bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender features of the chronic pain effect on some vascular endothelial growth factors and their skin receptors on the B16/F10 melanoma model.
Authors: Kotieva Inga Movlievna , Frantsiyants Elena M. 
Published: June 2022

e24061 Background: Patients with oncological pathology, especially with the progression of the disease, often have chronic pain[1]. Pain effects singly can cause dysfunction of the vascular system, which could be an additional risk of the tumor process progression. The aim of the study was to identify gender-specific chronic pain effects on some vascular endothelial growth factors and their skin receptors in the B16/F10 melanoma model. Methods: The study was conducted on mice of the C57BL/6 line (females, males; age 8 weeks, weight 21-22 g, n = 48, 12 animals in each group). Two weeks after the ligation of the sciatic nerve melanoma B16/F10 was transplanted under the skin in the back of the main groups of animals (I- females, II-males); control groups were held the same procedure without ligation (III-females, IV-males). The levels of VEGFA, sVEGFR1, VEGFC, sVEGFR3 were determined in intact skin by ELISA. All manipulations were carried out in accordance with the European Convention for the Protection of Vertebrates Used for Experimental and Other Scientific Purposes (ETS 123). Results: Chronic pain contributed to the accumulation of VEGF-A, sVEGF-R1, VEGF-C in the skin and the reduction of sVEGF-R3 in all animals: in females - 2.7 times, 2.9 times, 6.1 times and 6.1 times, accordingly, in males - 3.1 times, 3.7 times, 3.5 times and 7.2 times, accordingly. Consequently, in males the amplitude of fluctuations of VEGF and their receptors in the skin against the background of pain was higher than in females, except for VEGF-C, the amount of which increased in females more than in males, despite its identical initial level in the skin of animals of both sexes. As a result, the skin of males with pain contained more VEGF-A, sVEGF-R1 and sVEGF-R3, accordingly, by 1.4 times (p < 0.05), 2.0 times and 1.9 times (p < 0.05) and less VEGF-C - by 1.8 times (p < 0.05). Conclusions: Chronic neuropathic pain had different effects on changes in the level of vascular endothelial growth factors and their receptors in intact skin in females and males of melanoma B16/F10 tumor carriers. The gender characteristics of the effect of chronic pain on neoangiogenesis may be associated with different rates of growth and development of the malignant process in male and female mice in the experiment. References [1] Kotieva I.M. et al. Chronic pain and accumulation of growth factors in perifocal tissues of melanoma and impact on malignancy and early metastasis. Journal of Clinical Oncology . 2018. Т. 36. № S15. С. e21621.
Mortality and prognostic factors in hospitalized COVID-19 patients with cancer: An analysis from a large healthcare system in the United States.
Authors: Tarockoff Meri , Raez Luis E. , Uribe Carlos Carracedo , Niu Jianli , Sareli Candice , Sundararaman Nithya , Ion Jayme , Eckardt Paula , Hussein Atif Mahmoud 
Published: June 2022

e24063 Background: Coronavirus 19 (COVID-19) is a severe global pandemic and a public health challenge. Patients with COVID-19 and cancer are at an increased risk of poor clinical outcomes. Data is lacking in evaluating outcomes in patients with different cancers, races and ages; particularly in Florida with high proportion of elderly and the largest racial/ethnic disparities. We evaluated the in-hospital mortality of COVID-19 positive cancer patients. Methods: We used retrospective data of COVID-19 patients hospitalized at the Memorial Healthcare System between March 1, 2020 and January 18, 2021. Over 4,870 patients with COVID-19 were evaluated, of which 265 (5.4%) had cancer. The primary endpoint was in-hospital mortality in patients with cancer and COVID-19. Mortality was analyzed in COVID-19 patients with/without a cancer history. We used descriptive statistics to synthesize outcomes and characteristics from the study population. Univariate and multivariate logistic analysis were performed to define baseline clinical characteristics potentially associated with mortality in cancer patients with COVID-19. Results: 4,870 patients with COVID-19 were evaluated and 265 had malignancy. The study included all different races including Non-Hispanic Whites (NHW) 816 (16.8%), Hispanics 2,271 (46.6%), African-Americans (AA) 1,534 (31.5%) and other minorities 248 (5.1%). Of cancer patients, 24.1% NHW, 43% Hispanic, 28.7% AA and 4.2% other minorities. Amongst races, NHW with cancer accounted for the highest number of COVID-related deaths representing 37.5%, while Hispanics and AA accounted for 18.4% and 19.7% respectfully. Amid cancer subtypes, 24.6% of hematological cancers resulted in mortality and 23.5% of solid cancers resulted in mortality, but no statistical significance was seen. Additionally, after adjusting for age, gender, and race, cancer was linked to an increased in-hospital mortality. Lastly, older age (> 65), elevated creatinine levels (Cr) and elevated C-reactive protein (CRP) were associated with increased risk of death. Conclusions: Patients with COVID-19 and cancer had worse outcomes. Cancer subtypes included hematological and solid cancers, with similar in-hospital mortalities. Although NHW were the smallest group, they had the highest rate of in-hospital deaths amongst cancer patients with COVID-19, in comparison to Hispanics, the largest group in the study, had the least amount of in-hospital deaths. Additionally, factors such as advanced age, elevated Cr and CRP were associated with increased risk of COVID-related deaths. The findings indicate the need for close surveillance and monitoring of these patients as they are more likely to have complications such as mortality from COVID-19.
Palliative care integration and end-of-life outcomes in veterans with metastatic colon cancer.
Authors: Aung Ye , Kapoor Vidit , Datta Paromita 
Published: June 2022

e24069 Background: Metastatic Colon Cancer is associated with an overall poor prognosis with an estimated 5 year survival rate < 14% according to SEER data. There has been a movement in national society guidelines to advocate for increased utilization and integration of palliative care for all patients with metastatic solid tumors. Here through retrospective chart review we examined the impact of palliative care consultation on end of life outcomes at the Audie L Murphy Veterans Affairs Medical Center in San Antonio. Methods: With the help of the VA tumor registry we compiled a list of 103 Veterans diagnosed with metastatic colon cancer and who were seen from January 2013-December 2021 at the Audie L Murphy VAMC. Data was abstracted from electronic chart review in CPRS and analyzed to compare differences in end of life outcomes between patients that received palliative care and those that did not. Statistical significance was calculated using Fisher's Exact Test. Results: Overall 53/79 (67%) of Veterans were seen by a palliative care physician prior to death which is higher than the national average 45%. There was an overall high rate of completion of advance directives in this clinic 82/103 (79.6%), however, patients who were seen by palliative care were more likely to have completed advance directives (90.8% vs 60.5%, p < .001). Patients seen by palliative care were also more likely to have their setting of death occur outside of the hospital (86.4% vs 64%, p < .04), they were also less likely to be admitted to the ICU < 30 days prior to death (9.8% vs 30.4%, p < .04) and they were less likely to receive CPR < 30 days prior to death (3.9% vs 22.3%, p < .03). We did not find any statistically significant differences in hospice enrollment rates, (79.2% vs 56% p < .057) nor did we find any differences in chemotherapy < 30 days prior to death (15.4% vs 19.2% p < .75). Our study was limited by the smaller sample size of patients not receiving palliative care. Of note our population was overwhelmingly male (97%) and the average age at diagnosis of metastatic disease was 65.6. Conclusions: Overall the utilization of palliative care in Veterans with metastatic colon cancer is associated with better advanced care planning and decreased aggressiveness in end of life care. These results are consistent with other studies and our retrospective analysis provides more data supporting the increased utilization of Palliative Care for Veterans with metastatic colon cancer.
Palliative care utilization and mortality in patients who received inpatient chemotherapy.
Authors: Anderson Justine , Handa Shivani , Petrone Giulia , Chowdhury Nobel , Kwon Deukwoo , Bhardwaj Aarti Sonia , Jain Priya , Smith Cardinale B. , Berger Natalie S 
Published: June 2022

e24074 Background: Early integration of palliative care (PC) into advanced cancer care has been shown to improve quality of life and prognostic understanding. However, there is a paucity of data on utilization of inpatient PC consultation and survival outcomes in patients (pts) receiving inpatient chemotherapy (IC). Methods: A retrospective review was performed at a single academic center of pts receiving IC between Jan 2016 and Dec 2017. We evaluated utilization of PC services, reasons for consult, code status, disposition, and 60-day mortality. Descriptive statistics and odds ratios (OR) were estimated from logistic regression models with mixed-effect, taking into account correlations from multiple admissions per patient. Cumulative incidence plot and Cox proportional hazard regression models were used to assess the association between mortality and study covariates. Results: Of 880 admissions, 733 (83%) were hematologic malignancies (HM) and 147 (17%) were solid tumors (ST). PC consults were more likely in ST than HM (OR 3.19, 95% CI 1.85 - 5.50) and for KPS ≤50% (OR 22.20, 95% CI 11.51- 42.79). Of 159 PC consults, 91 (57%) were for pain and 25 (16%) for goals of care. 66 pts (10%) who received IC died within 60 days of admission, 44 (67%) HM and 22 (33%) ST (p = 0.002). In pts who died within 60 days, 63% had PC consult. Median time from admission to PC consult was 2 days for ST and 9 for HM. Of those with PC consult, 40% had a change from full code to DNR/DNI and were more likely to have a health care proxy (HCP) assigned (OR 7.31, p = 0.001). PC consults were also associated with significantly higher odds of discharge to hospice (OR 10.52, 95% CI: 4.3-25.6; p = < 0.0001; Table). Mortality risk was higher in those admitted for symptoms/complications related to their disease or with progression (HR 3.24, 95% CI (2.50-4.19), p < 0.001) and in those with advanced stage disease: Stage 3 (p = 0.033); Stage 4 (p = 0.0003). Of the pts who died within 60 days, 33 (50%) died during the admission and 24 (36%) in hospice. Conclusions: Significant 60-day mortality after receiving IC is consistent with aggressive end-of-life care. Pts with ST and those with poor performance status more frequently utilized inpatient PC services; however, there is opportunity to increase utilization amongst pts with HM and introduce PC earlier in the inpatient clinical course. PC consultations improve advanced care planning with appropriate transitions in code status, HCP assignments, and discharge to hospice.[Table: see text]
Effectiveness of NEPA, an oral fixed-dose combination of NEtupitant and PAlonosetron in the prevention of chemotherapy-induced nausea-vomiting in patient receiving highly emetogenic chemotherapy regimens.
Authors: Jadhav Amit Y , Gupta Sudeep , Biswas Ghanashyam , MV Chandrakanth , Dattatreya Palanki Satya , Thomas Boben , Gupta Sumant , Bhagat Sagar B , Patil Saiprasad , Barkate Hanmant B 
Published: June 2022

e24090 Background: Patients receiving Highly Emetogenic chemotherapy (HEC) are > 90% risk of nausea-vomiting due to the drug's emetogenic potential and patient-related factors such as young age, female gender, low/no alcohol, H/O morning sickness and use of alternative medications. The current study was designed to assess the effectiveness of NEPA in patients receiving HEC in a real-world setting in India. Methods: An open-label, single-arm, prospective study among chemonaive patients was conducted across six centers from April 2019 to December 2021 after approval from each institutional ethics committee (CTRI/2020/02/023586). Complete response and treatment-emergent adverse events were the primary endpoints. Secondary endpoints included completion protection, complete control and severity of nausea. Results: HEC regimens were prescribed in 289 of the 360 patients enrolled in the study. Most common HEC regimen was Anthracycline-Cyclophosphamide (44.2%) followed by Paclitaxel-Carboplatin (17.9%). Average age of study population was 52.8±9.8 yrs. with male: female ratio of 1:2.1. Hypertension (17.6%) and diabetes (12.4%) were common comorbidities. Complete response in acute, delayed and overall phases were 94.4%, 94.8%, and 92.7% respectively. In overall phase, complete protection and complete control was 86.8% and 77.5% respectively. Mild, moderate and severe nausea were reported in 11.7%, 7.6%, and 2.4%, patients respectively. Adverse events were seen in 10(3.4%) patients, with leg pain being the most common 3(0.8%). One serious adverse event, unrelated to the study drug was reported. Conclusions: NEPA was effective and well tolerated in patients on a HEC regimen in the acute, delayed and overall phases with a completed response rate of > 90%. Clinical trial information: CTRI/2020/02/023586. [Table: see text]
Trends in palliative care interventions for stage IV esophageal cancer: An analysis of the NCDB.
Authors: Seraphin Michael , Silberstein Peter T. , Cichon Gregory 
Published: June 2022

e24104 Background: Palliative care (PC) addresses patient quality of life and satisfaction with care. Oncological PC can be manifested through surgery, radiation, chemotherapy, and pain management. These treatments do not cure disease but improve quality of life. The survival rate for stage IV esophageal cancer is 15-20%, making it an excellent candidate for PC. This study will analyze patterns in who received each type of PC. Methods: This study looked at 8808 patients with stage IV esophageal cancer who received PC interventions from 2004-2018 in the National Cancer Database (NCDB). The NCDB listed 4 types of PC: surgical, radiation, chemotherapy/hormone therapy, and pain management. All modalities were to “alleviate symptoms, but no attempt to diagnose, stage, or treat the primary tumor is made.” Exclusion criteria was concurrent tumors and missing data. Histology subgroups were divided into adenocarcinoma, squamous cell carcinoma, and other, based on ICD-O-3 coding. Cross tabulation analysis was performed using Pearson chi-square and ANOVA tests. Kaplan Meyer curves with log-rank analysis were used to determine survival probabilities. Results: Of PC interventions, 9.0% were surgical, 42.5% radiation, 41.1% chemotherapy, and 7.4% pain management with no other treatment. From 2004-2018 pain management increased 380% and chemotherapy increased 250%. Radiation increased 32%, and surgical decreased 39%. Surgical patients were more often male (79.9%), white (87.4%), non-Hispanic (97.3%), treated at an academic/research program (39.6%), and have a mean survival of 8.6 months. The most common surgical interventions were photodynamic therapy and esophagectomy with partial gastrectomy. Radiation patients more often male (82.3%), white (83.9%), non-Hispanic (96.5%), treated at a comprehensive community cancer center (39.7%), and have a mean survival of 9.1 months. Most common phase I radiation treatments were external beams (photons) and external beams NOS. Chemotherapy patients were more likely to be male (84.5%), white (88.2%), non-Hispanic (96.8%), treated at a comprehensive community cancer program (39.4%), and have a mean survival of 13.9 months. Chemotherapy patients most often received multiagent chemotherapy and single agent chemotherapy. Pain management patients were more often male (80.2%), white (88.0%), non-Hispanic (96.5%), treated at an academic/research program (38.8%), and have a mean survival of 4.1 months. Chemotherapy patients had average age of 62, while all other interventions had an average age of 65 (p < 0.001). Conclusions: Major differences between subtypes of PC interventions included location of treatment, average age at diagnosis, and mean survival. Chemotherapy patients were diagnosed younger and had a longer mean survival time. Pain management patients had the lowest mean survival time. This data can be utilized as PC utilization increases in the United States.
Prevalence of antecipatory nausea and vomiting in cancer patients exposed to highly emetogenic chemotherapy.
Authors: Alves Rafaela de Brito , Reboucas Camilla Vieira de , Oliveira Louize Caroline Marques , Yamada Alayne Magalhaes Trindade Domingues , Cruz Felipe Melo 
Published: June 2022

e24112 Background: Anticipatory nausea (AN) and vomiting are unpleasant symptoms observed in anticipation of chemotherapy regimens. It is best described as a learned response through classical conditioning when one or more distinctive features of the chemotherapy clinic (conditioned stimuli) associated with the administration of emetogenic chemotherapy (unconditioned stimuli) trigger the emetogenic reflex. Little is known about AN's occurrence after the advent of the new neurokinin-1 antagonist. This prospective study evaluated AN's prevalence in ambulatory breast cancer patients receiving high effective antiemetic prophylaxis and evaluated potential predictors of AN. Methods: This prospective observational study was performed at a single Brazilian Institution. Key inclusion criteria were patients aged 18 years or older with breast cancer scheduled to receive anthracycline chemotherapy with an appropriate antiemetic regimen, including a neurokinin-1 receptor antagonist, a serotonin-3 receptor antagonist, and a corticosteroid. Eligible patients used a diary to record nausea, vomiting, and use of rescue medication in the first 2-cycle of treatment through 120 after infusion. AN was assessed before chemotherapy on day 1 of cycle two. We excluded patients with nausea and vomiting presented 24h before cycle one and patients who did not receive standard antiemetic prophylaxis. Results: Between August 04, 2020, and August 12, 2021, 60 patients were screened, and 52 patients were enrolled. The mean age was 50,8 (28 – 69), the majority had stage III (53,8%) and received chemotherapy with curative intent (94%). During cycle 1, the frequency of overall nausea and vomiting was 67.31%, and severe nausea and vomiting (defined as grade > 4 at a 10-point visual scale or use of rescue medication) was 55.77%. Ten patients had AN (19.23%). The occurrence of nausea and vomiting during cycle one was the only statistically significant predictor of AN (OR = 16, 95% CI 2.4, 670.9, p-value = 0.0003). Conclusions: The prevalence of AN is still high in the era of neurokinin-1 antagonists, and failure of antiemetic control on cycle one remains the main risk factor. All efforts should be made to control chemotherapy-induced nausea or nausea and vomiting on cycle one to avoid AN. Clinical trial information: NCT04785495.
Empowering colorectal cancer patients and caregivers through clinical trials education in COLONTOWN.
Authors: Schwarze Steve , Clauer Julie , George Manju , Musick Lindsey , Seybold Nancy , Terek Adrian 
Published: June 2022

e24129 Background: Clinical trials are increasingly part of the continuum of care for colorectal cancer patients, particularly those with metastatic disease. Yet most patients have limited knowledge about clinical trials, and many struggle to navigate the myriad barriers to enrollment. To bridge this gap, PALTOWN supports a broad array of activities in its COLONTOWN online community to help patients and caregivers interested in pursuing clinical trials. The function and impact of these activities is examined here. Methods: A comprehensive inventory of all clinical trial-related activity was conducted across three main sources: 1) resources and activity in COLONTOWN’s nine clinical trial-focused groups; 2) clinical trial materials posted in COLONTOWN UNIVERSITY, an online disease education center; and 3) patient feedback on clinical trial programming. Results: The MSS and MSI-High clinical trial groups in COLONTOWN serve more than 2,200 members, and more than 1,000 members are served by mutation- and location-specific trial groups. These groups have helped at least 187 members enroll in a clinical trial between 2019 and 2022. Among 10 trial-related activities, a majority (6/10) focused on sharing biomedical information, including : 1) patient-friendly descriptions of new trials; 2) explanations of trial results; 3) abstracts, articles, and videos from professional outlets such as ASCO Daily Post and OncLive; 4) patient-created resources on clinical trial basics in COLONTOWN UNIVERSITY; 5) “Doc Talks” by prominent CRC oncologists; and 6) patient advocates serving as information liaisons between patients and NCI Task Forces. A smaller number of activities (3/10) focused on psycho-social support from peers, including 1) accounts of patient experiences while seeking and participating in trials; 2) strategy discussions about how and when to pursue trials; and 3) “Alanna Project” database of members on a trial. COLONTOWN’s Clinical Trial Workshop (1/10) offers a novel approach to integrating biomedical education with psycho-social support via a four-week, peer-led clinical trial navigation program. Assessment of the cognitive and behavioral outcomes of the workshop demonstrate improvements in all four dimensions of health literacy: the ability to access, understand, appraise, and apply relevant information in the search for clinical trials. Conclusions: COLONTOWN's clinical trial programming offers comprehensive clinical trial education to patients and caregivers that leads to enrollment in trials. By embedding that education within a supportive community of peers, it enhances patients' capacity to collaborate with health care professionals in making informed decisions about clinical trials.