tbuckley/cabot-search huggingface dataset:
Mental health needs among parents of children with cancer: A commercial claims data analysis.
Authors: Xin Hu, Jordan Gilleland Marchak, Xu Ji
Journal: Journal of Clinical Oncology (2021)

e18722 Background: Caring for a child diagnosed with cancer may adversely affect mental health (MH) of parents. However, little is known about MH care needs among parents of pediatric cancer patients. This study examined the patterns of MH care for parents of children diagnosed with cancer, as compared to parents of children without cancer. Methods: We used MarketScan® Commercial Database to identify continuously-insured parents of children receiving therapy for leukemia, lymphoma, central nervous system, bone, or gonadal cancers (aged ≤21 years at diagnosis) in 2009-2017. We also identified parents who matched eligibility criteria but had no child with cancer (with a randomly-assigned, fictitious date of cancer diagnosis) as controls. Outcomes included parents’ visits related to a MH disorder (anxiety, depression, substance use disorder [SUD], post-traumatic stress disorder [PTSD]) during six months before to 12 months after their child’s cancer diagnosis. Multivariable regressions were estimated to compare MH visits between 9,870 parents of pediatric cancer patients and 3,396,097 parents in the control group, adjusting for sociodemographic factors (parents’ age and sex, rurality, region, number of children in household) and presence of MH history. Among parents of pediatric cancer patients, we explored sociodemographic factors, MH history, and clinical factors (children’s cancer types, age at diagnosis, therapeutic modalities) associated with MH-related visits in multivariable regression analyses. Results: While the likelihood of MH history was similar between the two groups, a higher proportion of parents caring for cancer patients than controls had any visits related to anxiety (13.1%% vs. 9.5%), depression (9.6% vs. 7.5%), PTSD (0.5% vs. 0.4%), or any MH disorders (22.0% vs. 17.6%). These differences persisted in adjusted analyses. For example, parents of cancer patients were 24%, 37%, and 27% ( p-values &lt; 0.001) more likely than controls to have any MH visits, anxiety-related visits, and depression-related visits, respectively. No difference was observed in SUD-related visits. Among MH care utilizers, no significant difference was observed in the number of MH visits. Among parents of cancer patients, those with MH history, mothers (vs. fathers), and parents of children with bone cancer (vs. leukemia) were more likely to have any MH visits ( p-values &lt; 0.05). Parents whose children received surgery only and those with ≥3 children in household were less likely to have any MH visits ( p-values &lt; 0.05). Conclusions: Parents of pediatric cancer patients have significantly higher needs for MH care as compared to the general parent population. Our finding underlines the importance of future interventions toward targeted MH counseling and supportive strategies for vulnerable parent groups, such as mothers and those caring for children undergoing more complex treatment plans.
Durvalumab with olaparib and paclitaxel for high-risk HER2-negative stage II/III breast cancer: Results from the adaptively randomized I-SPY2 trial
Authors: Lajos Pusztai, Christina Yau, Denise M. Wolf, Hyo S. Han, Lili Du, Anne M. Wallace, Erica String-Reasor, Judy C. Boughey, A. Jo Chien, Anthony D. Elias, Heather Beckwith, Rita Nanda, Kathy S. Albain, Amy S. Clark, Kathleen Kemmer, Kevin Kalinsky, Claudine Isaacs, Alexandra Thomas, Rebecca Shatsky, Theresa L. Helsten, Andres Forero-Torres, Minetta C. Liu, Lamorna Brown-Swigart, Emmanuel F. Petricoin, Julia D. Wulfkuhle, Smita M. Asare, Amy Wilson, Ruby Singhrao, Laura Sit, Gillian L. Hirst, Scott Berry, Ashish Sanil, Adam L. Asare, Jeffrey B. Matthews, Jane Perlmutter, Michelle Melisko, Hope S. Rugo, Richard B. Schwab, W. Fraser Symmans, Doug Yee, Laura J. van’t Veer, Nola M. Hylton, Angela M. DeMichele, Donald A. Berry, Laura J. Esserman
Journal: Cancer Cell (2021)
Biodegradation behaviour of Fe-based alloys in Hanks’ Balanced Salt Solutions: Part II. The evolution of local pH and dissolved oxygen concentration at metal interface
Authors: Cheng Wang, Christabelle Tonna, Di Mei, Joseph Buhagiar, Mikhail L. Zheludkevich, Sviatlana V. Lamaka
Journal: Bioactive Materials (2021)

Commercially pure Fe, Fe35Mn, and (Fe35Mn)5Ag alloys were prepared by uniaxial pressing of the mixture of individual powders, followed by sintering. The influence of the alloying elements Mn and Ag on the corrosion behaviour of these Fe-based alloys was investigated in Hanks' Balanced Salt Solution (HBSS). Furthermore, the role of the components in HBSS, particularly Ca
Efficacy of concurrent cetuximab (CTX) and nivolumab (NIVO) in previously untreated recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC).
Authors: Christine H. Chung, Nabil F. Saba, Conor Ernst Steuer, Jiannong Li, Priyanka Bhateja, Matthew Johnson, Jude Masannat, Maria Poole, Dirk Hoening, Feifei Song, Juan C. Hernandez-Prera, Helen Molina, Bruce Wenig, Joaquim Farinhas, Julie Ann Kish, Jameel Muzaffar, Kedar Kirtane, James William Rocco, Michael J. Schell, Marcelo Raul Bonomi
Journal: Journal of Clinical Oncology (2021)

6017 Background: Current standard of care for patients (pts) with previously untreated R/M HNSCC that are incurable is either pembrolizumab (pembro) with/without chemotherapy depending on the Programmed Death-Ligand 1 (PD-L1) combined positive score (CPS). We evaluated the combination of CTX and NIVO for its efficacy. Methods: Pts were treated with CTX 500 mg/m2 IV on Day (D) -14 as a lead-in followed by CTX 500 mg/m2 IV and NIVO 240 mg/m2 IV on D1 and D15 every 28-D cycle (C). Pts with CTX infusion reaction or who did not receive C1D1 for any reason were non-evaluable and replaced. NIVO dose reduction was not allowed. Results: Fifty-four evaluable pts were analyzed. Median age was 62 (42-85). ECOG performance status at baseline was 0 (20, 37%), 1 (30, 56%), and 2 (4, 7%). Primary sites were oral cavity 19 (35%), oropharynx 22 (41%), hypopharynx 3 (6%), larynx 9 (17%), and unknown primary 1 (2%). p16 status is positive 22 (41%), negative 29 (54%), and unknown 3 (6%). PD-L1 CPS is &lt; 1 in 6 (11%), &gt;1 in 26 (48%), and unknown 22 (41%). Median follow up time for overall survival (OS) was 12.2 months. The most common grade 3 treatment-related adverse events (TRAEs) occurring in ≥2 pts were hypomagnesemia 2 (4%), hypophosphatemia 2 (4%), fatigue 4 (7%), and rash-acneiform 4 (7%). The only grade 4 TRAEs were hypomagnesemia in 1 (2%) and CTX infusion reaction in 1 (2%). The most common grade 3 immune-related adverse event (IRAE) occurring in ≥2 was fatigue 2 (4%). No grade 4 IRAEs is observed. Median progression-free survival (PFS) and OS were 7.8 and 14.5 months, while 1-year PFS and 1-year OS were 39% and 61%, respectively. There were no statistically significant differences in either PFS and OS based on tumor p16 or PD-L1 status. Conclusions: The clinical trial met its primary endpoint of 1-year OS. Our data indicate the combination of CTX and NIVO is safe and effective in pts with previously untreated incurable R/M HNSCC. Clinical trial information: NCT03370276.
Association of a Sweetened Beverage Tax With Purchases of Beverages and High-Sugar Foods at Independent Stores in Philadelphia
Authors: Sara N. Bleich, Caroline G. Dunn, Mark J. Soto, Jiali Yan, Laura A. Gibson, Hannah G. Lawman, Nandita Mitra, Caitlin M. Lowery, Ana Peterhans, Sophia V. Hua, Christina A. Roberto
Journal: JAMA Network Open (2021)

The relationship between a sweetened beverage tax and changes in the prices and purchases of beverages and high-sugar food is understudied in the long term and in small independent food retail stores where sugar-sweetened beverages are among the most commonly purchased items.
Priming immunotherapy with radiotherapy (RT) in advanced non-small cell lung cancer (NSCLC) and head and neck squamous cell cancer (HNSCC): Interim analysis of phase II clinical trial.
Authors: Aasems Jacob, Alexander Kreimer, Jing Wei, Jianrong Wu, Lauren Corum, Ellen Reusch, Jerold Woodward, Donald Cohen, Subbarao Bondada, Val R. Adams, Rachael Morgan, Ronald C. McGarry, William H. St Clair, Mahesh R. Kudrimoti, Zin Myint, Susanne M. Arnold, John L. Villano
Journal: Journal of Clinical Oncology (2021)

2628 Background: Preclinical models demonstrate that combined RT with immune checkpoint inhibitor (ICI) results in specific CD8+ T-cell phenotype associated with a tumor-reactive population resulting in significant tumor response. Sequential treatment could allow radiation to release tumor antigens from immune inaccessible areas and provide robust anti-tumor immune response with ICI. We report an interim analysis of the phase II clinical trial evaluating the efficacy and safety of the combination. Methods: Advanced NSCLC and HNSCC patients who had initiated on FDA approved single-agent ICI were eligible. Patients were given SBRT (BED&gt;100Gy) or 30 Gy fractionated RT delivered as a 3-dimensional dose to a single metastatic site within 14 days of the first ICI dose. Primary objective was 6-month PFS and secondary objectives were safety and tolerability, 1Y PFS and OS. This interim analysis was done after enrollment of 43 patients. Results: Between 10/2017 to 1/2021, 43 patients were enrolled, and 38 included in this analysis. Median age was 62 years; 26 patients were male. 9 patients received ICI for NSCLC as first-line, 7 for NSCLC second-line and 22 for HNSCC second-line. 24 patients received pembrolizumab and 14 nivolumab; 21 had SBRT and 17 fractionated RT. Median follow up duration was 11.8m (range: 2.7 - 31.4m) for patients without progressive disease (PD). 10 patients were off-study, 7 continuing treatment. 15 died and 26 had PD. 14 patients died of malignancy and cause of death for one patient was unknown. 6-month PFS was 49.19% with median PFS of 5.5 months. (table) Fifty-two grade-3-5 adverse events (AEs) were reported among 21 subjects. Most common were transaminitis (n=15), lymphopenia (n=8), and GI side effects (n=4). Treatment related AEs included 19 grade-3 events, and none were grade 4/5. Two grade-5 AEs were from PD (oral bleeding and unspecified). There were 20 grade-1/2 and 3 grade-3 immune related adverse events (IRAEs). No grade-4/5 IRAEs were reported. Two patients discontinued treatment due to grade 3 transaminitis. Conclusions: Interim analysis shows that 6m PFS was acceptable with majority of patients being second-line metastatic HNSCC who historically had mPFS of 2.1-2.3 months and mOS 7.7-8.4 months in Checkmate-141/KEYNOTE-040 trials. Hence, the combination is of further interest and accrual will continue to reach the goal. The combination therapy was tolerable without unexpected AEs. Majority of deaths were from disease progression. No treatment related grade 4/5 adverse events were reported. Two patients discontinued treatment due to grade-3 IRAE. Clinical trial information: NCT03313804. [Table: see text]
Effect of induction intensity on survival in patients with acute myeloid leukemia.
Authors: Kieran Sahasrabudhe, Melanie Rebechi, Ying Huang, Gregory Behbehani, Bhavana Bhatnagar, James Stewart Blachly, Bradley Wayne Blaser, Uma Borate, Ramiro Garzon, Tamanna Zohra Haque, Karilyn T.M. Larkin, Meixiao Long, Alice S. Mims, Ayman A. Saad, Sumithira Vasu, Alison R. Walker, Sarah Allison Wall
Journal: Journal of Clinical Oncology (2021)

e19004 Background: Acute Myeloid Leukemia (AML) has traditionally been treated frontline with intensive induction chemotherapy in patients fit enough for this treatment. The FDA has approved several oral targeted therapies for AML in recent years. The survival impact of these agents vs induction chemotherapy is unknown. Methods: In this single-center, retrospective study, patients diagnosed with AML from 2015-2020 were included if they received treatment with either high intensity chemotherapy (HiC) or lower intensity targeted therapy (LITT). HiC was defined as a regimen containing cytarabine + anthracycline given on a “7+3” based schedule. Patients treated with liposomal cytarabine-daunorubicin were excluded. LITT was defined as venetoclax, gilteritinib, enasidenib, or ivosidenib alone or in combination with a hypomethylating agent. Patients fell into four groups: HiC only, LITT only, HiC followed by LITT, and LITT followed by HiC with assignment censored at transplant. Overall survival (OS) was estimated using Kaplan-Meier method and patients receiving any HiC vs LITT only were compared using log-rank test. Results: A total of 332 patients were included: 177 received HiC only, 116 LITT only, 32 HiC before LITT, and 7 LITT before HiC. Baseline characteristics and OS data are outlined in the table. The any HiC group had a lower median age and more patients with WBC &gt;10 K/µL at diagnosis, as well as more patients receiving allogeneic hematopoietic cell transplant (HCT). OS was superior in the any HiC group vs LITT only group. Receipt of any HiC remained predictive of OS after adjusting for age (HR 0.65, 95% CI 0.44-0.96, p = 0.03); however, was no longer predictive of OS after adjusting for age and receipt of HCT. Conclusions: While HiC was associated with superior OS compared to LITT only treatment in univariable analysis, the survival benefit was no longer apparent after adjusting for age and receipt of HCT. The results suggest that intensity of AML treatment is less impactful on prognosis than ability to receive HCT. Differences in age were likely confounded by clinical trial eligibility and prescribing information specifically affecting patients receiving LITT. In the era of LITT, prospective randomized studies of intensity of AML therapy, particularly in non-favorable risk disease, are imperative to striking a balance between toxicity and cure for patients of all ages.[Table: see text]
Circulating tumor DNA fraction (ctDNA%) to independently predict for clinical outcomes in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC).
Authors: Corinne Maurice-Dror, Nicolette Fonseca, Cameron Herberts, William Fan, Alexander W. Wyatt, Kim N. Chi
Journal: Journal of Clinical Oncology (2021)

5049 Background: CtDNA% (the tumour-derived proportion of cell-free DNA (cfDNA)) is abundant in &gt;60% of mCRPC pts and associates with adverse clinical prognostic factors. However, prognostic associations have not been comprehensively tested across clinical contexts. We evaluated the utility of ctDNA% as an independent prognostic biomarker in patients with mCRPC prior to first-line (1L) therapy. Methods: 410 treatment-naïve mCRPC pts had blood samples drawn prior to 1L therapy and followed prospectively for outcomes. Plasma cfDNA was subjected to deep targeted sequencing and ctDNA% was calculated using validated methods ( Annala, Cancer Discov, 2018 ). Overall survival (OS), PSA progression free survival (PSA PFS) and PSA declines ≥50% from baseline (PSA50 response rate (RR)) were stratified by ctDNA% and compared using Kaplan-Meier and Cox proportional hazards analysis. Results: Median age was 73 yrs. (range 45-98), the majority of pts had ECOG PS 0-1 (78%) and 9.5% had liver metastases at baseline. The most common 1L therapy employed was androgen receptor pathway inhibitors (90%). Median follow-up was 21 mo. (range 1-75) and median ctDNA% was 4.9% (range: 0-89%). Stratifying patients into high ctDNA (&gt;30%) and Low ctDNA (≤2%) groups showed stronger association with OS and PSA PFS than grouping by median (Table). In a univariate comparison to pts with low ctDNA (≤2%), pts with high ctDNA% (&gt;30%) had significantly shorter median PSA PFS, median OS and a lower PSA50 RR (Table). In a multivariable adjustment for clinical prognostic factors and cfDNA concentration, high ctDNA% remained strongly associated with OS (HR= 3.3, 95%CI: 2.1-5.3, p&lt;0.001) and PSA PFS (HR: 3.7, 95%CI: 2.4-5.9, p&lt;0.001). Although ctDNA% and total cfDNA concentration were correlated (R 2 =0.55), association with OS was stronger for ctDNA% than cfDNA concentration (stratified at median; HR: 2.9 (2.3-3.7), p&lt;0.001 vs HR: 2.1 (1.7-2.6), p&lt;0.001). Conclusions: In a large cohort of treatment-naïve mCRPC pts, ctDNA% prior to 1L treatment provided strong prognostic information independent of known clinical factors. These data further demonstrate the multipronged clinical utility of ctDNA-based profiling for actionable genomic alterations.[Table: see text]
Investigation of prognostic factors for second-line treatment with nivolumab for unresectable or recurrent esophageal cancer.
Authors: Takashi Ogata, Nozomu Machida, Kosuke Takahashi, Kazuki Kano, Keisuke Koumori, Hayato Watanabe, Hirohito Fujikawa, Takanobu Yamada, Yasuhiro Inokuchi, Mitsuhiro Furuta, Yoshihiro Kaneta, Kei Hayashi, Ayaka Ishida, Takashi Oshima
Journal: Journal of Clinical Oncology (2021)

e16055 Background: Nivolumab, an immune-checkpoint inhibitor for unresectable or recurrent esophageal cancer is used as second-line treatment. On the other hand, the relationship between indicators of cancer immunity (GPS, NLR, PLR), indicators of nutritional status (PNI, BMI), and prognosis of patients treated with nivolumab is unclear. Methods: We investigated the prognostic factors of nivolumab for unresectable or recurrent esophageal cancer. The subjects were 62 patients who received nivolumab as a second-line or later treatment for unresectable or recurrent esophageal cancer before January 2021. Of these 13 patients had previously been treated with taxan. We used GPS (Glasgow prognostic score), NLR (Neutrophil-Lymphocyte Ratio: cutoff value is 3.5), PLR (Platelet-Lymphocyte Ratio: cutoff value is 200), PNI (Prognostic nutrition index: cutoff value is 40), BMI (Body mass index: cutoff value is 18.5 for under 70 years old, and 20 for over 70 years old defined by Asian GLIM standard) as prognostic indicators. We examined the association between age, gender, PS, GPS, NLR, PLR, PNI, BMI and prognosis in patients treated with nivolumab. And we also examined the relationship between the history of taxan administration, the presence of adverse events and the prognosis. Results: Of the 62 cases, 48 cases were male and 14 cases were female. The median age was 70 years. Median OS was 359 days, and median PFS was 97 days. OS in patients with no prior taxan treatment group was significantly longer (P&lt;0.05). AE appeared in 49 cases (79%), and irAE appeared in 22 cases (35.5%). OS in patients with irAE was significantly longer (P&lt;0.01). PS (0/1/2) was 27 cases/33 cases/2 cases, and GPS (0 point/1 point/2 point) was 41 cases/11 cases/10 cases. NLR high was 35 cases, and NLR low was 27 cases. PLR high was 31 cases and PLR low was 31 cases. PNI high was 46 cases and PNI low was 16 cases. BMI normal or high was 27 cases and BMI low was 35 cases. In univariate analysis of OS, GPS (P&lt;0.001), NLR (P&lt;0.01), PS (P&lt;0.05), PNI (P&lt;0.001) showed a significant difference in survival, and in multivariate analysis, PS (p&lt;0.05) and PNI (P&lt;0.05) were significant prognostic factors. Conclusions: PS and PNI were good prognostic factors with nivolumab after second or later treatment for unresectable or recurrent esophageal cancer.
Characteristics, management and outcomes of patients with hepatocarcinoma in a low-income country.
Authors: Jennifer Dominguez, Bonnie Macario, Rixci Ramirez, Mario Daniel Castro
Journal: Journal of Clinical Oncology (2021)

e16166 Background: Worldwide, every year, there are nearly 905,000 patients diagnosed with liver cancer; it is the sixth most common malignancy and the third most lethal malignancy. Almost three quarters of new patients live in areas with low and medium-income country. Guatemala has the highest mortality and incidence of liver cancer. Objectives: Describe the clinical characteristics, main risk factors, treatment and outcomes of patients with hepatocarcinoma (HCC) in Guatemala. Methods: A retrospective review was performed among patients with HCC from January 2002 to December 2019 in the Instituto Guatemalteco de Seguridad Social (IGSS). Kaplan Meier curves, Cox regression and log-rank test were used to calculate overall survival (OS) and mortality. Results: 140 patients with HCC were analyzed, 114 women and 26 men with a median age of 60 years (20 - 99), 102 patients (73%) have history of excessive alcohol consumption and 11 (8%) has history of chronic hepatitis B or C virus infection. All of the patients have liver cirrhosis, Child-Pugh A 100 patients (71%), B 34 (24%) and C 6 (5%). 10 patients (7%) have HCC BCLC A, 0 (0%) BCLC B, 121 (81%) BCLC C and 9 (6%) BCLC D. All patients with HCC BCLC A received surgical treatment with a median OS of 123 months (95% CI 89 - 156 p &lt; 0.001). 122 patients (89%) received target therapy with Sorafenib with a median OS of 17 months (95% CI 12 - 21 p &lt; 0.001) and 8 patients (6%) underwent to chemoembolization with a median OS of 32 months (95% CI 12 - 52 p &lt; 0.001). At this time, 111 patients (79%) died from the disease, 11 (8%) are alive with the disease and 8 (6%) are alive without disease. Conclusions: The most frequent risk factor for HCC is the excessive alcohol consumption, survival of patients with HCC are associated with treatment at the beginning of the disease.
Feasibility of an adapted schedule of carboplatin plus paclitaxel in elderly women with advanced ovarian cancer: A retrospective cohort.
Authors: Benjamin Nicaise, Soraya Mebarki, Mathilde Gisselbrecht, Elisabeth Ashton, Henri Azais, Meriem Koual, Anne-Sophie Bats, Laure Fournier, Marie-Aude Le Frère - Belda, Jacques Medioni, Elena Paillaud, Stephane Oudard, Nicolas Delanoy
Journal: Journal of Clinical Oncology (2021)

5546 Background: The EWOC-1 trial compared Carboplatin monotherapy (C mono) to two different Carboplatin + Paclitaxel (CP) regimens (weekly or 3-weekly) in vulnerable elderly patients treated for advanced ovarian cancers (OC). This study was closed prematurely because of a worse outcome in the C mono group. Both CP regimens were equivalent in terms of feasibility and efficacy with different toxicity profiles. Optimal CP regimen in elderly patient is still unknown. Here we propose a study of another adapted regimen of CP (aCP) performed in elderly patients in our institution. Methods: We retrospectively analyzed OC patients ≥ 70 years who received a Carboplatin AUC 4-5 d1q3week + Paclitaxel 80 mg/m² d1-d8 q3week regimen between 2015 and 2019. Primary endpoint was treatment feasibility according to the EWOC-1 standard: completion of 6 courses of chemotherapy without early stopping for disease progression, death or unacceptable toxicity (adverse event (AE) related to chemotherapy or treatment procedure leading either to early treatment stopping, to an unplanned hospital admission or to death or to a dose delay lasting more than 14 days or more than 2 dose reductions). Results: We identified 36 pts with a median age of 79 years (table). All patient but one had an ONCODAGE-G8 score ≤ 14, 30.6% of patients had a comorbidity Charlson’s index &gt; 4 and 52.5% had an albumin rate &lt; 35 g/L. The feasibility endpoint was met in 58.3% of patients (IC95% = [25.6; 57.8]). Main causes of treatment failure (TF) were early discontinuation because of toxicity in 6 patients (16.7%) and progressive disease in 3 patients (8.33%). Median PFS was 35.3 months (IC95% = [22.7; NR]) and median OS was 62.1 months (IC95% = [31.4.0; NR]). The most frequent AE were asthenia (all grades = 94.4%, grade 3-4 = 13.9%), anemia (all grades = 94.4%, grade 3-4 = 27.8%), neutropenia (all grades = 66.7%, grade 3-4 = 38.9%) and neuropathy sensory (all grades = 61.1%, no grade 3-4). Non high-grade-serous histological type and a poor Charlson’s score were associated with a higher rate of TF (100% and 63.6%, respectively). Conclusions: These results are consistent with the findings of the EWOC-1 trial in both CP regimens and suggest that aCP could be non-inferior with an acceptable toxicity profile. Further prospective and comparative studies are mandatory to confirm this trend and to better identify predictive factors of TF in OC elderly patients.[Table: see text]