bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phase 1b/2 study of GX-I7 plus pembrolizumab in patients with refractory or recurrent (R/R) metastatic triple-negative breast cancer (mTNBC): The KEYNOTE-899 Study.
Authors: Sohn Joohyuk , Kim Gun Min , Lee Keun Seok , Kim Sung-Bae , Kim Jee Hung , Ahn Hee Kyung , LEE JIEUN , Park Kyong Hwa , Kim Jee Hyun , Lee Kyoung Eun , Shin Eui-Cheol , Park Su-Hyung , Yang Se Hwan , Heo MinKyu , Woo Jung Won , Sung Young Chul , Im Young Hyuck 
Published: June 2022

1081 Background: GX-I7 (efineptakin alfa) is a hybrid Fc-fused long-acting recombinant human IL-7 which plays an essential role in the development and homeostasis of T-cells. GX-I7 can potentially enhance the anti-tumor effect of pembrolizumab via induction of T-cell activity. Here, we report results of phase 1b/2 study of GX-I7 plus pembrolizumab in patients with R/R mTNBC. Methods: Eligible patients had R/R mTNBC that failed up to 3rd lines of chemotherapy in the metastatic setting. Phase 1b patients received GX-I7 in 5 dose levels ranging from 360 µg/kg to 1,440 µg/kg every 9 (Q9W) or 12 (Q12W) weeks plus pembrolizumab 200 mg Q3W (n=51). Phase 2 is an expansion cohort where 33 patients were treated with the recommended phase 2 dose (RP2D). The primary objective was to determine the RP2D for phase 1b and to assess the objective response rate (ORR) for phase 2. Results: The study included 84 patients (phase 1b, n=51; phase 2, n=33) and 53.6% (45/84) of patients have received 2nd to 3rd lines of previous therapy. In phase 1b, one dose-limiting toxicity (DLT; grade 3 skin rash) was reported in the 1,440 µg/kg cohort and GX-I7 1,200 µg/kg Q9W was selected as RP2D. The ORRs were 15.7% [95% confidence interval (CI): 7.0 – 28.6] for phase 1b (n=51) and 21.2% [95% CI: 9.0 – 38.9] for phase 2 (n=33). Median PFS was 2.4 months (95% CI: 2.1 – 2.7) at the median follow-up of 10.4 months for all patients combined (n=84). GX-I7 induced up to 3.6-fold (range 1.2 – 8.1) increase in absolute lymphocyte counts (including CD4+ and CD8+ T cell) in all dose levels. The most common treatment-related adverse events (AEs) of any grade were injection site reaction (50.0%), ALT increased (39.3%), pyrexia (38.1%) and rash (35.7%). The additional correlative study data will be presented. Conclusions: GX-I7 in combination with pembrolizumab demonstrated a manageable safety profile with promising anti-tumor activity in patients with R/R metastatic TNBC. Clinical trial information: NCT03752723. [Table: see text]
Is cure possible for breast cancer metastatic to the liver?
Authors: Adam Rene , Badrudin David , Allard Marc Antoine , Golse Nicolas , Ulusakarya Ayhan , Cherqui Daniel , Sa Cunha Antonio , Vibert Eric , Azoulay Daniel , Ciacio Oriana , Pittau Gabriella , Lucchese Angelica , Hammel Pascal , Lewin Maite , Giacchetti Sylvie 
Published: June 2022

1099 Background: Metastatic breast cancer (MBC) is a lethal disease and is generally only amenable to systemic treatment. Although increasingly recommended on selected patients, local treatments, and particularly surgery, are seldom used in the therapeutic armamentarium for MBC and their long-term survival benefit is unknown. We hypothesized that combining surgery to systemic treatment for selected patients with breast cancer liver metastases could lead to long-term survival or even an option of cure. Methods: A retrospective study of prospectively gathered data from a surgical series of liver resections for MBC was conducted. Patients with no or limited and stable extra-hepatic disease were offered surgery after multidisciplinary discussion, if the liver metastases were responding to systemic treatment and were amenable to complete macroscopic resection. Five- and ten-year actual survivors were identified and their characteristics were explored. Results: From 1984 to 2020, 207 female patients underwent liver resections for MBC in our institution. There was no postoperative mortality. Postoperative complication rate was 23.3% and liver-specific complication rate was 19.0%. There was a total of 48 repeat hepatectomies. Median disease-free interval between initial breast cancer and liver metastasis was 36 ± 90.1 months. There was a median of 2 ± 1.8 liver metastases at diagnosis with a median size of 33.0 ± 18.3 mm and 73.1% of patients had radiological response before resection. Five- and ten-year overall survivals (OS) as well as 5- and 10-year disease-free survivals (DFS) were 39.6% and 12.7% as well as 14.2% and 6.4%, respectively. Median OS was 44.0 ± 47.2 months in the whole series. Focusing on the 5- and 10-year survivors, median OS were 89.5 ± 44.7 months and 144.0 ±42.6 months, respectively. In the 10-year survivors’ group, median DFS was 98 ±62.3 months. Observed survivals in this study underestimate true actual survivals owing to censoring of patients lost to follow-up. Conclusions: Long-term survival (≥ 5 years) as well as a curative perspective (≥ 10 years survival) are achievable for selected patients with breast cancer liver metastases by combining surgery to systemic treatment. Considering the recent improvements in the results of systemic treatments, introducing surgical resection in the treatment sequences of MBC could play an even more beneficial role.
Alleviating the click fatigue on clinicians to improve referrals for colorectal cancer screening.
Authors: Amin Robby , Odhiambo Lorriane Achieng , Ali Sayeda , Islam KM , Yates Joycelyn W , Hotz James , Desai Koosh , George Cynthia , Mitchell Katreena , Durham Lynn M. , Gabram Sheryl G. A. , Cortes Jorge 
Published: June 2022

11021 Background: The impact of clinician burnout on patient care is pervasive across medical delivery systems. The effects are also felt in preventive care where cancer screening efforts rely on clinician referrals through the electronic medical records (EMRs). Though designed to support healthcare, EMRs are a significant source of clinician burnout given the number of clicks or navigation time needed to refer a patient. This is a barrier to Patient Navigation (PN) when ordered tests do not materialize into screenings or when clinicians order labs/imaging and the pending orders are not created. This causes frustration for all clinical staff involved, delays the workflow processes, and leads to missed opportunities for PN. We implemented an ‘order set’ intervention to reduce the click burden linked to colorectal cancer (CRC) screening referral among clinicians in South Georgia. Methods: The ‘order set’ intervention was developed to facilitate PN for a Colorectal Cancer Control Program (CRCCP) aimed at implementing Evidence-Based Interventions to increase CRC screening rates in Georgia. The ‘order set’ was designed to address workflow issues by consolidating steps associated with CRC screening. This reduced typing input and the need to click between multiple windows within the EMR while making a referral to PN. The intervention was piloted in the Albany Area Primary Health Care (AAPHC) system after modifications were made to the EMR and clinician workflows. The monthly CRC screening rates continue to be generated and tracked post-implementation. Results: The use of the ‘order set’ reduced the click burden from 78 to 7 inputs and clinician EMR interaction time from 110 seconds to 29 seconds. Providers from 4/7 clinics have adopted the ‘order sets’ when making referrals for CRC screening. Two clinics provided post-implementation screening data. The pre-implementation screening rates for one clinic were comparable (August = 59.3%, September = 57.6%) to post-implementation (October = 56.3%, November = 56.6%, December = 57.2%), while the second clinic showed some increase (August = 58.6%, September = 60%) vs. (October = 61%, November = 62.1%, December = 62.8%). Conclusions: The ‘order sets’ intervention reduced the time clinicians spent creating referrals for CRC screening, including fecal immunochemical tests (FIT) and colonoscopies. Additional follow-up and rollout to clinics participating in the program is underway to evaluate further the impact of the order sets on CRC screening outcome and process measures, including qualitative interviews with clinicians. There is significant potential in the application of order sets to various workflow processes to aid in preventative health efforts. Challenges linked to the COVID-19 pandemic and staff turnover affected acquisition of patient referral data.
Applying cognitive integration to oncology: A novel asynchronous foundational science curriculum for medical students during clerkships.
Authors: Brondfield Sam , Hyland Katherine , Cornett Patricia A. , Kirsch Heidi 
Published: June 2022

11028 Background: Cognitive integration (CI) connects foundational science (FS) to medical practice and improves clinical reasoning. While evidence supports CI in medical training, the clinical relevance of FS is often obscure to medical students, particularly in oncology, and few learning materials exist to support CI during clerkships. Providing effective and engaging tools to promote CI may enhance understanding of FS relevance to clinical medicine. We therefore aimed to create an online module to integrate FS into clerkships. Methods: Previous student feedback at our institution advocated for clinically relevant FS content. Applying Cognitive Theory of Multimedia Learning principles, we (an oncologist, a biochemist, and an instructional designer) created a cancer module grounded in the hallmarks of cancer (HoC), a key FS principle. To emphasize clinical relevance, we recorded patient interviews incorporating FS. The module, composed in Qualtrics, includes an introduction and four cases, each starting with a brief patient interview, followed by clinical text, images, questions, and explanations. Content co-created by the oncologist and biochemist combined clinical and FS perspectives and referenced the HoC throughout. We piloted a draft with a focus group of four students. The evaluation plan includes written learner feedback, a case-based pre/post-test, and review of clerkship assessments for evidence of CI. Results: We produced an FS oncology module with an estimated engagement time of two hours, which students may complete over multiple sittings. The development team met monthly over the course of one year. Filming and editing cost $100/hour. Overall, the project required approximately 60 faculty person-hours and 12 instructional designer person-hours. The patients interviewed for the module expressed gratitude for sharing their stories with students. The student focus group yielded unanimously positive feedback about the content, the multimedia format, the level of FS covered, and the use of authentic patient videos to enhance clinical relevance. Students strongly preferred this module compared to prior online learning activities. Conclusions: This novel interactive module can serve as a model for development of clerkship curricula promoting CI. Module creation based on real patients resulted in authentic story-telling and enhanced FS relevance. Content development involving a clinician and a basic scientist aligned with CI goals. Limitations include the need for funding and instructional design assistance. A randomized controlled trial comparing a series of novel FS modules to older recorded lectures may demonstrate improved outcomes. Involving learners in curriculum development may decrease faculty burden and increase student interest in FS.
Transdisciplinary research in energetics and cancer (TREC) training program for early career investigators.
Authors: Irwin Melinda L. , Lowry Diana , Neuhouser Marian L. , Henry Curtis , Sears Dorothy , Schmitz Kathryn , Nebeling Linda , Ligibel Jennifer A. 
Published: June 2022

11031 Background: Given the rising prevalence of obesity, poor diet and physical inactivity, known in combination as “energy balance” or “energetics”, as well as their associations with cancer incidence and mortality, innovative research, clinical care and training of scientists are needed to lower the prevalence of these risk factors and in turn, lower cancer incidence and mortality rates. Methods: With NCI support (R25CA203650) from 2016-2021, we developed and offered an annual one-week, in-residence Transdisciplinary Research in Energetics and Cancer (TREC) Training workshop, followed by a yearlong mentoring program, that focused on energy balance and cancer research across the cancer control continuum. Results: We recruited, educated, trained and mentored 123 early career investigators (TREC Fellows) from 64 different institutions and from diverse academic backgrounds (i.e., 20% basic, 33% clinical and 47% population sciences) in transdisciplinary research in energetics and cancer. Fellows accepted to the TREC Training Program worked with more than 20 expert international TREC Faculty on developing grant applications and original research toward key gaps in energy balance and cancer research. TREC Fellows have published over 270 manuscripts in peer-reviewed journals, with at least 62 published manuscripts including the TREC Fellow as first or senior author and including a TREC Faculty and/or Fellow as co-author. Since completing the Program, TREC Fellows have received at least 31 extramural grants, as principal investigator. Building upon the strengths of the previous five years, we were awarded a competitive renewal to continue the TREC Training Program through 2026. TREC Training program goals are: (1) to continue to offer a TREC Training Program for ̃100 academically diverse early career investigators including a 5-day in-residence workshop focused on the Fellows research, networking, mentoring and professional development; (2) to evaluate the TREC Training Program and track TREC Fellows career development; and (3) to disseminate the TREC Training sessions, webinars and newsletter to the broader community of investigators. Conclusions: To our knowledge, no other in-residence training program exists that focuses on energetics and cancer research. Our vision is to continue the TREC mission of training scientists and clinicians to develop a cadre of well-trained, diverse researchers. The overall impact of this transdisciplinary training course will be defined by the degree to which TREC Fellows produce innovative research approaches and discoveries, thereby accelerating the dissemination and implementation of evidence-based approaches into everyday practice and patient care and improving the health of the population at risk for cancer as well as cancer survivors.
Are YouTube videos a reliable information source for young women with metastatic breast cancer?
Authors: Morena Nina , Ahisar Yitzchok , Wang Xena , Nguyen Diana , Rentschler Carrie A. , Meguerditchian Ari N. 
Published: June 2022

11042 Background: Young women with metastatic breast cancer (MBC) are an underserved population, rendering them susceptible to media sources that lack in credibility and reliability. YouTube (YT) is the most commonly used search engine following Google. This study aims to assess the quality of MBC YT videos and to identify common themes in MBC experiences. Methods: A systematic review of YT videos with search terms “metastatic breast cancer young” was conducted in 08/2021. Title, date uploaded, length, poster identity, number of likes, dislikes, and comments were collected. Understandability, actionability were assessed using the Patient Education Materials Assessment Tool (PEMAT) for audiovisual (A/V) materials; information reliability/quality was assessed with DISCERN. Scoring was done by 3 reviewers. Themes, presence of sponsorships, healthcare professionals’ and patients’ narratives were also reported. Results: 101 videos were identified. Of these, 78.2% were sponsored. Average video length was 14.9 minutes (SD 22.5). Majority were posted by nonprofit groups and breast cancer advocacy organizations. Mean PEMAT A/V score was 78.8% (SD 15.3) and 43.1% (SD 45.2) for understandability and actionability, respectively. Overall, videos had moderate reliability and quality levels; mean DISCERN score was 2.44/5 (SD 0.7). Patient narratives were shared in 63.3% and healthcare professionals in 57.4%. Identified themes include treatment (66.3%), family relationship (45.5%), motherhood (37.6%), terminal status (31.6%), the path to diagnosis (28.7%), and spousal relationship (24.7%). Conclusions: YouTube videos about MBC are highly understandable but demonstrate low to moderate rates of actionability, with low reliability and quality scores. Many have a potential commercial bias. More research is needed to evaluate their impact on patient decisions and possible interventions provided by healthcare institutions. [Table: see text]
#SurgOnc: Global discussions about surgical cancer care on Twitter during COVID-19.
Authors: Gereta Sofia , Patel Vishal R. , Mackert Michael , Haynes Alex Bernard 
Published: June 2022

11045 Background: Social media platforms such as Twitter are highly utilized to communicate about cancer care. Although surgery is the primary treatment for solid malignancies, little is known about public perceptions or communication behaviors regarding this treatment modality. Further, prolonged lockdowns and widespread delays of planned operations during the COVID-19 pandemic have magnified the importance of virtual communication about surgical cancer care. Methods: Tweets referencing cancer surgery were collected from January 2018 to January 2022 using Twitter’s Application Programming Interface. Account metadata was used to predict user demographic information and to compare tweeting metrics across users. Natural language processing models were applied to tweet content to resolve common topics of conversation and to classify tweets by cancer type. Results: There were 442,840 original tweets about cancer surgery by 262,168 users. Individuals accounted for most users (65%) while influencers accounted for the least (1.4%). Influencers made the most median impressions (19,139). Of 240,713 tweets discussing surgery for specific cancers, breast (20%) and neurologic (17%) cancers were most mentioned. When adjusting for national rates of procedures performed, tweets about surgery for neurologic cancers were the most common (231 tweets per 1000 procedures) whereas those for urologic cancers were the least common (15 tweets per 1000 procedures). Discussions about cancer surgery research made up 31% of tweets before the pandemic but only 11% of tweets during the pandemic. During the pandemic, concern regarding COVID-19 related delays was the most tweeted topic (23%). Cancer surgery research was most cited by oncologists, as well as in tweets about hepatopancreatobiliary and colorectal cancers. The cost of surgery was commonly mentioned in tweets about breast and gynecologic cancers and contained the most negative sentiment score (-0.7). Conclusions: Twitter was highly utilized to discuss surgical cancer care during the COVID-19 pandemic. During the pandemic, conversations shifted focus from research to survivorship and reflected real-time events such as COVID-19-related surgical delays. We identified the financial burden of cancer care as a commonly held concern among patients discussing cancer surgery on social media. Future public health outreach about cancer surgery may be optimized by coordinating with influencers and by targeting topics of concern like cost of surgery and undermentioned content like urologic cancers. Twitter’s role as a platform for research dissemination was disrupted by the COVID-19 pandemic, and further tracking is needed regarding online research discussions after the pandemic.
Evaluation of trends in breast cancer–related content on TikTok.
Authors: Siva Nanda , Koirala Monika , Raiker Rahul , Waris Shanawar , Pakhchanian Haig , Puckett Yana 
Published: June 2022

11046 Background: Social media plays an important role in disseminating information to patients. It is important to investigate the healthcare content on popular platforms to understand the material consumed by patients that may influence their medical decision making. TikTok has over 1 billion monthly active subscribers and has become common ground to communicate healthcare information, including that of breast cancer. This study aims to provide an analysis of breast-cancer related information on TikTok. Methods: The most popular TikTok hashtag related to breast cancer was identified, and the top videos were gathered on January 23, 2022. Data was collected to reach a target of 100 videos. Exclusion criteria were non-English videos, repeated videos, or upload of movie/tv clip without educational info. The video source was characterized based on healthcare role, gender, and race. Healthcare provider was defined as an individual with a professional medical degree (MD, PA, RN, other). The videos were categorized into patient experience, educational, advertisement, and other. Specific content components, including chemotherapy, surgical intervention, mammogram, and self-breast exam, were tracked. Results: The hashtag “#breastcancer” was identified as the most popular, with 773.8 million views. The videos had a combined 258,886,300 views, 31,573,400 likes, 413,604 shares, and 567,520 comments. Of the 100 videos analyzed, 91 were uploaded by a layperson, 2 by a healthcare professional, and 7 by a company. The healthcare professionals consisted of one OB/GYN and one general surgeon. The racial designations of the main subjects in the videos were 87.2% White, 3.2% Black, 2.1% Hispanic, 4.3% Asian, and 3.2% undetermined. Content categorization revealed 81% patient experience, 22% educational, 6% advertisement, and 8% other. The major topics presented in the videos related to surgical treatment (39%), chemotherapy (37%), and radiation treatment (2%). Conclusions: An overwhelming majority of breast cancer related information on TikTok was not presented by qualified healthcare professionals and exhibited a lack of cultural diversity and inclusivity.[Table: see text]