bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prevalence of HPV infection in Chinese solid tumor patients.
Authors: Yang Cheng , Wang Yizhou , Liu Ming , Huang Tanxiao , Liao Wenting , Li Yingmei , Mu Tianhao , Chen Shifu 
Published: June 2022

e22519 Background: Human papillomavirus (HPV) is a family of small double-stranded DNA viruses. It is associated with a series of cancer types, such as cervical, oropharyngeal, anal, vulvar, vaginal, and penile cancers. In the world, nearly 70% of HPV-related cancer cases are HPV types 16 and 18. In this study, we investigated HPV infection prevalence among a cohort of Chinese solid tumor patients. Methods: The study enrolled thousands of Chinese patients with different types of cancers. We finally collected 4,606 tumor tissue DNA (ttDNA), 7,296 plasma cell-free DNA (cfDNA), and 7,509 peripheral blood mononuclear cell genomic DNA (gDNA) samples, respectively. Using a targeted capture technique that covering the whole reference genome of HPV16 and HPV18 and the next generation sequencing (NGS) technology, we calculated the percentage of HPV16 and HPV 18 reads in all sequencing reads for each sample. Finally, we explored the prevalence of HPV infection in each cancer type. Results: Based on different types of DNA samples, the HPV infection rate was 38.75%, 28.62%, and 10.43% in ttDNA, cfDNA, and gDNA samples, respectively. Besides, the magnitudes of the mean percentage of HPV reads in all the sequencing reads in ttDNA, cfDNA and gDNA samples were 10-5, 10-6 and 10-8, respectively, while in the HPV infection positive the percentages of ttDNA, cfDNA, and gDNA samples increased to 10-4, 10-5, and 10-7, respectively. The prevalence of HPV infection rate in different cancer types was shown in table. Conclusions: ttDNA and cfDNA are better material for HPV infective detection compared with gDNA, and NGS is capable of HPV detection.[Table: see text]
Ovarian cancer mortality: implications of income-inequality and availability of medical doctors in Brazil.
Authors: Maselli-Schoueri Jean Henri , Werneck De Carvalho Luis Eduardo , Paiva Laercio da Silva , de Almeida Roediger Manuela , de Abreu Luiz Carlos , Fonseca Fernando Luiz Affonso , Sette Claudia Vaz De Melo , Adami Fernando 
Published: June 2022

e22520 Background: Ovarian cancer mortality varies by region and age group in Brazil. However, it is still unknown if socioeconomic inequalities may affect its outcome even if indirectly as it happens for other gynecologic neoplasms in the country. Methods: Ecological study conducted with secondary data from 2016-2018 to examine the relationship between income-inequality and the amount of doctors per inhabitant on ovarian cancer mortality in Brazil. All data were gathered from Brazil’s public health system. Mortality was analyzed by sex and age, which was standardized according to the World Health Organization’s population. Income-Inequality was measured using the Gini index, obtained from the United Nations Development Programme. The number of doctors was obtained from the Unified Health System and was also calculated as the rate per 100,000 inhabitants. Linear regression was performed using stepwise selection/backward elimination. Results: Despite income inequality as measured by the Gini index not having any statistically significant relationship with ovarian cancer mortality rates, we found that the amount of doctors per inhabitant was positively associated with ovarian cancer mortality rates (β 0.037, IC95% 0.028;0.045), whereas the amount of clinical oncologists (β-0.426, IC95% -0.805; -0.047) and higher income (β -0.004, IC95% -0.005; -0.003) were all negatively associated with those rates (p < 0.05), meaning that the higher those variables, the lower the mortality. Conclusions: Ovarian cancer mortality differs among federative units in Brazil. Higher mortality is associated with a greater amount of doctors per inhabitant, whereas lower mortality rates were found to be associated with higher income and more clinical oncologists available.
Educational webcast series targeted to the interprofessional bladder cancer care team improves clinician knowledge, confidence, and competence.
Authors: Gitzinger Susan H. , Taylor Bryan Carson , Carranza Vanessa , Fowler Joan B. , Trieu Tina , Lilly Ashley 
Published: June 2022

e23002 Background: There are an estimated >81,000 new cases of metastatic urothelial bladder cancer (mUBC) diagnosed in the U.S each year, resulting in more than 17,000 deaths. mUBC has been shown to be susceptible to immune checkpoint inhibitors (ICIs), and beyond currently approved first and second line indications, these agents are being studied in bladder-sparing regimens and for high risk NMIBC patients who are BCG-unresponsive. Needs assessments demonstrate educational gaps involved in medication selection, dosing, and immune-related adverse event management as barriers to immunotherapy use by the interprofessional bladder cancer care team. The webcast series, “Key Issues for the Advanced Bladder Cancer Care Clinic: Incorporating Immunotherapy into your Community-Based Urology Practice” was designed specifically for the interprofessional team of bladder cancer clinicians to address unmet educational needs by focusing on the communities where the significant majority of patients are diagnosed, evaluated, and managed. Methods: Four online activities were designed to target urology and uro-oncology community physicians, physician assistants, nurse practitioners, nurses, and pharmacists focused on ICI therapies for bladder cancer, with a focus on the role of the team. Learning and confidence change were objectively assessed by analyzing pre- and post-test results before and after the educational activities. Statistical testing between pre- and post-tests were conducted via chi square analysis with a priori significance set at 0.05. Results: Evaluations were collected from N=706 participants. Knowledge advancements, as determined by significant ( P<0.05) increases in correct responses, were observed in several specific topic areas: recognition of ongoing clinical trials (29% pre-test vs. 69% post-test) biomarkers and treatment selection (43% pre-test vs. 81% post-test) logistical concerns for patients initiating ICIs (60% pre-test vs. 80% post-test) Participant self-reported mean confidence scores increased with statistical significance in implementation of appropriate immunotherapy and in recognizing and mitigating irAEs from pre- to post-test ( P<0.05). Conclusions: As the treatment paradigm for bladder cancer continuously evolves, all members of the oncology healthcare team must be equipped to evolve with it to ensure optimal patient care. This analysis shows that online accredited education can significantly improve the knowledge and confidence of the interprofessional bladder cancer care team in multiple areas surrounding the effective and appropriate use of ICIs.
Is a ‘cancer check-up’ near for high-risk adults? clinician attitudes and perspectives on multicancer early detection tests.
Authors: Ackbarali Tariqa , Marinac Catherine , Beer Tomasz M. 
Published: June 2022

e23008 Background: Current screening guidelines for many cancers are limited and multiple cancer-screening tests are not yet FDA approved. The development and potential use of a pan-tumor or multi-cancer early detection (MCED) test has been met with both enthusiasm and hesitation, despite its potential for early detection and a resultant reduction in cancer-related mortality and morbidity. The lack of knowledge of clinician perceptions of MCED test and the need to educate a multidisciplinary team prompted the design of educational initiatives in 2020 and 2021. Methods: In September 2020 and July 2021; two 1-hour CME activities were launched live-online on OMedLive.com; the 2021 activity remains on-demand until July 2022. The 2020 activity introduced the value proposition and trial designs of MCED tests and reviewed the current cancer screening guidelines. Challenges revealed from the 2020 activity informed the multidisciplinary approach of the 2021 activity presenting epidemiology, oncology, and primary care perspectives. In both activities, participants were assessed at 3 time points (pre-, immediate post-, and 2 mos. post-activity) and McNemar tests compared paired responses with Cohen’s d for effect size. Behavioral impact, perception, and practice pattern questions were also assessed immediately post-activity and year-to-year data analyzed. Results: As of 02/13/22, 1,015 clinicians have participated in the 2020 activity and 3,372 in the 2021 activity. Across the eight CME test questions, seven exhibited improvements in knowledge/competence related to screening modalities, trial data, value of MCED tests, and clinical workflow following results. In the analysis of perception and practice pattern questions, 50% of clinicians were likely to integrate MCED tests into their practice; however, expectation of high costs and access/availability to utilize MCED tests at their practice were the top barriers identified. A lack of consensus in identifying adults at higher risk of cancer was observed in 2020 with improvements seen in 2021. At 2-mos. follow-up for the 2020 and 2021 activity, respectively, clinicians reported practice behavior changes as 89% and 73% related to clinical practice, while 89% and 72% reported improved patient experience/outcomes. Qualitative data including clinician write-in examples of specific practice behavior changes will be analyzed. Conclusions: These data provide real-world insight into clinician perspectives on MCED tests and the clinical, patient-care, and workflow challenges that should be considered before incorporating future approaches on multi-cancer screening. As the primary care setting is most suited for the introduction of novel cancer-screening tools, PCPs and oncologists will require continued education to apply practical strategies for point-of-care decision-making and transitions of care protocols.
Surgical subtype and survival in stage I chondrosarcoma: A National Cancer Database (NCDB) analysis.
Authors: Burdyny Michael , Eaton Vincent , Tupper Connor , Legenza Ashton , Silberstein Peter T. 
Published: June 2022

e23502 Background: Chondrosarcoma is one of the most common primary malignancies of bone and commonly presents in adults in its early stages. Standard of care for chondrosarcoma is currently surgical intervention, with radiation therapy for cases where complete resection is not possible; chemotherapy is minimally effective. To the authors’ knowledge, there is little literature regarding different surgical subtypes for chondrosarcoma patients. To address this, the aim of our study is to assess survival outcomes in stage I chondrosarcoma patients based off of different surgical subtypes. Methods: Using the NCDB, patients diagnosed with stage I chondrosarcoma between 2004-2018 were identified using ICD-O-3 histology codes 9220 and 9221. The cohort was analyzed to determine if they received any form of surgical intervention and which surgical subtype they received. We then performed univariate analysis to assess patient length of survival for each surgical subtype. Data was analyzed using SPSS and statistical significance was set at α = 0.05. Results: A total of 5186 patients were included that had survival data, of which 4752 received surgical intervention. The mean survival time was 152.1 months for all patients. Surgical patients survived an average of 156.6 months while nonsurgical patients survived just 97.7 months (p < .0001). Analysis of surgical types revealed local destruction and local excision had the longest mean survival but were not different from each other (p > .05). Local excision had significantly longer survival than radical excision with limb sparing (p < .05). Local, partial, and radical excision all resulted in longer survival than limb and major amputations (all p < .01). Patients who underwent major amputation survived longer than limb amputation, but this difference was not significant (p > .05). Conclusions: This study found that receipt of surgery is associated with improved survival in chondrosarcoma patients. Receiving different surgical interventions may influence survival as patients receiving local excision survived longer than radical excision with limb sparing. Future studies should investigate additional variables that may influence receipt of surgery such as patient demographics, insurance status, and treatment facility type.[Table: see text]
Phase 2 trial of palbociclib and ganitumab in patients with relapsed Ewing sarcoma.
Authors: Shulman David Stephen , Merriam Priscilla , Choy Edwin , Guenther Lillian M. , Cavanaugh Kerri , Kao Pei-Chi , Posner Andrew , Fairchild Grace , Barker Emma , Stegmaier Kimberly , Crompton Brian D. , London Wendy B. , DuBois Steven G. 
Published: June 2022

e23507 Background: Ewing sarcoma (EwS) is an aggressive sarcoma with few treatment options for patients with relapsed disease. CDK4 is a known genomic vulnerability in EwS, but an unappealing monotherapy target given propensity for innate resistance. In laboratory studies to identify targets synergistic with CDK4 inhibition, IGF-1R scored highly. We present the results of a phase 2 study combining palbociclib (CDK4/6 inhibitor) with ganitumab (IGF-1R monoclonal antibody) for patients with relapsed or refractory EwS. Methods: This was a prospective open-label, non-randomized, single-center, phase 2 study (NCT04129151) for patients with relapsed EwS and RECIST measurable disease. Patients with relapsed EwS ≥12 years and a documented fusion consistent with EwS were eligible. Patients initially received Palbociclib 125 mg on days 1-21 and ganitumab 18 mg/kg on days 1 and 15 of a 28-day cycle. The primary endpoints were objective response (complete or partial) per RECIST and toxicity by CTCAE. Secondary endpoints included progression-free survival (PFS) and overall survival (OS). A one-stage design required ≥4 responders out of 15 to evaluate an alternative hypothesis of 40% response rate against a null of 10%. Results: Ten evaluable patients enrolled between 5/2019-8/2021. The study closed 12/2021 due to lack of ganitumab drug supply. The median age at enrollment was 25.7 years (range 12.3-40.1; Table). The median duration of therapy was 2.5 months (range = 0.9-10.8). There were no complete or partial responders. Three of 10 patients had stable disease for > 4 cycles and 2 had stable disease at completion of planned therapy or study closure. 6-month PFS was 30±14.5%. Two patients had cycle 1 hematologic DLTs triggering the pre-defined toxicity rule; the palbociclib dose was subsequently reduced to 100 mg daily for 21 days. Among the remaining 8 patients, two had cycle 1 hematologic DLTs at the 100 mg dose. 80% of patients had grade 3/4 AEs; the most commons AEs were neutropenia (n = 8), white blood cell decreased (n = 7), and thrombocytopenia (n = 5). Total IGF-1 testing demonstrated intrapatient elevations in serum levels after a single cycle of therapy. Analysis of serial ctDNA samples is ongoing. Conclusions: Four responders out of 15 were required to reject the null hypothesis of a 10% response rate. With 0/10 responders, we concluded that this combination lacked adequate therapeutic activity for further study. The combination was tolerable at a palbociclib dose of 100 mg, with primarily hematologic toxicity in patients with relapsed EwS. Clinical trial information: NCT04129151. [Table: see text]
Role of anlotinib in the treatment of early advanced osteosarcoma of limbs in children.
Authors: Li Zhifan , Wang Junlan , Wen Zhuoyu , Long Zuoyao , Pan Kaili , Wang Zhen 
Published: June 2022

e23509 Background: The prognosis of advanced or early advanced osteosarcoma during neoadjuvant chemotherapy is unfavorable. Many patients can only accept brutal amputation without a new and reliable limb rescue solution. There are no clinical data on the efficacy and safety of anlotinib in the treatment of osteosarcoma in children and adolescents. We investigate the efficacy of anotinib plus first-line chemotherapy (platinum + doxorubicin liposome/ifosfamide) in the treatment of early advanced osteosarcoma in children and adolescents. Methods: Early advanced osteosarcoma in this study was defined as pathologically identified osteosarcoma that progressed within 6 months after radical surgery, with neoadjuvant chemotherapy or adjuvant chemotherapy. 11 cases of limb osteosarcoma with Enneking stage IIB (8 cases in the lower femur and 3 cases in the upper tibia), aged 8-15 years, were selected from February 2018 to December 2021. After 1 cycle of first-line neoadjuvant chemotherapy, patients locally advanced received anlotinib (12mg/d) combined with first-line chemotherapy for 1-2 cycles. The tumor shrinkage rate, limb salvage rate, disease-free survival time (DFS), progression-free survival time (PFS), disease control rate (DCR), and safety were analyzed. Results: 9 patients had locally advanced during neoadjuvant chemotherapy. After 2 cycles of anlotinib combined with first-line chemotherapy, the tumor shrunked and was well demarcated from surrounding tissue. All patients underwent limb salvage surgery Postoperative chemotherapy lasted for 4-6 cycles, with a median DFS of 12 months. 2 patients who developed recurrence or metastasis after radical surgery continued to complete at least 8 cycles of standard first-line chemotherapy combined with anlotinib, PFS showed separately 6 months and 8 months. The tumor shrinkage rate was 54.55% and the DCR was 72.73%. The adverse reactions associated with anlotinib were epistaxis (8 cases, 72.72%) and oral ulcer (1 case, 9.09%), which were controlled immediately after withdrawal. Conclusions: Combination of anlotinib with first-line chemotherapy can shrink the tumor, improve limb salvage rate for children with early advanced osteosarcoma, and delay disease progression for children with recurrence and metastasis after radical surgery. The toxicity of anlotinib combined with first-line chemotherapy were tolerated which is expected to be a new approach for the treatment of early advanced osteosarcoma.
Surgical subtypes and survival in Ewing sarcoma: A National Cancer Database (NCDB) analysis.
Authors: Tupper Connor , Silberstein Peter T. , Eaton Vincent 
Published: June 2022

e23511 Background: Ewing sarcoma (EWS) is the one of the most common primary malignancies of bone, more commonly affecting the pediatric population Standard of care for EWS currently involves surgical intervention in combination with chemotherapy, in addition to the potential use of preoperative and/or postoperative radiation on a case by case basis. To date, there is not much in the literature reported regarding different surgical subtypes in these patients. Thus, this study aims to analyze survival outcomes amongst the different surgical subtypes in EWS patients. Methods: Using the NCDB, patients diagnosed with EWS between 2004-2018 were identified using ICD-O-3 histology code 9260. The cohort was analyzed to determine if they received any surgical intervention and, if so, which surgical subtype was used. Univariate analysis was then performed assessing patient length of survival for each surgical subtype. Data was analyzed using SPSS and statistical significance was set at α = 0.05. Results: A total of 2208 patients were included that had survival data and had received surgical intervention. The mean survival time of all patients was 118.1 months. Surgical patients survived an average of 137.2 months while nonsurgical patients survived 96.0 months on average (p < .00001). Analysis of surgical subtypes revealed significantly longer survival in patients who underwent radical excision with limb salvage compared to patients who underwent partial resection (p < .05). Patients who received a partial limb amputation survived significantly longer than patients who received a total limb amputation (p < .01). Patients who underwent local tumor excision or radial excision with limb salvage also survived significantly longer than patients with total limb amputation (p < .05 and p < .01, respectively). Conclusions: This study found that receipt of surgery is associated with longer survival in Ewing sarcoma patients. Further, different surgical interventions may influence survival in Ewing sarcoma as patients receiving radical excision with limb salvage fared better than partial resection and partial limb amputation better than total limb amputation. Future studies would benefit from investigating additional variables that may influence receipt of surgical interventions including patient demographics, socioeconomic status, and surgical center type.[Table: see text]
Clinicopathologic characteristics and patient outcomes of malignant phyllodes tumors: A multi-institution experience.
Authors: Al-Awadhi Aydah , Hussein Mawada , Al Qawasmeh Khaled H , Trad Diaeddine Ahmad , Ansari Jawaher , Anwar Emad , Bennini Nouri , Azribi Fathi 
Published: June 2022

e23528 Background: Phyllodes tumors (PT) are rare fibroepithelial neoplasm that start in the connective tissue of the breast. PTs are classified by their histologic features into benign, borderline, and malignant. Malignant PTs account for about 1 in 4 PTs and are most likely to come back after treatment and metastasize. This study was conducted to investigate the incidence, clinical presentation, pathological characteristics, treatment and outcome of malignant PTs in the Abu Dhabi Health Services Company (SEHA) institutions in the United Arab Emirates. This will provide a better insight on factors that influences outcome in these patients. Methods: We retrospectively analyzed data of malignant PT treated at Tawam Hospital, Sheikh Khalifa Medical City and Sheikh Shakbout Medical City between 2000 and 2020. Information was obtained from the SEHA Cancer Registry and analyzed using excel software. Results: A total of 36 patients with malignant PT were identified. All were females. The median age at diagnosis was 38 (17-60). Median BMI at diagnosis was 27 (21-47). Out of the 36 patients, 3 were diagnosed during pregnancy, 16 (44%) had a history of fibroadenoma and 8 had a family history of first degree relative with breast cancer. Initial symptom at presentation was breast mass in 30 patients and fungating breast mass in 6 patients. Out of the 26 patients, 4 (11%) had tumor < 5 cm, 10 (28%) had tumor ≥5 cm and < 10 cm, 22 (61%) had tumor ≥10 cm, 2 patients had heterogenous tumor with component of invasive ductal carcinoma, no patient had metastatic ipsilateral axillary adenopathy at diagnosis and 5 (14%) presented with de-novo metastatic disease (4 in the lung and 1 in the contralateral breast as the first metastatic site). Of the 31 patients with non-metastatic disease at presentation, 17 underwent mastectomy, 14 underwent lumpectomy, 14 had axillary lymph node dissection, 8 had no axillary surgery, 9 had sentinel lymph node biopsy, 16 had adjuvant radiation therapy and 2 had adjuvant chemotherapy. Of the 31 patients, 13 patients developed locoregional recurrence of which 9 had positive margin on initial surgery and 4 had negative closet margin of ≤1 cm, 7 patients developed metastatic disease of which lung and/or the chest are the main sites. Of the total population to date, 7 patients passed away from the disease. Conclusions: Malignant PT patients are a unique population with limited characterization to date. Our study demonstrates the clinical and pathological characteristics and the treatment pattern of these patients. Further analysis is underway to assess risks associated with surgical and survival outcome of this disease.