bluuebunny/crossref_metadata_2025_split huggingface dataset:
Piloting virtual mentorship: Evaluating acceptability and influence on wellness and professional identity in medical oncology (MO).
Authors: Fung Andrea S. , Nowell Lorelli , Afzal Arfan R. , Thiessen Maclean Harvey , Campbell Alexi , Hao Desiree 
Published: June 2022

11022 Background: Despite extensive literature on the value of mentorship in academic medicine, little evidence exists to inform mentorship practices in MO. In 2021, the Canadian Association of Medical Oncologists (CAMO) piloted a national, 6-month virtual mentorship program consisting of 2 group mentoring events and additional 1-on-1 mentoring activities, to better support the needs of MO trainees. Feedback was obtained from participants to gain insight into how virtual mentorship might impact physician wellness and formation of professional identity, and to inform future iterations of CAMO’s virtual mentorship strategy. Methods: All Canadian MO residents/fellows were invited to participate in the program. Electronic surveys were completed by participants at baseline, after each group event, and at program completion. Surveys evaluated the program content and format, and used validated questionnaires for evaluating physician wellness/burnout (Stanford Professional Fulfillment Index [SPFI]), and professional identity (Macleod Clark Professional Identity Scale [MCPIS]). Cohort characteristics and survey responses were summarized using descriptive statistics. Procedures for survey data collection and analysis were ethics approved. Results: At baseline, respondents (n = 38) were predominantly female (63%), and < 35 years (76%). 50% were married. On average, 78% of respondents ranked the virtual group mentoring events as meeting expectations. Program strengths identified by participants included meeting mentors outside of their own centre, meeting other trainees from across the country, and learning more about work-life balance/physician wellness. The main critique was insufficient time for interaction. Of the 34 MCPIS respondents, 94% were pleased to belong to the profession of MO, 91% identified positively with members of their profession and 77% felt like a member of the profession themselves. The average score on the SPFI scale was 2.73±0.71 (n = 34). Although 85% of respondents found their work meaningful, 71% satisfying, and 50% felt they were contributing professionally in valued ways, only 38% met criteria for professional fulfilment (score ≥3.00). 27% met criteria for burnout (score ≥1.33), 15% found their work physically exhausting and 9% found their work emotionally exhausting. Conclusions: CAMO’s pilot virtual mentorship program highlights that technology can be successfully leveraged to facilitate mentoring. The majority of MO trainees identified positively with their profession, yet only 38% reached the threshold for professional fulfillment and nearly a third met criteria for burnout. Longitudinal follow-up among mentored trainees is needed to provide insight into whether mentorship may influence physician wellness and professional identity over time.
A needs assessment survey to inform a general practitioner in oncology (GPO) training program in Nepal.
Authors: Gyawali Bishal , Carson Laura M. , Thapa Niresh , Savage Colleen , Rawal Mangal , Berry Scott R. , Poudyal Bishesh Sharma 
Published: June 2022

11024 Background: Nepal is a low-income country with a population of over 30 million that faces a significant burden of cancer, with approximately 60,000 patients receiving a cancer diagnosis per year. However, a lack of cancer care providers is recognized as a major barrier to cancer care in Nepal. To address this gap, a national GPO training program may be an effective task-shifting strategy to increase the oncology workforce. A needs assessment survey was conducted to determine baseline oncology training for Nepalese General Practitioners (GPs) and the feasibility and desirability of establishing a GPO training program in Nepal. Methods: A survey was distributed to 171 GPs in Nepal. The survey was distributed via the REDCap electronic database, a secure-web-based software platform based at Queen’s University in Kingston, Ontario, Canada. Reminders were sent out via social media accounts. The survey results were recorded anonymously from February to July 2021. Results: Data was collected from 71 GPs in Nepal. Data revealed significant gaps in oncology training, with only 6% of respondents reporting undergoing a mandatory oncology rotation during their training, and 15% indicating their training adequately prepared them to care for patients with cancer. Although respondents reported seeing an average of 1-5 cancer patients per day, only 9% reported providing chemotherapy treatment, and 36% indicated regular provision of follow-up cancer care. Only 1 in 5 general practitioners reported having radiation oncology services available at their institution or an institution within the same zone. 96% of GPs surveyed agreed that there is a need for a GPO program, and 71% reported they would be very interested in participating in this type of training. A majority of respondents indicated a preference for self-directed and small-group learning as the preferred modes of content delivery in a GPO training program. Conclusions: Our findings indicate a need and high level of desirability for a national GPO training program in Nepal. Further, the needs assessment provides insight into practitioner perspectives on information needs and content delivery. This data will be used to guide future curriculum development for the Nepal GPO program. [Table: see text]
Gaps in adolescent and young adult oncology education during medical and pediatric hematology/oncology fellowship training.
Authors: Duvall Adam , Moerdler Scott , Freyer David R. , Grimes Allison , Hayes-Lattin Brandon M. , Monga Varun , Prasad Pinki Kumari , Roth Michael 
Published: June 2022

11026 Background: There are limited data on the extent of adolescent and young adult (AYA) education in pediatric and medical oncology fellowship programs. The purpose of this study was to assess the prevalence and content of AYA-focused training during pediatric and medical oncology fellowship and identify knowledge gaps for targeted educational curricular development. Methods: An anonymous, web-based survey for educators and trainees was developed, piloted and optimized by a study team comprising pediatric and adult oncologists. The survey contained questions on respondent demographics, AYA curriculum, provider comfort in managing specific AYA care domains, and priorities for future AYA educational content. In October 2021, email invitations containing the survey link were sent to program directors (PDs) and associate program directors (APDs) at 251 hematology/oncology fellowship programs (with 119 pediatric and 178 adult PDs/APDs) identified through the American Medical Association’s Fellowship and Residency Electronic Interactive Database Access. PDs were asked to participate and also distribute the survey to current fellows. The survey remained open for 3 months. Fisher’s exact test was used to assess for associations between discrete variables including amount of current education vs level of importance and demographic groups. Results: Respondents represented 69 programs (27%). There were 130 respondents who completed curriculum and demographic questions and 112 who completed detailed topic questions. Respondents comprised 51 PDs/APDs (32 pediatric and 19 adult) and 58 fellows (33 pediatric and 25 adult). 85% of PDs (44/51) do not have a formal AYA curriculum. Of these, 80% (35/44) offer some topic-specific lectures, while 20% (9/44) provide little/no education in any topics. For nearly all topics, at least 45% of respondents reported little/no education. Although onco-fertility and survivorship are the most frequently taught topics, 36% and 42% of respondents, respectively, reported little/no education in these areas. Substance abuse is least commonly taught. Both PDs and fellows believe that AYA topics are more important for inclusion in future curricula despite how infrequently they are currently taught (very/extremely important for inclusion vs moderate/great deal of current amount of education, p = 0.0001 for all topics). Overall, respondents indicated the most important topics for inclusion in fellowship curriculum were onco-fertility (82%), survivorship (78%), and communication (77%). Conclusions: These data highlight the large gap in hematology/oncology fellowship education in AYA topics and a paucity of formal educational curricula. Efforts are needed to provide both medical and pediatric oncology fellows with the knowledge and skills required to provide optimal care for AYAs.
Patient-reported outcomes for measuring the quality of life in advanced breast cancer treated with third-line and beyond chemotherapy-based regimens: A national cross-sectional study.
Authors: Guan Xiuwen , Yan Xiaoyan , Wang Ying , Hu Xichun , Sun Xiaoying , Chen Zhanhong , Zhang Xiaochen , Dong Ying , Chen Wenyan , Shi Yanxia , Cheng Jing , Mei Zhihong , Ma Fei 
Published: June 2022

1103 Background: Prolongation of survival and maintenance of quality of life (QoL) are the primary therapeutic goals in advanced breast cancer. Around 10% of adverse events (AEs) in the CTCAE are symptomatic AEs (e.g., nausea, sensory neuropathy), which can severely and directly affect the QoL of patients. However, seldom evidence mapped the QoL and symptomatic AEs utilizing patient-reported outcomes (PROs) in heavily pretreated breast cancer patients. This study aimed to investigate the PROs for measuring the QoL and symptomatic AEs of advanced breast cancer treated with third-line and beyond chemotherapy-based regimens in China. Methods: This national survey enrolled patients with advanced breast cancer receiving third-line and beyond chemotherapy-based regimens in 59 centers all over China from March to April in 2021. Each patient filled out a questionnaire containing demographic information, medical history, EORTC-QLQ-C30, and symptomatic AEs. The symptomatic AEs included fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, alopecia, fever, and limb numbness. The range method was used for the linear conversion of the PRO scores, which were converted into standardized scores of 0 to 100. Results: This study enrolled 1015 patients with the median age of 52 years. The QoL of all patients were poor, with the global health status score of 52.4±17.7 (Table). All the symptomatic AE scores were low among the patients. However, no significant differences were observed in global health status and symptomatic AEs between mono-chemotherapy and multi-agent chemotherapy (All P>0.05). Conclusions: The QoL of advanced breast cancer patients treated with third-line and beyond chemotherapy were poor, especially in symptomatic AEs. In addition, the EOTRC-QLQ-C30 scale appears to underestimate the differences in symptomatic AEs between mono-chemotherapy and multi-agent chemotherapy, probably due to a lack of sensitivity of the scale, which fails to match the actual clinical observations of the PROs and QoL. Therefore, new scales need to be developed for the evaluation of symptomatic AEs and QoL in advanced breast cancer. [Table: see text]
Are we doing it right? Mentorship challenges for oncology fellows and early-career faculty from backgrounds underrepresented in medicine.
Authors: Idossa Dame , Velazquez Manana Ana I. , Horiguchi Miki , Alberth Julia , Abuali Inas , Smith-Graziani Demetria Joy , Lopes Gilberto , Lubner Sam Joseph , Duma Narjust 
Published: June 2022

11047 Background: Physician workforce diversity can be a driver of institutional excellence, improving innovation and reducing health disparities. The current diversity of the hematology/oncology (HO) workforce does not reflect that of the US population. The role of mentorship in increasing HO fellows’ interest in pursuing careers in HO has been described previously. However, the mentorship experiences of fellows and early career faculty from backgrounds underrepresented in medicine (UIM) in HO has not been fully characterized. Therefore, we compared the mentorship experiences of UIM and non-UIM trainees and early career faculty in HO subspecialties. Methods: We conducted cross-sectional online survey of HO subspecialists including current fellows and faculty within 5 years of end of training. The anonymous survey was distributed via email and social media channels in April 2020. Fisher’s exact test and multivariable logistic regression models were used to conduct comparisons between study groups. Results: Of the 306 respondents, 64 (21%) were UIM and 161 (53%) identified as male. UIM participants were less likely to have a primary mentor (66%) than non-UIM participants (80%, p = 0.015). Among those who had a primary mentor, UIMs were more likely to meet infrequently (greater than every 3 months, p = 0.007). Furthermore, UIMs were more likely to report having mentors outside their own institution (47% vs 40% non-UIM, p = 0.002) and making compromises to gain access to mentorship (36% vs 23% non-UIM, p = < 0.001). In addition, UIM participants were less likely to have an advisor (38% vs 54% non-UIM, p = 0.017), a coach (13% vs 20% non-UIM, p = 0.054), or a sponsor (19% vs 26% non-UIM, p = 0.046). UIMs were also less likely to apply for grants (34% vs 42% non-UIM, p = 0.035) and awards (28% vs 43%, non-UIM p = 0.019). In multivariable models, UIM individuals were more likely to make compromises to gain access to mentors (OR = 1.96, p = 0.047) and this remained significant for females (OR = 2.17, p = 0.005). Lastly, US born individuals had higher odds of having a primary mentor than non-US-born individuals (OR = 2.43, p = 0.004). Conclusions: In the largest study to date characterizing the mentorship experience of HO trainees and junior faculty, we found that UIM individuals were significantly less likely to find effective mentorship and were less likely to apply for awards and grant support. Understanding the challenges of UIM trainees can help shape training environments in academic medicine to ensure these are grounded in diversity and inclusion. Given the importance of workforce diversity, training programs in HO must consider structured programs and other innovations to improve mentoring experiences of UIM trainees and junior faculty.
Comparison of methodology in the collection of gender and race/ethnicity in hematology and oncology journal editorial boards.
Authors: Patel Shruti Rajesh , Riano Ivy , Abuali Inas , Ai Angela , Geiger Gabriella , Pimienta Jacqueline , Ramirez Roggio Adriana C. , Dhawan Natasha , Salinas Alexandra Lizette , Duma Narjust , Dizman Nazli 
Published: June 2022

11061 Background: Reporting on disparities is strongly influenced by the methodology used to collect race/ethnicity and gender data. Incorporating gender and race into research has its challenges, as these variables are difficult to define. As underrepresentation of minorities and women continues to persist in many facets of academia, it is important to assess the accuracy of differing methodologies. While asking individuals to self-identify their race and gender remains the gold standard of reporting, low response rates and response bias have been shown to affect results. In our initial study on representation in editorial boards, gender and race/ethnicity were determined based on publicly available data which can lead to misclassification of editors. We aimed to add to our study by asking editors to self-report their gender and race in hopes to validate our methodology given the importance of considering gender and race in academia. Methods: Of the 60 highest impact journals in oncology, hematology, radiation oncology, and surgical oncology identified, race/ethnicity and gender determinations were made using two methods. All senior editors were sent a survey via email asking participants to self-report their gender, race/ethnicity, age, and job characteristics. Gender and race were also assigned to the editors by a diverse coding team based on publicly available data and the NIH's OMB Directive 15 as a framework. The self-reported data was then compared to data that was assigned by our team. Results: 66 of the 793 (8.3%) editorial board members included in the study responded to the survey. Of the 66 respondents, gender was assigned correctly 100% (66/66) of the time and race was assigned correctly 95.5% (63/66) of the time. Of the 66 respondents to the self-survey of the 793 editorial board members surveyed. A significantly lower proportion of men responded to the survey compared to the gender breakdown of the 793 editorial board members (54.5% vs 72.6%; p = 0.000279). The three incorrectly identified respondents self-identified as Native Hawaiian, White, and Middle Eastern. Conclusions: Multiple recent reports have demonstrated high rates of sexual harassment, gender bias, and exclusion in the field of oncology. Collecting data on racial/ethnic groups and gender is imperative to understand the academic landscape of oncology and work towards a more equitable environment. Notably, this data from our study supports the methodology of a diverse coding team assigning gender and race based on publicly available data and the NIH's OMB Directive 15 as a framework as an alternative to self-report. Our study also demonstrates the low response rates and significant discrepancies in the demographic of respondents seen in survey-based identification.
Interim analysis of a phase I study of SNK01 (Autologous Nongenetically Modified Natural Killer Cells with Enhanced Cytotoxicity) and avelumab in advanced refractory sarcoma.
Authors: Chawla Sant P. , Chua-Alcala Victoria S. , Gordon Erlinda Maria , Kim Ted T. , Feske William , Gibson Brenda L. , Chang Paul Y , Robinson Debra , Song Paul Y. 
Published: June 2022

11517 Background: For patients (pts) with advanced sarcomas in the relapsed/refractory setting, there are very few if any effective salvage treatment options. The likelihood of response and/or tumor control only diminishes with each subsequent line of therapy. Monotherapy of PD-L1 inhibitors has shown modest to no activity in most sarcomas, especially in tumors that have little to no PD-L1 expression. Natural killer (NK) cells have recently been implicated in the antitumor response to immune checkpoint inhibitors with some evidence suggesting a role in PD-L1 negative tumors. SNK01 is a first-in-kind, autologous nongenetically modified NK cell therapy with highly enhanced cytotoxicity and over 90% activating receptor expression which can be consistently produced from heavily pretreated pts. Avelumab is an anti-PD-L1 immunotherapy with dual engagement of both the adaptive and innate immune systems. We hypothesized that this combination would be safe, and together better overcome the immunosuppressive tumor microenvironment. Methods: In this Phase I study (NCT03941262), cohort 4 is comprised of up to 18 pts treated with 800 mg of avelumab + 4 x 109 SNK01 cells every two weeks via IV Infusion. Pts were eligible regardless of PD-L1 status and permitted to continue treatment indefinitely until progression or unacceptable toxicity. The primary endpoint is safety. The secondary endpoints include overall response rate (ORR), progression free survival (PFS), and overall survival (OS). Results: As of February 1, 2022, 15 pts with advanced refractory sarcoma have been enrolled. Median age is 50 (range 20-75) and 8 were male. Pts had a median of 5 lines of prior therapy (range 1-8). The subtypes included 6 leiomyosarcoma, 2 osteosarcoma, 1 pleomorphic liposarcoma, 1 Ewing’s sarcoma, 1 epithelioid sarcoma, 1 epithelioid mesothelioma, 1 endometrial stromal sarcoma, and 1 sarcoma NOS. There were three Grade 2 or 3 adverse events related to avelumab, but unrelated to SNK01. Best objective response by RECIST 1.1 was PR in 2 pts (ORR of 13.3%) and SD in 3 pts. Median PFS is 11.14 weeks. Several pts had PD-L1 negative disease and response appears to be independent of PD-L1 status. Of pts who progressed in this cohort, several reported an overall improvement in their QoL and some pts became eligible to be treated with additional salvage chemotherapy, resulting in some additional clinical response. Conclusions: SNK01 combined with avelumab was safe and well tolerated and appears to have some clinical activity against several types of heavily pretreated advanced sarcoma, independent of PD-L1 status. It may also keep rapidly progressing disease stable enough to allow additional cytotoxic chemotherapy. A proposed study expansion is planned. Clinical trial information: NCT03941262.
Phase I study of pegylated liposomal doxorubicin in combination with cyclophosphamide and vincristine in pediatric patients with relapsed/refractory sarcoma and other malignant solid tumors.
Authors: Lu Suying , Wang Juan , Huang Junting , Sun Feifei , Zhu Jia , Zhen Zijun , Li Hui , Sun Xiaofei , Zhang Yizhuo 
Published: June 2022

11519 Background: Pegylated liposomal doxorubicin (PLD) was found to have improved toxicity profile, especially with regards to reduced cardiotoxicity. The objectives of this study were to determine the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of PLD in combination with cyclophosphamide and vincristine (PCV regimen) and describe the toxicities and response of this regimen. Methods: This was an open-label, single-center, single-arm phase I study utilizing a “3 + 3” design. The primary endpoint was the MTD of PLD, and the secondary endpoints included safety, objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS). Efficacy was evaluated using RECIST 1.1. PFS was defined as the time from treatment until disease progression or death. This study included cohort A and cohort B. Three dose levels were studied in cohort A, PLD 30 mg/m2 (L1), 40 mg/m2 (L2) or 50 mg/m2 (L3) d1 + cyclophosphamide and mesna at 1 g/m2/d d1-2 + vincristine 1.5 mg/m2/d (≯2mg) d1 every 3 weeks. As the endpoint of the study could not be reached, we changed the dose of cyclophosphamide and mesna to 1.5 g/m2/d d1 in cohort B. Results: Eleven in cohort A and 34 in cohort B were enrolled, the median age was 6 years (range 1-15). Forty-three patients were eligible and evaluable for toxicity, and 35 (77.8%) patients were evaluable for response. Diagnoses were rhabdomyosarcoma (n = 29, 64.4%), Ewing's sarcoma (n = 4), and others. The median number of prior regimens was 2 (range 1-5). The most common adverse event (AE) was grade 3 or grade 4 neutropenia with a proportion of 90.9% and 65.5% in cohort A and cohort B, respectively. There was no significant difference in ORR (60% vs. 48%) and DCR (90% vs. 88%) between the two cohorts. The ORR (60% vs. 0, P = 0.019) and DCR (96.7% vs. 40%, P = 0.006) were significantly higher in Group 1 (rhabdomyosarcoma, Ewing's sarcoma, Wilm's tumor, fibrosarcoma, undifferentiated sarcoma) compared with Group 2 (neuroblastoma, osteosarcoma, embryonal sarcoma, epithelioid sarcoma, extrarenal rhabdoid tumor). The 12-month PFS of Group 1 was also better than Group 2 (79% vs. 60%, P = 0.041). Conclusions: The PCV regimen demonstrated an acceptable toxicity profile and promising clinical efficacy in pediatric patients with R/R rhabdomyosarcoma, Ewing's sarcoma, Wilm's tumor, fibrosarcoma, and undifferentiated sarcoma. Increasing the dose of cyclophosphamide did not improve the efficacy, but increased the toxicity. The RP2D for future studies is PLD 30 mg/m2/d for one day. Clinical trial information: NCT04213612. [Table: see text]