bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival and prognostic factors in oligometastatic breast cancer.
Authors: Van Ommen - Nijhof Annemiek , Steenbruggen Tessa Gerjanne , Capel Laura C. , Vergouwen Michel J.P. , Vrancken Peeters Marie-Jeanne T.F.D , Wiersma Terry G. , Sonke Gabe S. 
Published: June 2022

1089 Background: Clinical guidelines for the treatment of oligometastatic breast cancer (OMBC) propagate multimodality treatment including polychemotherapy and ablative local therapy for all detected disease. The aim of this aggressive approach is prolonged disease remission, or even cure, but randomized data to support this strategy lack and long-term outcomes are not well known. We report prognostic factors, and event-free survival (EFS) and overall survival (OS) in a real world, single center cohort of patients with OMBC with long-term follow-up. Methods: Patients with breast cancer and 1-3 distant metastatic lesions who underwent treatment in the Netherlands Cancer Institute were identified via text mining of medical files. We collected patient, tumor and treatment characteristics as well as recurrence and survival data from the medical records. The Kaplan-Meier method was used to calculate EFS and OS estimates, and Cox regression analyses to assess potential prognostic factors. Results: The cohort included 239 patients (of whom two males), diagnosed between 1997 and 2020. Median follow-up was 75.0 months. Fifty-one percent had hormone receptor (HR)-positive/ human epidermal growth factor receptor 2 (HER2)-negative disease, 20.1% had HER2-positive disease, and 19.2% had triple negative (TN) disease. Median age at OMBC diagnosis was 49.0 years and 47.3% of patients had synchronous disease (metastases ≤6 months of primary diagnosis). Most patients (81.2%) received chemotherapy and local therapy (surgery, radiotherapy and/or radiofrequency ablation) of all metastatic lesions (83.7%). Of 239 patients, 134 experienced disease recurrence with a median EFS of 40.0 months (95% confidence interval (CI): 28.6-51.4); 97/239 died and median OS was 93.0 months (95% CI 74.5-111.5). The table shows factors associated with favorable OS in multivariable analysis. Cox regression analysis for EFS showed similar results. Conclusions: In this large real world cohort of OMBC patients, EFS and OS compare favorably to survival in the general MBC population. HR-positive and/or HER2-positive subtypes, synchronous disease or long DFI, favorable response to first-line systemic therapy and local therapy of all distant lesions are independently associated with better survival. Future studies should be directed at optimizing patient selection and therapy choices in this population with the potential for cure. [Table: see text]
Quantitative proteomics landscape and association with BASP1 and breast cancer metastasis.
Authors: Kaur Jaspreet , Austdal Marie , Jung Sung Yun , Janssen Emiel , Søiland Håvard , Aneja Ritu 
Published: June 2022

1090 Background: Tumor recurrence and metastatic progression remain the leading cause for breast cancer related mortalities. The study aimed to identify differences in proteomics landscape in serum between (i) healthy controls and breast cancer patients, (ii) baseline samples at time of diagnosis from patients that later developed metastases versus those that did not and, (iii) baseline samples presented after completed treatment versus the samples collected before patients developed metastasis. Methods: We performed mass spectrometery-based proteome profiling of 100 serum samples from 51 breast cancer patients and 27 healthy donors. Of the 51-breast cancer patients, 29 patients did not metastasize, and 22 patients had a metastatic recurrence. Each of the 22 breast cancer patients with metastasis had 2 samples-one collected within a year of diagnosis and second one collected within a year before the patient developed metastases. Intensity-based absolute quantification (iBAQ) method was employed to convert recovered peptide information to quantificational gene protein product and then normalized to final quantificational value using an in-housed software. Protein values were normalized using z-score before differential expression analyses. FDR < 0.1 and a p-value < 0.05 was used as the cutoff to identify differentially expressed proteins. Results: We identified 1177 proteins in total from 100 serum samples of healthy women and breast cancer patients. PCA analysis revealed a complete separation of the breast cancer and healthy control samples. However, we found overlapping but distinct groups of metastatic and non-metastatic samples. We found 179 proteins to be differentially expressed between normal healthy control samples and baseline breast cancer samples irrespective of their metastatic status. Upon comparing baseline breast cancer samples that metastasized with breast cancer samples that did not metastasize, we found BASP1 as the top-ranked gene that was significantly upregulated in metastatic samples. We did not find any significant differences between paired baseline samples collected at diagnosis and pre-metastatic samples collected before the patient developed metastasis. Conclusions: Our results show distinct proteomic profiles exist between breast cancer and normal healthy control samples. Further studies are required to confirm if serum BASP1 can be used as a putative biomarker for predicting metastatic risk in breast cancer patients.
A phase IB/II study of nivolumab in combination with eribulin in HER2-negative metastatic breast cancer (KCSG BR18-16).
Authors: Kim Se Hyun , Suh Koung Jin , Im Seock-Ah , Lee Kyung-Hun , Kim Min Hwan , Sohn Joohyuk , Park Yeon Hee , Kim Ji-Yeon , Jeong Jae Ho , Lee Kyoung Eun , Choi In Sil , Park Kyong Hwa , Kim Hee Jun , Cho Eun Kyung , Park So Yeon , Kim Milim , Kim Jee Hyun 
Published: June 2022

1098 Background: Combining immune checkpoint inhibitors with chemotherapy has become a promising therapeutic strategy in metastatic breast cancer. Eribulin is a potent microtubule inhibitor and modulates the immune microenvironment of tumor cells. Therefore, combining eribulin to nivolumab may synergize antitumor efficacy in metastatic breast cancer. Methods: Adult patients with histologically confirmed recurrent/metastatic HER2- breast cancer were enrolled prospectively from 10 academic hospitals in Korea (ClinicalTrials.gov Identifier: NCT04061863). Key eligibility criteria included prior treatment with taxanes and/or anthracyclines, ≥1 measurable disease, and ≤2 prior cytotoxic chemotherapies in the metastatic setting. Patients received nivolumab 200 mg intravenously (IV) on day 1 plus eribulin 1.4 mg/m2 IV on day 1 and 8 of every 3 weeks until disease progression or intolerable toxicity. The dose level was determined from safety profile of three patients in run-in phase. The primary endpoint was investigator-assessed progression-free survival (PFS) rate at 6 months. Secondary endpoints included investigator-assessed objective response rate (ORR) per RECIST v1.1, disease control rate (DCR), overall survival (OS), and toxicity profile of the combination treatment. The association between PD-L1 expression by SP142 Ab and efficacy was analyzed. Results: From August 2019 to June 2021, 90 patients (HR+HER2- 45 pts/TNBC 45 pts), with a median age of 51 (range 31–71), were enrolled in the study. With a median study follow-up time of 16.3 months, 68 (75.6%) patients experienced progressive disease. PFS rate at 6-months was 49.6% and 24.1% in patients with HR+HER2- and TNBC group, respectively. Median PFS was 5.6 months (95% CI: 4.3-6.8) and 3.0 months (95% CI: 1.3-4.7) for HR+HER2- and TNBC group, respectively. ORRs were 53.3% (CR:0, PR: 24) for HR+HER2- and 21.8% (CR1, PR: 12) for TNBC. Patients with PD-L1+ tumors (PD-L1 expression ≥ 1% on TC or IC) had similar ORR compared to PD-L1- tumors (ORR 50% vs. 53.8% in HR+HER2-, 30.8% vs. 29.0% in TNBC). The most common grade 3/4 adverse event was neutropenia (15/90, 16.7%), and the most common immune-related adverse events were grade 1/2 hypothyroidism (19/90, 21.1%) and grade 1/2 pruritus (16/90, 17.8%). Five patients had discontinued study treatment due to immune-related adverse events (3 pneumonitis, 1 hepatitis, 1 skin rash). Conclusions: In this parallel phase II clinical trial, the addition of nivolumab to eribulin showed promising efficacy and tolerable safety profile in previously treated HER2- MBC. Further survival and exploratory analyses to find predictive markers will be followed. Clinical trial information: NCT04061863. [Table: see text]
The parent penalty: Parental leave and return to work in trainees and early-career faculty in oncology.
Authors: Malapati Sindhu Janarthanam , Singh Sunny R K , Idossa Dame , Jordan Bruno Ximena , Chino Fumiko , Patel Monica Arun , Wei Zihan , Duma Narjust 
Published: June 2022

11005 Background: Prime childbearing years occur during medical training and early career, leaving physicians with tough choices between family planning and career growth. Restrictive parental leave (PL) policies can affect physician well-being and limit decisions about reproduction. We evaluated Medical and Radiation Oncology trainees and early career faculty to assess policies and practices regarding PL and return to work. Methods: An anonymous 48 question cross-sectional survey developed by researchers with expertise in gender equity was distributed via email and social media channels between May and June 2021 to oncology trainees and physicians within 5 years of terminal training. Descriptive statistics were used to compare study groups. Results: 255 physicians completed the survey- 54% female, 65% Medical Oncology and 35% Radiation Oncology, 71% trainees and 29% early career faculty. 46% (117) had no formal PL policy during training. PL impacted selection of first job for 37% (94) participants. Of all responders, 114 used PL, either in early career (18%), as a trainee (69%) or both (13%). Duration of PL during training was ≤4 weeks in 37%, 4-6 weeks in 19%, 6-8 weeks in 12% and ≥8 weeks in 24%. 27% of those who took PL as a trainee had to extend training to allow for this. Only 27%(31) of those who took PL had resources available at workplace to assist with transitioning back to work, primarily from informal mentoring by faculty/colleagues (65%, 20). Other important findings are summarized in the Table. Conclusions: In this study evaluating parental leave in oncology trainees and early faculty, almost half of the participants had no formal parental leave policy during training and majority of those who took parental leave during training had parental leave only for 6 weeks or less. Most participants experienced a parental leave penalty: guilt when seeking help and feeling overwhelmed at return to work. Policies and practices around parental leave need to be restructured to meet the needs of the evolving oncology workforce. [Table: see text]
Burnout among early-career medical oncologists: A single-institution experience.
Authors: Singh Anmol , Xiao Lianchun , O'Brien Barbara Jane , Flowers Christopher , Bruera Eduardo , Morris Van K. , Shah Amishi Yogesh 
Published: June 2022

11015 Background: Burnout is a psychological syndrome defined by the Maslach Burnout Inventory (MBI) as emotional exhaustion, depersonalization, and a low sense of personal accomplishment. Risk of job-related burnout for early-career medical oncologists can significantly impact career longevity and health outcomes for providers and patients alike. Because little is known about burnout specific to early-career academic oncologists, we sought to characterize the prevalence of burnout and associated factors among Assistant Professors at MD Anderson Cancer Center (MDACC). Methods: For this IRB-approved retrospective study, an electronic survey was developed for Assistant Professors in medical oncology at MDACC. Participants were all involved directly in patient care with at least some clinical effort. Our survey included nine questions validated in the MBI addressing equally the 3 aforementioned domains of burnout. An additional 31 questions were formulated to assess personal and professional factors that may contribute to burnout at our institution (clinical workload, research expectations, communication, COVID, and home-life). Each question was scored on a scale of 1 to 5, with higher scores correlating to higher levels of burnout. Descriptive statistics were used to describe the prevalence of burnout, and logistic regression analyses were performed to identify characteristics associated with burnout. Results: Among 70 (of 86 total) Assistant Professors who responded, mean duration on faculty was 3.1 years (standard deviation +/-1.8). Mean clinical effort was 67% (range, 19-95). Gender identifications were 44% female, 54% male, and 2% non-binary. 54% of respondents reported symptoms of burnout already, including 21% endorsing severe burnout. Severe burnout was more common for solid tumor providers than liquid tumor providers (55% vs 13%, p =.03). Using the MBI, severe emotional exhaustion (25%) was more prevalent (p <.0001) than depersonalization (6%) or lack of personal accomplishment (17%). Sentiments of being “emotionally drained” (20%), fatigue to face another day on the job” (37%), and “becoming more callous” (30%) were especially concerning among early-career faculty. Emotional exhaustion was associated with a feeling of less autonomy over personal decision making (p =.03) and female gender (p =.04). Conclusions: Burnout exists with high prevalence among early-career medical oncologists in this single-institution analysis. Emotional exhaustion was the specific manifestation of burnout in this population. Further validation of these data nationwide is anticipated. Interventions focusing on reducing emotional exhaustion are under development to reduce medical oncology-specific burnout in an academic setting for faculty retention and for deliverance of optimal care to patients with cancer.
Medical student readiness to treat LGBTQ patients.
Authors: Schabath Matthew B. , Karpel Hannah C , Sampson Amani , Charifson Mia , Fein Lydia , Murphy Devin , Sutter Megan , Tamargo Christina , Quinn Gwendolyn 
Published: June 2022

11030 Background: The lesbian, gay, bisexual, transgender and queer (LGBTQ) community experiences cancer health disparities. It is thus imperative that medical trainees receive training in the care of LGBTQ populations. Identifying gaps in trainees’ knowledge and comfort in providing care for this population is important in preparing future physicians. Methods: A Likert-scale survey of US medical students at three institutions assessed attitudes, comfort and knowledge in providing care for LGBTQ patients. Results were quantified with descriptive and stratified analyses. Exploratory factor analysis found four factors in which attitude summary measure (ASM) scores were calculated; lower values indicate more agreeability with given attitude items. Total knowledge scores were calculated with higher values indicating greater knowledge. Results: Of 300 medical students who completed the survey, the majority were female (55.7%), white (54.7%), and heterosexual (64.3%). The majority of students felt comfortable (strongly agree/agree) participating in the care of patients who identify as lesbian (94.3%), gay (96.0%), and bisexual (96.3%); this percentage dropped to 82.3% for non-binary and 71.3% for transgender patients. Only 27.0% of students reported confidence in their knowledge of health needs of transgender patients. LGBTQ self-identification, percent of core rotations completed, and having LGBTQ friends/family were significantly associated with various ASM subscales (Table 1). Knowledge questions had high percentages of “neutral” responses, and students who identified as LGBTQ had significantly higher total knowledge scores. Conclusions: Overall, medical students feel comfortable and willing to provide care for LGBTQ patients. However, as in our prior study in oncologists, there is limited knowledge about specific LGBTQ health and cancer needs. More education and training in the needs of transgender and non-binary patients is indicated. [Table: see text]
A longitudinal study assessing the impact of ongoing COVID-19 pandemic among hematology-oncology trainees.
Authors: Shikdar Sufana , Saleem Rabia , Alcid Joel , Mukherjee Sarbajit , Hassan Ayesha , Keshava Vinay E. , Razaq Humza , Aljumaily Raid 
Published: June 2022

11033 Background: Hematology-Oncology (HO) trainees faced significant challenges due to the COVID-19 pandemic highlighted by a previous survey (Durani, Urshila, et al. "Impact of COVID-19 on Hematology-Oncology Trainees: A Quantitative and Qualitative Assessment." JCO Oncology Practice (2021): OP-21). Despite the positive impact of effective vaccines, the pandemic is still ongoing; thus, the challenges remain. Our aim is to evaluate how well the trainees have adapted to changes in their clinical training environment after the early phase of the COVID-19 pandemic. Methods: A cross-sectional internet-based survey (Shih, Grace, et al. "The impact of the COVID‐19 pandemic on the education and wellness of US Pediatric Anesthesiology Fellows." Pediatric Anesthesia 31.3 (2021): 268-274) from December 10, 2021, to January 10, 2022, was obtained from the trainees enrolled in Accreditation Council for Graduate Medical Education (ACGME)-accredited HO fellowship programs in the United States in their fourth (PGY4), fifth (PGY5), and sixth (PGY6) postgraduate year. Results: The survey was completed by 102 trainees. Demographics of the participants are reported in Table. Interestingly, 51% reported an impact of COVD-19 on their employment plans, primarily due to the inability to interview in person (24%, n=23). Trainees experienced several stressors due to the pandemic, including fear of getting sick from a patient (71%) or a coworker (66%). Approximately 27% (n=26) experienced mental health issues requiring additional care. Less than one-third of the trainees were concerned about clinical expertise and procedural skills. Trainees also felt that the change of conference to virtual format impacted their learning activities compared to in-person education (66%, n=64). Most trainees (52%, n=53) reported limited involvement in COVID-related research and journal club education. Most had access to socialization (59%, n=60), virtual office hours (70%, n=72), and telehealth visits (83%, n=85). Female trainees (18%) were more likely to seek mental health care than the male trainees (7.8%) (P=.02). Female trainees (33%) also reported facing more challenges in their employment plans compared to males (16%) (P=.003). Conclusions: Our study highlights the challenges experienced by hematology-oncology trainees with the ongoing COVID-19 pandemic and reveals the gender gap related to employment plans and seeking mental health care. [Table: see text]
Gender disparity in authorship of clinical trials leading to cancer drug approvals between 2008 and 2018: The glass ceiling of academic oncology.
Authors: Chapman Lynne O. , Loree Jonathan M. , Anand Seerat , Mendis Shehara Ramyalini , McNeill Lorna H , Raghav Kanwal Pratap Singh , Varadhachary Gauri Rajani 
Published: June 2022

11048 Background: Authorship, expressly premier positions (first, corresponding, or senior author), in peer reviewed journals is widely acknowledged as scientific credit in academia. Yet, gender inequities and biases pervade this facet of the scientific ecosystem. We reviewed the authorship of pivotal FDA trials that established the standards of care in oncology over the past decade with the goal of defining the magnitude of gender disparity in the most influential literature of the field in recent years. Methods: We collected and assessed data from the primary publication of 231 trials that enabled FDA drug approvals in hematology and oncology from July 2008 to June 2018. Author gender was assigned from listed names using statistical probability and confirmed using institutional websites and online databases (genderchecker database, biographical paragraphs, and social media). Authors where gender was not clearly identified (1.23%) were excluded. To account for equal authorship contribution, we included co-authors as distinct data points, and credit was given to reports for any women in premier authorship positions (first, corresponding, or senior author) to avoid overestimating disparity. Descriptive statistics were used, and 95% confidence intervals (95%CI) were reported using modified Wald method. Proportions were compared using Fisher-exact and Chi-squared test. Unadjusted P values of < 0.05 were considered significant. Results: A total of 4664 (98.8%) authors were included in this analysis across 227 publications. Of these, 1287 (27.6%) were female with a median of 25.9% female authorship in total per trial. Female authorship was significantly higher for non-randomized (30.4% v 26.5% for randomized, P = 0.007) and phase 1/2 trials (29.9% v 26.3% for phase 3, P = 0.009) and varied with trial size (P < 0.001), with the proportion greater in trials with ≤100 patients versus those with > 500 patients. Female authorship in fields of breast and gynecological oncology was higher (41.3%) than other cancers (26.0%, P < 0.001). Women were proportionally less likely to hold premier (9.2% v 18.2%, OR 0.46, 95%CI: 0.4 – 0.6, P < 0.001), first (3.2% v 6.3%, OR 0.49, 95%CI: 0.3 – 0.7, P < 0.001), senior (3.3% v 6.0%, OR 0.54, 95%CI: 0.4 – 0.8, P = 0.002) and corresponding (2.5% v 5.8%, OR 0.42, 95%CI 0.3 – 0.6, P < 0.001) authorship but not second author role (4.1% v 5.1%, OR 0.80, 95%CI 0.6 – 1.1, P = 0.17). Conclusions: The under-representation of women in premier authorship positions in pivotal clinical trials, demonstrated in our study, serves as a barometer of a biased academic infrastructure, amplifying existing calls to address barriers that limit the full inclusion of women in oncology.