bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coupling gamified continuing education with confidence-based assessment to address knowledge gaps and assess attitudes towards liquid biopsy for cancer screening among primary care providers.
Authors: Scavone Jillian L , Robinson Katie , Scully Emily , Cooper Simon , Esgro Robert A. , Klein Eric A. 
Published: June 2022

11012 Background: Blood-based liquid biopsy assays offer a simplified approach to detect cancer early, guide clinical decision making, and predict treatment success. Given their novelty, primary care providers need education to improve knowledge and confidence regarding their use. The use of gamification in continuing medical education (CME) has been shown to increase engagement and knowledge transfer, and confidence-based learning can improve the educational experience by identified areas in which learners lack comfort. Methods: We provided a gamified CME activity based on the principles of confidence-based learning designed to educate primary care providers (PCPs) on the latest advances regarding the use of liquid biopsy for cancer screening. The game coupled knowledge questions with self-assessment of confidence to gage awareness of these topics. Pre- and post-test was used to quantify the impact of the education. The CE activity was available for credit from March 31, 2021 to March 31, 2022. Results: As of January 2022, 389 PCPs have participated. Overall, participants scored an average 76% on gaming questions related to the rationale behind the use of cell free DNA (cfDNA) for cancer screening and the benefits of liquid biopsy over tissue biopsy, demonstrating relatively high baseline knowledge on these topics. Self-reported confidence among those who answered correctly, however, was only 3.4 out of 5.0, suggesting a lack of comfort with the concepts despite answering correctly. On topics related to specific studies that demonstrated the clinical utility of liquid biopsy, participants scored only 59% and confidence scored averaged 3.17 out of 5.0, demonstrating a lack of knowledge and comfort on these topics. Across all topics, providers scored a 61% on a pre-test. Post-learning, providers scored 89%, highlighting the impact of the education on knowledge gaps. Moreover, while 52% of participants had never ordered a liquid biopsy for cancer screening prior to the education, 69% report being likely or extremely likely to do so because of the education provided. Conclusions: Integration of gamified and confidence-based learning into CE activities is an impactful way to identify and address knowledge gaps while also informing the need for future education. In this study, while self-report of confidence generally correlated with knowledge scores, confidence scores were only average even among those who answered correctly, demonstrating the need for skills-based learning that may improve comfort with liquid biopsy in the clinical setting.
ASCO oral presenters five years later: Leaks in the pipeline?
Authors: Kwong Forrest , Lerner Kimberly , Tao Derrick L. , Patel Sarah , Prasad Vinay 
Published: June 2022

11019 Background: There is growing awareness of the challenges of retaining oncologists engaged in research, and this leaky academic pipeline is most notable for women in medicine. Studying academic oncologists is challenging due to their many affiliations, but with an estimated attendance of over 30,000 oncologists, the ASCO annual meeting is a highly sought-after stage for presenting new research. To better understand the continued research engagement of oncologists active in research, we used public data from ASCO annual meetings to follow a cohort of oral abstract presenters over 5 years. Methods: To define our initial cohort of oncologists engaged in research, we used the 2016 ASCO Annual Meeting Digital Program to identify first author oral abstract presenters. We tracked if each presenter was subsequently listed as an author of any research type (oral abstract session, poster session, education session, etc.) at the 2017, 2018, 2019, 2020 and 2021 ASCO conferences. We then filtered out researchers who were not listed as authors at ASCO in consecutive years to look at only those researchers who continued to have active ASCO involvement. To evaluate by gender, each presenter’s name was referenced with the publicly available Wiki-Gendersort tool for an unbiased assignment. Results: 209 first author oral abstract presenters were identified at the 2016 ASCO conference. We found that 67.9% of the initial 209 researchers were listed as authors at ASCO in 2017, 55.5% continued to be authors in 2018, 46.9% in 2019, 42.6% in 2020, and only 38.3% were still listed as authors 5 years later in 2021. When looking at sustained first authorship, 8.1% of the initial 209 research cohort continued to be listed as first authors for 5 consecutive years through 2021. We also looked at the breakdown of other types of ASCO presentations and found that 122 of the initial 209 research cohort presented posters in 2016. Of these 122 researchers, 60 (49.2%) remained authors of posters throughout the consecutive 5 years. This is significantly higher than the number of researchers who continued to author oral abstracts in 2021 49.2% vs. 3.8% (P < 0.0001). When evaluating the differences between gender, there were approximately twice as many men presenters as women (122 men vs 65 women; 22 names were unisex or unknown). The rate of retention was similar for men (47 of the initial 122 males, 38.5%) and women (25 of the initial 65 females, 38.5%) at 5 years (P = 1). Conclusions: We conducted a descriptive study evaluating the rate of sustained activity in academic oncology over 5 years. Our research suggests that about one-third of ASCO presenters will continue to have sustained yearly authorship at 5 years post-oral abstract presentation. Compared to men, the leaky academic pipeline is comparable for women in the 5 years following an oral abstract presentation at ASCO.
Evaluating the quality of clinical evidence in gastrointestinal cancers PubMed searches: How relevant are the results?
Authors: Riano Ivy , Pomares-Millan Hugo , Hammill Chet W. , Trikalinos Nikolaos 
Published: June 2022

11037 Background: Bibliographic repositories have become increasingly important as clinical evidence is more accessible on the internet. Often, oncologists rely on published literature to guide patient care. However, with the proliferation of journals and increasing number of peer reviewed papers, current search strategies have the potential to retrieve large numbers of irrelevant or misleading articles. Moreover, access to current best evidence may require paid subscriptions. Here, we assessed the quality of retrieved medical literature pertaining to treatment of gastrointestinal cancers using the PubMed database. Methods: We interrogated 6 focused-therapy questions in 3 categories: medical oncology (MedOnc), surgical oncology (SurgOnc), and alternative medicine (AltMed). We extracted journal metrics of the first two pages (40 results) from each search. We defined the composite outcome “relevant result” as the product of removing results from 1) predatory journals (Beall’s list), 2) non-English language, and 3) no free access publications. As a sensitivity analysis, we defined 2007 as a cutoff for “relevant” publications and Impact Factor (IF) > 3 or H-index > 50. Results: Two hundred and forty results were retrieved (80 per search type). Forty-eight percent of the journals were European (n = 115), 40% US-based (n = 96), and 94% were in English (n = 225). Most journals (n = 170; 70.8%) had an IF between 1-10, followed by ̃21% with an IF > 10 (n = 51); yet ̃45% (n = 107) were in the Clarivate Analytics top quartile. Sixty percent (n = 139) of articles were free to access. The articles had a median H-index of 117 [IR 59, 168]. When modelling the multivariate association with “relevant result”, year of publication after 2007 had an OR = 1.07 (95% CI = 1.01-1.14; p< 0.02) and availability through GOLD Open Access by Clarivate Analytics had an OR = 1.09 (95% CI = 1.03-1.15; p< 0.0008). MedOnc retrieved more papers published in journals with IF > 10 (n = 31; 38.8%) than SurgOnc searches (n = 12; 15%; p< 0.001). Only the AltMed searches included non-peer reviewed publications (n = 4; 5%) and 4 results were from “predatory journals”, all in MedOnc. Conclusions: Articles had a 7% higher chance of being considered a “relevant result” if they were published after 2007 and a 9% higher chance if available under GOLD Open Access. Publications identified as “relevant results” with an IF or H-index above the established cutoffs, had a 6% higher chance to be in the top 40 PubMed search results. In the sensitivity analysis the results remain virtually unchanged. Importantly, nearly 40% of papers indexed in PubMed do not have free full-text articles, making them unavailable to oncologists without access to a medical library or paid subscription. These results highlight the imperative to deliver relevant, freely accessible information that can impact the care of the cancer patients.
Characterizing online engagement and academic impact of oncology research during the COVID-19 pandemic.
Authors: Muthiah Chandrasekar , Muthiah Arun , Wei Chapman , Khan Hina 
Published: June 2022

11043 Background: There is increasing use of social media as a platform to discuss research and educate. An article’s impact can be assessed through the Altmetric Attention score (AAS), which considers the volume of social media mentions (Twitter, Facebook, Wikipedia, policy, etc), and the PlumX Impact score, which incorporates interactions on these platforms and citations. COVID-19 has encouraged novel literature in oncology, and these metrics may holistically evaluate the immediate impact of articles in addition to gradual accrual of citations. We explored the relationship between traditionally used bibliometrics (citations, impact factor) and new bibliometrics (AAS, PlumX) of the top 100 trending articles on cancer and COVID-19. Methods: The 100 articles with highest AAS featuring keywords “cancer” and “COVID-19” between March 1, 2019 and January 15, 2022 were identified via Altmetric explorer. AAS, journal, social media mentions, open access status and other characteristics were collected. Scopus database was utilized to identify PlumX scores and citation count. Analysis included Spearman correlation coefficients and ANOVA. Results: Of the 100 articles, 64% were original investigations, 18% editorials/perspectives, 6% guidelines/consensus articles and remaining article types < 6% each. Original investigations comprised of 41% retrospective cohort, 33% cross-sectional, 20% prospective cohort, and remainder < 4% each. Most articles were open access (91%), from cancer-focused journals (77%), and based in North America (36%); 25% were in Europe, 24% multi-continental, and remainder < 8% each. Most publications were in 2020 (56%) and 2021 (40%). AAS and PlumX did not correlate with number of citations or impact factor. Open access publications were associated with greater PlumX (p = 0.033) compared to closed access; this was not seen with AAS. ANOVA showed greater AAS in Australian articles (p =.004) and greater PlumX in North American articles (p =.04). Article type or publication year did not impact AAS and PlumX. Conclusions: In our analysis, Altmetrics and PlumX did not correlate to traditional bibliometrics (citation count, impact factor) in cancer and COVID-19 articles. This suggests that these tools may be complimentary rather than predictive of citations. However, this may change given likely insufficient time for citations to accrue for 2021 studies. There were more editorials/perspective articles compared to similar studies in other specialties, suggesting greater impact of such articles in oncology during COVID-19; this is perhaps due to reliance on expert opinion given paucity of data. Additionally, we noted that PlumX benefits from open access status. Overall, as the use of social media for research dissemination grows, researchers and journal editors may employ alternative metrics to better understand ways to increase the influence of oncology literature during the pandemic.
Recent trends of “manels” and gender representation among panelists at the ASCO annual meeting.
Authors: Kamran Sophia C. , Yeap Beow Y. , Ghosh Anushka , Aldrighetti Christopher , Willers Henning , Vapiwala Neha 
Published: June 2022

11053 Background: Gender disparities in academic medicine are a long-acknowledged concern. Efforts to recognize this imbalance and increase inclusivity continue, particularly in academic medical conferences. In June 2019, NIH Director Francis S. Collins MD, PhD publicly called for an end to all-male speaking panels (“manels”). It is unclear whether academic oncology conferences followed suit. We investigated the prevalence and longitudinal trends of manels and gender representation at the ASCO Annual Meeting during 2018-2021. Methods: Using ASCO online programs, 2018-2021 faculty information was obtained. Data collected included perceived or self-reported gender, medical specialty, panel role (chair vs. non-chair), type of session, and topic. Primary outcomes included percentage of manels and proportion of female panelists over time. Female representation among chairs, specialties, and topics were evaluated. Cochran-Armitage test was used to analyze time trends in the proportion of manels and female representation. Fisher’s exact test was used to compare each session type, topic, or specialty to other categories combined. P-values are based on a two-sided hypothesis. Results: During 2018-2021, there were 670 sessions total, 81 of which (12.1%) were manels. Among 2,475 faculty members, 1,181 (47.7%) were females. Over time, there was a significant decrease in the number of manels, from 17.4% in 2018 to 9.9% in 2021 (p = 0.030) and a corresponding increase in proportion of female panelists from 41.6% to 54.0% (p < 0.001). The largest decrease in manels occurred between 2018 (17.4%) and 2019 (10.5%). Among session type and topic, the highest proportion of manels was observed for leadership/special sessions (17.1%, p = 0.419) and translational/pre-clinical topics (19.6%, p = 0.024), respectively. The chair role was majority male (53.2%) in 2018 but increased to > 50% female representation in 2019-2021 (p = 0.157). The lowest proportion of female panelists were in pathology/radiology/dermatology specialties (combined 26.2%, p = 0.001). Female panelists were underrepresented for the topics of genitourinary cancers (38.6%, p = 0.029) and translational/pre-clinical sciences (36.7%, p < 0.001). Females were overrepresented in the topic of supportive oncology (70.3%, p < 0.001). There was a positive trend toward improved female representation among translational/pre-clinical sciences (27.4% in 2018 to 41.8% in 2021, p = 0.031), but with little improvement among genitourinary cancers (41.1% in 2018 to 40.7% in 2021, p = 0.969). Conclusions: The number of female ASCO panelists increased during the study period and surpassed 50% in 2021, with a corresponding decrease in the proportion of manels. Still, there are certain topics/specialties where female representation has remained stagnant. ASCO Annual Meeting organizers should continue to strive for diverse gender representation and the elimination of manels.
Optimal timing and interval of imaging for metastatic breast cancer.
Authors: Patel Shruti Rajesh , Itakura Haruka , Sledge George W. 
Published: June 2022

1106 Background: Breast cancer is a family of diseases with varying disease trajectories based on intrinsic biology of the tumor. The time of progression varies across & within subtypes, and with increasing rates of drug resistance depending on prior therapeutic exposure. There is no strong consensus about optimal surveillance and routine imaging in patients with metastatic breast cancer (mBC), but many oncologists report that monitoring strategies are based on strategies used in clinical trials. Methods: We reviewed 17 prior Phase III studies that led to FDA approval in mBC. We reviewed 8 studies for ER+ mBC, 5 studies for HER2+ mBC, 2 studies for triple negative (TNBC) mBC, and 2 studies for BRCA+ mBC. We calculated rates of progression or death (POD) per month for the first year on therapy using data from survival analysis tables and compared them across the different types and lines of therapy. Results: Risk of progression in mBC varies based on receptor status and line of therapy (Table). There was a significant difference in POD rates between ER+ therapies compared with all other disease types (HER2+, TNBC, BRCA) (p = 0.012). Patients with TNBC or receiving PARP inhibitors or later line HER2 therapies had higher POD rates than those with ER+ breast cancer or receiving first line HER2 therapy (6.9% vs 4.1% per month; p = 0.0004). No significant difference was seen in the monitoring frequency between ER+ and HER2+ disease (p = 0.39). Conclusions: These data suggest that shorter interval imaging should be performed for patients with TNBC or receiving PARP inhibitors or later line HER2 therapies. Surveillance imaging for patients with mBC should be based on disease biology, number of prior regimens, time since initiation of therapy, and regimen efficacy. Current imaging recommendations are not data-based and do not adjust for new agents that have been approved. Oncologists should integrate these into individualized estimates to determine optimum frequency of imaging in clinical practice and research. [Table: see text]
Outcomes following preoperative chemoradiation +/- pazopanib in non-rhabdomyosarcoma soft tissue sarcoma (NRSTS): A report from Children's Oncology Group (COG) and NRG Oncology.
Authors: Weiss Aaron R. , Chen Yen-Lin , Scharschmidt Thomas , Xue Wei , Gao Zhengya , Black Jennifer O. , Fanburg-Smith Julie , Zambrano Eduardo , Choy Edwin , Davis Jessica L. , Kayton Mark , Million Lynn , Okuno Scott H. , Ostrenga Andrew , Randall R. Lor , Terezakis Stephanie , Venkatramani Rajkumar , Wang Dian , Hawkins Douglas S. , Spunt Sheri L. 
Published: June 2022

11504 Background: Pazopanib is a multi-targeted tyrosine kinase inhibitor (TKI) with activity in advanced soft tissue sarcoma. ARST1321 was a phase II study designed to compare the near complete pathologic response rate (≥ 90% necrosis) following preoperative chemoradiation +/- pazopanib in children and adults with intermediate/high risk chemotherapy-sensitive body wall/extremity NRSTS. Enrollment was stopped early following a predetermined interim analysis that found the rate of near complete pathologic response to be significantly greater with the addition of pazopanib. As a planned secondary analysis of the study, we now report the outcome data for this cohort. Methods: ARST1321 was a jointly designed COG and NRG Oncology study open to enrollment July 2014-October 2018. Eligible adult (≥18 years) and pediatric (< 18 years) patients with newly-diagnosed unresected body wall/extremity NRSTS were enrolled into the Chemotherapy Cohort (> 5 cm, FNCLCC grade 2/3, protocol-designated chemotherapy-sensitive histology). Following a dose-finding phase, patients were randomized to receive (Regimen A) or not receive (Regimen B) pazopanib (< 18 years: 350 mg/m2/day; ≥ 18 years: 600 mg/day) in combination with ifosfamide (7.5 gm/m2/cycle) and doxorubicin (75 mg/m2/cycle) + 45 Gy preoperative RT followed by primary resection at week 13, then further chemotherapy to week 25. Results: Eighty-five eligible patients were enrolled in the Chemotherapy Cohort and randomized to receive or not receive pazopanib. Median age 22.1 years (range: 5.7-64.2 years); 30 patients < 18 years. Most common histologies were synovial sarcoma (n = 42) and undifferentiated pleomorphic sarcoma (n = 19). As of December 31, 2021, at a median survivor follow-up of 3.3 years (range: 0.1 – 5.8 years), the 3-year event-free survival (EFS) for all patients in the intent-to-treat analysis was 52.5% (95% CI: 34.8%-70.2%) for Regimen A and 50.6% (32%-69.2%) for Regimen B (p = 0.8677); 3-year overall survival (OS) was 75.7% (59.7%-91.7%) for Regimen A and 65.4% (48.1%-82.7%) for Regimen B (p = 0.1919). Conclusions: Although the rate of near complete pathologic response was significantly greater with the addition of pazopanib to preoperative chemoradiation in children and adults with intermediate/high risk body wall/extremity NRSTS, outcomes were not statistically significantly different between the two regimens. Pathologic response could be a TKI-related phenomenon and may not be a good surrogate marker of outcome in future studies. Clinical trial information: NCT02180867.
A phase 1b study of unesbulin (PTC596) plus dacarbazine for the treatment of patients with locally recurrent, unresectable, or metastatic relapsed/refractory leiomyosarcoma.
Authors: Van Tine Brian Andrew , Ingham Matthew , Attia Steven , Meyer Christian Frederick , Baird John , D'Silva Dhiren , O'Keefe Kylie , Maliakal Pius , Wahba Mona M. , Weetall Marla , Schwartz Gary K. 
Published: June 2022

11507 Background: Leiomyosarcoma (LMS) is one of the most common subtypes of soft tissue sarcoma and is associated with high risk of relapse and a poor prognosis for advanced disease. In preclinical LMS models, unesbulin, a microtubule polymerization inhibitor, potentiated the activity of dacarbazine (DTIC) (Jernigan F, et al. Mol Cancer Ther. 2021;20:1846–1857). Here, we report preliminary safety and efficacy results from a Phase 1b dose escalation study evaluating the combination of unesbulin with DTIC in patients with advanced LMS (NCT03761095). Methods: In this single-arm, open-label, Phase 1b clinical trial, patients with advanced LMS received unesbulin orally at 200, 300, or 400 mg twice weekly (BIW) in combination with intravenous DTIC at 1,000 mg/m2 once every 21 days. The primary objectives were to determine the maximum tolerated dose (MTD) and recommended Phase 2 dose (RP2D) of unesbulin in combination with DTIC and to characterize the safety profile of the combination. The time-to-event continual reassessment model (TITE-CRM) was used for dose finding. An expansion cohort with up to 12 additional patients is currently being enrolled. Results: As of the data cutoff on January 6, 2022, 29 LMS patients have been treated. Median prior lines of therapy were 3 (range 1–6). Of 27 evaluable patients, 12 had non-uterine and 15 had uterine LMS. The MTD/RP2D of unesbulin was determined to be 300 mg BIW with DTIC 1,000 mg/m2 every 21 days using the TITE-CRM. At the RP2D, the most common treatment-related adverse events included fatigue, diarrhea, neutropenia, and thrombocytopenia. In the intent-to-treat population, the overall response rate (ORR) was 17.2% (5/29) and the disease control rate (DCR) (DCR = complete response + partial response + stable disease at 12 weeks) was 58.6%. At the 300 mg dose level, the ORR was 19% (4/21) and the DCR was 57.1%. Patients received a median of four cycles (range 1–12). The study is ongoing, with patients continuing to receive treatment. Conclusions: Unesbulin 300 mg BIW in combination with DTIC 1,000 mg/m2 every 21 days was well tolerated and demonstrated promising efficacy in a heavily pre-treated patient population with advanced LMS; these results support further investigation. Updated clinical results will be presented as the data mature. A randomized, placebo-controlled, Phase 2/3 trial is planned. Clinical trial information: NCT03761095.