 2022

e18036 Background: Oral cavity cancer is the second most common cancer in India; India bears the most burden of oral cancer in the world. The most effective way to study the effectiveness of treatments is in clinical trials, but the quality of life (QOL) and post-treatment effects of those treatments are seldom studied in real-world settings. Methods: All oral cancer survivors treated with curative intent at our institute from September 2019 to January 2021, who were disease-free for a minimum of six months following treatment, were included in this study. The QOL of these cancer survivors was compared with that of their caregivers using the WHOQOL BREF questionnaire. The complete survivorship profile was evaluated using a Constant shoulder score for shoulder dysfunction, clinical oral dryness score (CODS) for xerostomia, Sydney Swallow Questionnaire (SSQ) for swallowing dysfunction, Patterson scale for lymphedema, Comprehensive Score for financial Toxicity (COST)‐Functional Assessment of Chronic Illness Therapy (FACIT) questionnaire for financial toxicity, Depression, Anxiety and Stress Scale - 21 Items (DASS-21) for psychological wellbeing. Results: A total of seventy-nine survivors were included. The median age was 49 years. Though both survivors and caregivers had similar QOL scores in the physical and environmental domains, survivors had poor scores in the social (M = 58.7,SD = 21.9) and psychological domains (M = 60.4,SD = 15.6). The T stage (p = 0.06), surgery (p = 0.008), and trismus (p = 0.03) were significant factors affecting swallowing. Those patients who had undergone selective neck dissection had better shoulder scores compared to those who had modified radical neck dissection (p = 0.006). 75% of people had xerostomia and 10.9% had severe xerostomia. Internal lymphedema was seen in 30.4% of people. Depression and anxiety were recorded in 46 (58.2%) and 33 (41.8%) patients respectively. Employment status (p = 0.04) and treatment modality (p = 0.05) were significant factors affecting financial toxicity. Conclusions: Oral cancer survivors had a poor psychosocial QOL compared to their caregivers. Treatment-related functional sequelae had a significant negative impact on quality of life across all domains. Clinical trial information: CTRI/2020/07/026848.
Annual household income and its association with financial toxicity, health utility, and survival in head and neck cancer.
Authors: Noel Christopher W , Hueniken Katrina , Forner David , Goldstein David Paul , de Almeida John R 
Published: June 2022

e18040 Background: While several studies have documented a link between socioeconomic status and survival in head and neck cancer, nearly all have used ecologic, community-based measures. Studies using more granular patient level data are lacking. We sought to determine the association between baseline annual household income with financial toxicity, health utility and survival. Methods: This was a prospective cohort of adult head and neck cancer patients treated at tertiary cancer center between September 17, 2015, and December 19, 2019. Our primary exposure was annual household income at time of diagnosis. Outcomes of interest included disease-free survival, financial toxicity, measured using the FIT tool, and health utility, measured using the Health Utilities Index Mark 3. Cox proportional hazards models were used to estimate the relationship between household income and survival. Income was regressed onto log-transformed FIT scores using linear models. The association between income and health utility was explored using generalized linear models. A generalized estimating equations approach was incorporated to account for patient level clustering. Results: There were 555 patients included in this cohort. Two-year disease-free survival was worse for patients in the bottom income quartile (< $30,000 - 67% [95%CI 58-78])) compared to the top quartile (≥$90,000 - 88% [95%CI 83-93]). In risk adjusted models, patients in the bottom income quartile had inferior disease-free survival (aHR 2.13 [95%CI 1.22-3.71]) but not overall survival (aHR 2.01 [95%CI 0.94-4.29]). The average FIT score was 22.6 in the lowest income quartile vs. 11.7 in the highest quartile. In adjusted analysis, low-income patients had 12-month FIT scores that were, on average, 134% higher (worse) [95%CI 16%-253%] than high-income patients. Similarly, health utility scores were, on average, 0.106 [95%CI 0.029-0.184] points lower for low-income patients. Conclusions: Head and neck cancer patients with a household income < $30,000 experienced worse financial toxicity, health status and disease-free survival. Significant disparities exist for Ontario’s head and neck cancer patients.
Establishment of 5-hydroxymethylcytosine expression model of circulating-free DNA gene in early diagnosis of nasopharyngeal carcinoma.
Authors: Chen Bijuan 
Published: June 2022

e18047 Background: Nasopharyngeal carcinoma (NPC) has no obvious symptoms in the early stage of onset, and more than 65% of patients have been diagnosed as intermediate and advanced stage. Studies have shown that early diagnosis and timely treatment of NPC play a key role in the survival of patients.5-hydroxymethylcytosine (5hmC) as an important epigenetic modification of DNA is closely related to gene regulation and NPC pathogenesis. Objective: To clarify the diagnostic value of 5hmC expression in circulating free DNA (cfDNA) gene for NPC. Methods:The expression of 5hmC in cfDNA of 166 NPC and 165 controls was detected with high-throughput technology, and the differentially expressed gene map of 5hmC was drawn. Based on the screened 5hmC Top50 differentially expressed genes, the NPC diagnosis model was established with 70% of the sample size as the training set and 30% as the verification set. The efficacy of 5hmC in distinguishing NPC from healthy controls was evaluated by drawing the receiver operating characteristic curve (ROC) and calculating the sensitivity, specificity, area under the curve (AUC) and accuracy rate (AR). Results: High throughput detection showed that there were significant differences in 5hmC expression of 194 genes between NPC and control cfDNA, of which 185 genes were up-regulated and 9 down regulated in NPC. The results of diagnostic test show that when the Youden index threshold of 0.4749 at the verification set is taken as the cut-off value, the sensitivity, specificity, AUC and AR of the training set are 0.7652, 0.7304, 0.8250 and 0.7478, while in the verification set, they are 0.6863, 0.7400, 0.7388 and 0.7129 respectively. Conclusions: Our findings suggest that cell-free 5hmC signatures are valuable as potential noninvasive diagnostic biomarkers of NPC, which can be transformed into clinical application by further optimizing the diagnostic model.