tbuckley/cabot-search huggingface dataset:
Adoption of immune checkpoint inhibitors (ICI) for unresectable locally advanced or metastatic urothelial carcinoma (u/mUC): A retrospective assessment of community oncology practices.
Authors: Kathleen M. Aguilar, Petros Grivas, Brian S. Seal, Nicholas J. Robert, Kalatu Davies, Mark T. Fleming
Journal: Journal of Clinical Oncology (2021)

293 Background: ICI approval provided new treatment options for patients (pts) with u/mUC. We aimed to assess the adoption of ICI and describe 1L treatment patterns in the US community oncology setting. We hypothesized that most pts would receive ICI either as first- (1L) or second- line (2L) treatment given their FDA approval indications within the study period. Methods: This was a retrospective study of all study-eligible adult pts with u/mUC who initiated 1L treatment between 5/1/16 – 11/30/18 within The US Oncology Network. Data were sourced from structured and unstructured electronic health record data through 5/31/19 and assessed descriptively. Results: Among 750 eligible pts, 327 received 1L ICI (median age 74, 72.5% men, 77.1% white, 27.2% never smokers, 63.6% Eastern Cooperative Oncology Group performance status (ECOG PS] score of 0/1) and 423 1L non-ICI agents (median age 72, 74.0% men, 84.2% white, 26.0% never smokers, 60.5% ECOG PS score of 0/1). The most common treatment sequences were 1L ICI or 1L non-ICI without 2L treatment (n = 301 [40.1%] and n = 197 [26.3%], respectively), followed by 1L non-ICI and 2L ICI (n = 176, 23.5%). Platinum-based chemotherapy was the most common non-ICI therapy. Among a subset of patients randomly selected for chart review who received 1L ICI (n = 70), the most common reasons for 1L discontinuation were death (22.9%), transition to hospice (21.4%) and disease progression (11.4%). In contrast, the most common reason for 1L discontinuation among patients who received 1L non-ICI therapy selected for chart review (n = 133) were toxicity (27.8%), disease progression (22.6%) and completion of planned treatment (19.5%). Conclusions: As a retrospective observational study, limitations include lack of randomization, missing data, selection bias and unmeasured confounders. The high proportion of pts who received ICI during this period suggests enthusiasm for new therapies with less toxicity than chemotherapy. Nonetheless, the high attrition across treatment lines indicates an unmet need for tolerable and effective 1L u/mUC therapies, including switch maintenance ICI, which recently emerged as the new standard of care with level I evidence. Further investigation is needed to understand factors considered by pts and providers when determining treatment, as well as prognostic and predictive biomarkers.
Utilization of palliative care services in patients who died from stage IV non-small cell lung cancer (NSCLC): A retrospective study from a tertiary care center in rural Maine.
Authors: Sheila Rajan, Anannya Patwari, Vineel Bhatlapenumarthi, Antoine Joseph Harb
Journal: Journal of Clinical Oncology (2021)

95 Background: It is known that palliative care involvement in metastatic NSCLC cancer patients has been shown to improve quality of life in previous studies. The aim of our study was to analyze the utilization of palliative care services among patients who died from NSCLC and the setting in which these patients first received palliative care. Methods: This is a retrospective chart review analysis of patients with stage IV NSCLC who were diagnosed at Eastern Maine Medical center and the affiliated cancer center who died between January 2016 and December 2018. We collected demographic data, date and stage of diagnosis, location of palliative referral, location of first palliative care contact with the patient, time between diagnosis and death, utilization of hospice services and time between the initial palliative care consult and death. Results: 255 patients with stage IV NSCLC died between 2016 and 2018. Mean age was 65.5 years. Women were 49% and men were 51%. Majority (60%) of patients had good performance status with ECOG score between 0-1 at presentation. All 255 patients were referred to palliative care. The location of initial palliative care referral following diagnosis was 40% from the hospital, 32% from the oncology clinic and 28% from the outpatient specialist or PCP office. Overall, 174 patients (68%) were seen by palliative care and 81 (32%) were not seen. Of the patients seen 119 (68%) had their initial palliative evaluation in the hospital, and 55 (32%) in the clinic. Majority (55%) had more than one follow-up visit. Consults initiated in the inpatient setting were more likely to be seen by palliative care than in the outpatient setting (p 0.0009). Time between diagnosis to palliative care consult was less than one month in 39%, 1-2 months in 25%, 2-6 months in 21%, and more than 6 months in 14% patients. Patients seen by palliative care had a more likelihood to end up on hospice (p 0.09). The majority of patients seen by palliative care (53%) died within a month of initial consultation. Conclusions: All patients in our study population were referred to palliative care with 100% provider compliance. Among these, 68% were seen by palliative care. Interestingly, inpatient referrals were more likely to be seen by palliative care than the outpatient referrals. We think this is likely related to ease of access to palliative care team in the hospital as well as some of the patients being at terminal stages of their disease. About 33% of patients died within a month of their initial diagnosis, likely giving palliative care team a shorter window of opportunity to be seen in the outpatient setting. Prioritizing referrals of stage IV NSCLC patients might decrease the wait time after initial referral and increase the availability of palliative care services to these patients.
Real-world EGFR testing patterns among U.S. patients with advanced NSCLC.
Authors: Julie Vanderpoel, Chris Pericone, Jinghua He
Journal: Journal of Clinical Oncology (2021)

298 Background: Guidelines recommend mutation testing prior to initiating first-line therapy (L1) for patients with advanced non-small cell lung cancer (aNSCLC), including testing for epidermal growth factor receptor (EGFR) mutations. Guidelines also recommend further testing after patients progress on targeted therapy to identify possible resistance mutations and inform selection of subsequent treatment. The present study characterized real-world (RW) EGFR testing patterns in aNSCLC patients. Methods: This retrospective observational cohort study evaluated an aNSCLC cohort (stage IIIB or higher) from the Flatiron Health database. Eligible patients were newly diagnosed, ≥18 years old, and received at least one line of therapy (LOT) during 2015-2020. Patients were followed to last activity, death, or end of the study period, whichever came first. Results: The final study cohort included a total of 22,726 patients. Of these, 17,165 (75.5%) had ≥1 EGFR test and 2,611 (15.2% of the tested study population) tested positive for EGFR mutations at any time during the study. The proportion of aNSCLC patients receiving EGFR testing prior to L1 initiation increased from 45.2% in 2015 to 56.6% in 2020. Among 11,791 patients who had an EGFR test prior to initiation of L1, 1,944 (16.5%) had positive results. Of these, the cumulative proportion of patients receiving a second EGFR test prior to L2, L3, and L4 (contingent on receiving the following LOT) was 36.3% (322 out of 888), 55.4% (241 out of 435), and 67.0% (146 out of 218), respectively. From 2015-2020, the median time from sample collection to EGFR test results decreased from 26 to 16 days for next generation sequencing (NGS) tests and from 17.5 to 12 days for polymerase chain reaction (PCR) tests. During this same period, the proportion of NGS EGFR tests increased from 27.6% to 75.0%. In addition, use of plasma samples for EGFR tests increased substantially (6.3% to 36.5%). Conclusions: The proportion of aNSCLC patients tested for EGFR mutations has increased over time (2015-2020). Median time to available EGFR test result has decreased for both NGS and PCR tests. NGS testing has become increasingly more common as has use of plasma samples. However, opportunities for improvement exist, including further increasing the proportion of patients tested prior to initiation of L1 therapy, as well as testing prior to the selection of subsequent therapy when indicated. As more targeted therapies emerge and resistance mutations to current therapies are further characterized, continued refinement of RW testing practices is required to optimize patient care.
Magnetic Resonance Elastography Reconstruction for Anisotropic Tissues
Authors: Behzad Babaei, Daniel Fovargue, Robert A. Lloyd, Renee Miller, Lauriane Jugé, Max Kaplan, Ralph Sinkus, David A. Nordsletten, Lynne E. Bilston
Journal: Medical Image Analysis (2021)

Elastography has become widely used clinically for characterising changes in soft tissue mechanics that are associated with altered tissue structure and composition. However, some soft tissues, such as muscle, are not isotropic as is assumed in clinical elastography implementations. This limits the ability of these methods to capture changes in anisotropic tissues associated with disease. The objective of this study was to develop and validate a novel elastography reconstruction technique suitable for estimating the linear viscoelastic mechanical properties of transversely isotropic soft tissues. We derived a divergence-free formulation of the governing equations for acoustic wave propagation through a linearly transversely isotropic viscoelastic material, and transformed this into a weak form. This was then implemented into a finite element framework, enabling the analysis of wave input data and tissue structural fibre orientations, in this case based on diffusion tensor imaging. To validate the material constants obtained with this method, numerous in silico phantom experiments were run which encompassed a range of variations in wave input directions, material properties, fibre structure and noise. The method was also tested on ex vivo muscle and in vivo human volunteer calf muscles, and compared with a previous curl-based inversion method. The new method robustly extracted the transversely isotropic shear moduli (G⊥', G∥', G″) from the in silico phantom tests with minimal bias, including in the presence of experimentally realistic levels of noise in either fibre orientation or wave data. This new method performed better than the previous method in the presence of noise. Anisotropy estimates from the ex vivo muscle phantom agreed well with rheological tests. In vivo experiments on human calf muscles were able to detect increases in muscle shear moduli with passive muscle stretch. This new reconstruction method can be applied to quantify tissue mechanical properties of anisotropic soft tissues, such as muscle, in health and disease.
No clinically relevant removal of meropenem by cytokine adsorber CytoSorb® in critically ill patients with sepsis or septic shock
Authors: Uwe Liebchen, Christina Scharf, Michael Zoller, Ferdinand Weinelt, Charlotte Kloft, Robin Michelet, Ines Schroeder, Michael Paal, Michael Vogeser, Michael Irlbeck, Josef Briegel, Johannes Zander, Wilhelm Huisinga
Journal: Intensive Care Medicine (2021)
P-50 Prognostic factors in patients receiving trifluridine/tipiracil for refractory metastatic colorectal cancer in the real-life setting: The ROS study
Authors: P. García-Alfonso, J. Reina Zoilo, E. Mata Velasco, M. Llanos, A. Illán Varella, M. Safont Aguilera, M. Delgado Ureña, C. Castañón, P. Pimentel, V. Alonso Orduña, J. Mendez, F. Rivera Herrero, I. Siso, J. Rodriguez-Pascual, C. Grávalos Castro, R. Afonso, I. Fernandez Rañada, R. Grández, M. Moreno, A. López Muñoz, B. García-Paredes, E. Aranda
Journal: Annals of Oncology (2021)
Embedding global access in development of future pandemic vaccines
Authors: Suerie Moon, Surabhi Agarwal, Anna Becker, Adrian Alonso Ruiz
Journal: BMJ (2021)

Faster, broader, fairer global access to covid-19 vaccines is needed now.Vaccines can protect lives and livelihoods, help end the pandemic, mitigate threats of increased impoverishment and inequality, and reduce the risk of new variants. 1It makes ethical, epidemiological, and economic sense to redistribute doses from high income countries, which have more than they can use and a disproportionate share of global supply, to low and middle income countries facing severe shortages. 2So does proactively transferring vaccine technology to help scale-up production in all regions so that no country has to go without.
Early-onset pulmonary and cutaneous vasculitis driven by constitutively active SRC-family kinase HCK
Authors: Veronika Kanderova, Tamara Svobodova, Simon Borna, Martina Fejtkova, Vendula Martinu, Jana Paderova, Michael Svaton, Jarmila Kralova, Eva Fronkova, Adam Klocperk, Stepanka Pruhova, Min Ae Lee-Kirsch, Ludmila Hornofova, Miroslav Koblizek, Petr Novak, Olga Zimmermannova, Zuzana Parackova, Anna Sediva, Tomas Kalina, Ales Janda, Jana Kayserova, Marcela Dvorakova, Milan Macek, Petr Pohunek, Petr Sedlacek, Ashleigh Poh, Matthias Ernst, Tomas Brdicka, Ondrej Hrusak, Jan Lebl
Journal: Journal of Allergy and Clinical Immunology (2021)
Oral versus Intravenous Antibiotics for Endocarditis
Authors: Jehan Chowdhury, Robin Patel, Henry Chambers
Journal: New England Journal of Medicine (2021)

This interactive feature about the treatment of endocarditis offers a case vignette accompanied by two essays supporting a full 6-week course of intravenous antibiotics or a switch from intravenous to oral antibiotics after several weeks.
Diabetes Status and Association With Risk of Tuberculosis Among Korean Adults
Authors: Jung Eun Yoo, Dahye Kim, Kyungdo Han, Sang Youl Rhee, Dong Wook Shin, Hyun Lee
Journal: JAMA Network Open (2021)

<h3>Importance</h3> The risk of tuberculosis (TB) associated with diabetes status, considering impaired fasting glucose or duration of diabetes, has not been well established. <h3>Objective</h3> To evaluate the association of diabetes status with the development of TB in the general population. <h3>Design, Setting, and Participants</h3> This population-based cohort study used data from the Korean National Health Insurance System database. Adult participants without a history of TB who underwent a health screening in 2009 were included. Eligible participants were followed up for incident TB cases from 1 year after the day of health screening until December 31, 2018. Data analysis was performed from September 2019 to September 2020. <h3>Exposures</h3> Five levels of diabetes status were evaluated: normal glucose, impaired fasting glucose (considered as without diabetes), new-onset diabetes, diabetes duration less than 5 years, and diabetes duration 5 years or longer (considered as having diabetes). <h3>Main Outcomes and Measures</h3> Newly diagnosed TB. <h3>Results</h3> Among 4 423 177 participants, the mean (SD) age was 46.5 (13.9) years, and there were 2 597 142 men (58.7%). A total of 26 458 participants (0.6%) received a diagnosis of TB within a median (interquartile range) of 8.3 (8.1-8.6) years of follow-up. An increased risk of TB was observed in participants with diabetes compared with those without diabetes (adjusted hazard ratio [aHR], 1.48; 95% CI, 1.42-1.53). Although participants with impaired fasting glucose did not show an increased risk of TB incidence (aHR, 0.97; 95% CI, 0.93-1.01), the risk of TB incidence increased with diabetes duration (new-onset diabetes, aHR, 1.32; 95% CI, 1.23-1.42; diabetes duration &lt;5 years, aHR, 1.45; 95% CI, 1.36-1.54; diabetes duration ≥5 years, aHR, 1.57; 95% CI, 1.48-1.66). Among participants with new-onset diabetes, compared with those in the lowest decile (fasting plasma glucose [FPG] level ≥126 but &lt;128 mg/dL), the risk of TB was significantly increased for those in the highest decile (FPG level ≥202 mg/dL, aHR, 1.79; 95% CI, 1.42-2.26). <h3>Conclusions and Relevance</h3> These findings suggest that longer diabetes duration is associated with development of TB, showing a dose-response association. Among participants with new-onset diabetes, incident TB was more common among those with FPG levels greater than or equal to 202 mg/dL.
Covid-19: Booster dose reduces infections and severe illness in over 60s, Israeli study reports
Authors: Elisabeth Mahase
Journal: BMJ (2021)

Covid-19: Booster dose reduces infections and severe illness in over 60s, Israeli study reports Elisabeth MahaseRates of infection and of severe illness were substantially lower in people aged over 60 who received a booster (third) dose of the Pfizer-BioNTech covid-19 vaccine than in those who had only two doses, Israeli researchers have reported. 1
NORMAL WEIGHT-CENTRAL OBESITY IS ASSOCIATED WITH THE HIGHEST MORTALITY RISK IN OLDER ADULTS WITH CORONARY ARTERY DISEASE
Authors: Saurabh Sharma, John Batsis, Virend Somers, Thais Coutinho, Ondrej Sochor, Charlotte Kragelund, Alka Kanaya, Marianne Zeller, Francisco Lopez-Jimenez
Journal: Journal of the American College of Cardiology (2014)
Author Correction: Low-count whole-body PET with deep learning in a multicenter and externally validated study
Authors: Akshay S. Chaudhari, Erik Mittra, Guido A. Davidzon, Praveen Gulaka, Harsh Gandhi, Adam Brown, Tao Zhang, Shyam Srinivas, Enhao Gong, Greg Zaharchuk, Hossein Jadvar
Journal: npj Digital Medicine (2021)
P14.49 Prescription preferences of antiepileptic drugs in brain tumor patients: an international survey
Authors: P B van der Meer, L Dirven, M J van den Bent, M Preusser, M J B Taphoorn, R Ruda, J A F Koekkoek
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND This study aimed at investigating antiepileptic drug (AED) prescription preferences in patients with brain tumor-related epilepsy (BTRE) among the European neuro-oncology community, the considerations that play a role when initiating AED treatment, the organization of care, and practices with regard to AED withdrawal. MATERIAL AND METHODS A digital survey containing 31 questions about prescription preferences of AEDs was set out among members of the European Association of Neuro-Oncology (EANO). RESULTS A total of 198 respondents treating patients with BTRE participated of whom 179 completed the entire survey. Levetiracetam was the first choice in patients with BTRE for almost all respondents (90% [162/181]). Levetiracetam was considered the most effective AED in reducing seizure frequency (72% [131/181]) and having the least adverse effects (48% [87/181]). Common alternatives for levetiracetam as equivalent first choice included lacosamide (33% [59/181]), lamotrigine (22% [40/181]), and valproic acid (21% [38/181]). Most crucial factors to choose a specific AED were potential adverse effects (82% [148/181]) and interactions with other antitumor treatments (76% [137/181]). In the majority of patients neuro-oncologists were involved in the treatment of seizures (73% [132/181])). Other relevant findings were that a minority of respondents ever prescribe AEDs in brain tumor patients without epilepsy solely as prophylaxis (29% [53/181]), but a majority routinely consider complete AED withdrawal in seizure free BTRE patients after antitumor treatment (79% [141/179]). CONCLUSION Our results show that among European professionals treating patients with BTRE levetiracetam is considered the first choice AED, with the presumed highest efficacy and least adverse effects.
P14.72 Involving patients and caregivers in the production of guidelines for palliative care in primary brain tumours: identification of intervention priorities
Authors: A Pace, A Solari, L De Panfilis, B Lissoni, E Pronello, R Rudà, A Silvani, A Salmaggi, R Merli, U De Paula, E Bertocchi, M Verza, S Veronese
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND Involving patients and caregivers is an important component of clinical guideline development. The three main Italian scientific associations for neurology, neuro-oncology and palliative care (SIN-AINO-SICP) recently appointed a joint task force (TF) of clinicians and researchers to develop specific guidance on palliative care of people with primary brain tumours, following the GRADE approach. To identify clinical questions meaningful to the patients and caregivers, a qualitative approach was used. MATERIAL AND METHODS Based on the existing literature and on consensus, the TF identified nine intervention areas, whose relevance was apprised by patients (via personal semi-structured interviews) and bereaved caregivers (via focus groups, FGs) from five tertiary neuro-oncology centres. Participants were prompted to provide their personal disease-related experience, and were asked to elicit the areas that mostly impacted their own lives. Interviews and FGMs were audio-recorded, transcribed and analysed using thematic analysis. RESULTS Twenty interviews and five FGs (28 caregivers) were completed between late 2020 and early 2021. Preliminary findings show that all the pre-specified areas were defined as important by participants. Most discussed topics were communication, organization and service satisfaction, cognitive and psychological issues, and advance care planning (ACP). Caregivers focused their discussions on the need for patient psychological support, difficulties experienced with symptoms control (e.g. epileptic seizures, behavioural changes), communication and organizational issues. CONCLUSION Participation of Italian patients with brain tumours and family caregivers was high and information-rich. All of the nine guideline intervention areas were considered important, communication, care organization, symptom control and ACP being the most discussed.
P-270 Impact of intestinal stoma on quality of life in Tunisian patients with colorectal cancer
Authors: R. Melliti, N. Ammar, A. Souilem, N. Sabrine, N. Bouzaabia, I. Chabchoub, F. Ezzairi, I. Belaid, M. Hochlef, L. Ben Fatma, H. Boussen, S. Ben Ahmed
Journal: Annals of Oncology (2021)