tbuckley/cabot-search huggingface dataset:
Using blood wisely in oncology patients: An institutional analysis of the Choosing Wisely Canada restrictive transfusion strategy guidelines.
Authors: Megan Elizabeth Tesch, Mae Alghawas, Alina S. Gerrie
Journal: Journal of Clinical Oncology (2021)

10 Background: Numerous studies support the safety of single-unit red red blood cell (RBC) transfusions and restrictive pre-transfusion hemoglobin (Hg) thresholds (≤ 70-80 g/L) among diverse populations of hospitalized patients, including those with malignancies on myelosuppressive systemic therapy. Using Blood Wisely is a national Choosing Wisely Canada (CWC) initiative that challenges hospitals to benchmark themselves on evidence-informed restrictive transfusion strategies, with the aim to decrease inappropriate RBC transfusions in Canada. We assessed transfusion practices among oncology inpatients at BC Cancer Vancouver Centre as part of this initiative and performed an exploratory analysis among outpatients. Methods: BC Cancer Vancouver RBC transfusion records were obtained for the period of October 2019-September 2020. The percentage of single-unit transfusions and transfusions for Hg ≤ 80 g/L were measured, to assess adherence to CWC targets of ≥ 65% and ≥ 80%, respectively, for these metrics. Univariate analyses were used to compare treatment variables and transfusion outcomes. Results: During the 1-year audit period, 120 inpatient and 586 outpatient RBC transfusions occurred. For inpatient transfusions, 40.8% (n = 49) were single-unit and 79.2% (n = 95) were for Hg ≤ 80 g/L. For outpatient transfusions, 11.8% (n = 69) were single-unit and 65.7% (n = 304) were for Hg ≤ 80 g/L. Outpatients and patients with solid malignancies were more likely to receive multiple-unit transfusions, compared to inpatients (p &lt; 0.001) and patients with hematological malignancies (p &lt; 0.001), respectively. Patients with solid malignancies and those on active treatment were more likely to be transfused when Hg was &gt; 80 g/L, compared to patients with hematological malignancies (p = 0.004) and those off treatment (p = 0.003), respectively. Multiple RBC units were more likely to transfused when the interval from pre-transfusion bloodwork to receipt of transfusion was &gt; 3 days (p = 0.029). Conclusions: A high rate of inappropriate RBC transfusions are being ordered for oncology patients at our institution, in discordance with CWC restrictive transfusion strategy guidelines. Quality improvement interventions are planned to adopt best practices in transfusion medicine in this high-use population.[Table: see text]
Adaptive immunity and neutralizing antibodies against SARS-CoV-2 variants of concern following vaccination in patients with cancer: the CAPTURE study
Authors: Annika Fendler, Scott T. C. Shepherd, Lewis Au, Katalin A. Wilkinson, Mary Wu, Fiona Byrne, Maddalena Cerrone, Andreas M. Schmitt, Nalinie Joharatnam-Hogan, Benjamin Shum, Zayd Tippu, Karolina Rzeniewicz, Laura Amanda Boos, Ruth Harvey, Eleanor Carlyle, Kim Edmonds, Lyra Del Rosario, Sarah Sarker, Karla Lingard, Mary Mangwende, Lucy Holt, Hamid Ahmod, Justine Korteweg, Tara Foley, Jessica Bazin, William Gordon, Taja Barber, Andrea Emslie-Henry, Wenyi Xie, Camille L. Gerard, Daqi Deng, Emma C. Wall, Ana Agua-Doce, Sina Namjou, Simon Caidan, Mike Gavrielides, James I. MacRae, Gavin Kelly, Kema Peat, Denise Kelly, Aida Murra, Kayleigh Kelly, Molly O’Flaherty, Lauren Dowdie, Natalie Ash, Firza Gronthoud, Robyn L. Shea, Gail Gardner, Darren Murray, Fiona Kinnaird, Wanyuan Cui, Javier Pascual, Simon Rodney, Justin Mencel, Olivia Curtis, Clemency Stephenson, Anna Robinson, Bhavna Oza, Sheima Farag, Isla Leslie, Aljosja Rogiers, Sunil Iyengar, Mark Ethell, Christina Messiou, David Cunningham, Ian Chau, Naureen Starling, Nicholas Turner, Liam Welsh, Nicholas van As, Robin L. Jones, Joanne Droney, Susana Banerjee, Kate C. Tatham, Mary O’Brien, Kevin Harrington, Shreerang Bhide, Alicia Okines, Alison Reid, Kate Young, Andrew J. S. Furness, Lisa Pickering, Charles Swanton, Sonia Gandhi, Steve Gamblin, David L. V. Bauer, George Kassiotis, Sacheen Kumar, Nadia Yousaf, Shaman Jhanji, Emma Nicholson, Michael Howell, Susanna Walker, Robert J. Wilkinson, James Larkin, Samra Turajlic
Journal: Nature Cancer (2021)

Abstract Coronavirus disease 2019 (COVID-19) antiviral response in a pan-tumor immune monitoring (CAPTURE) ( NCT03226886 ) is a prospective cohort study of COVID-19 immunity in patients with cancer. Here we evaluated 585 patients following administration of two doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after two doses were 85% and 59% in patients with solid and hematological malignancies, respectively. A lower proportion of patients had detectable titers of neutralizing antibodies (NAbT) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOC) versus wild-type (WT) SARS-CoV-2. Patients with hematological malignancies were more likely to have undetectable NAbT and had lower median NAbT than those with solid cancers against both SARS-CoV-2 WT and VOC. By comparison with individuals without cancer, patients with hematological, but not solid, malignancies had reduced neutralizing antibody (NAb) responses. Seroconversion showed poor concordance with NAbT against VOC. Previous SARS-CoV-2 infection boosted the NAb response including against VOC, and anti-CD20 treatment was associated with undetectable NAbT. Vaccine-induced T cell responses were detected in 80% of patients and were comparable between vaccines or cancer types. Our results have implications for the management of patients with cancer during the ongoing COVID-19 pandemic.
Competence Is About Skill, Not Procedure Case Numbers—Reply
Authors: Amanda C. Purdy, Christian de Virgilio, Farin Amersi
Journal: JAMA Surgery (2021)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
P-194 Study of efficacy and safety of combination of octreotide acetate LAR with lenvatinib as second-line therapy in patients with advanced G1-G2 NETs of non-pancreatic origin
Authors: V. Goel, N. Patnaik, V. Talwar, K. Chaudhari, V. Koyyala, P. Goyal
Journal: Annals of Oncology (2021)
Interdisciplinary clinician perspectives on an embedded palliative oncology model in pediatric cancer care.
Authors: Marta Salek, Cameka Woods, Jami S. Gattuso, Belinda Neal Mandrell, Justin N. Baker, Erica Kaye
Journal: Journal of Clinical Oncology (2021)

9 Background: Integration of palliative care into cancer care is recognized as best practice by international oncology and pediatrics organizations. However, optimal strategies for integration of pediatric palliative care (PPC) within cancer care remain understudied. While the majority of PPC provision for cancer patients occurs through subspeciality consultation, growing evidence suggests that models embedding PPC within cancer care have the potential to improve quality of care. Embedded models rely on partnerships with multidisciplinary clinicians, whose perspectives regarding this model are not well known. Methods: We conducted 25 focus groups with 175 clinicians in an academic pediatric cancer center, with groups stratified by discipline (physicians, advance practice providers (APPs), nurses, psychosocial providers) and by care team (hematologic malignancy, bone marrow transplant, solid tumor, brain tumor). Focus groups were led by trained research facilitators and audio-recorded for subsequent targeted content analysis to identify clinician perspectives regarding embedded PPC models. Results: Across 4 physician, 5 APP, 12 nurse, and 4 psychosocial focus groups, 25 physicians, 30 APPs, 71 nurses, and 49 psychosocial providers participated, respectively. When asked to describe features of an “ideal” PPC model, physicians, APPs, and nurses predominantly discussed care delivery and identified early integration of PPC into cancer care as a core feature of an ideal model. Physicians, nurses, and psychosocial providers also emphasized the importance of having a formalized, structured care model. The need for collaboration was the dominant theme for psychosocial providers. Clinicians in all disciplines identified potential benefits from an embedded model, including access to PPC across care settings, normalization of PPC integration, and emphasis on collaboration, teamwork, communication, and earlier PPC involvement. Physicians, APPs, and nurses anticipated similar challenges with an embedded model, including possible reticence of oncology providers and inadequate PPC staffing. Nurses, APPs, and psychosocial providers also voiced concern about potential lack of clarity in delegation of roles and responsibilities between PPC and oncology providers. Conclusions: Pediatric oncology multidisciplinary providers recognize the potential value of an embedded model for integration of PPC in the care of children with cancer. Though providers at times identified similar themes with respect to ideal PPC provision and the benefits and challenges to an embedded model, some identified priorities varied by discipline. These findings highlight the importance of integrating varied interdisciplinary perspectives when developing an embedded care model to align with priorities of diverse pediatric cancer stakeholders.
Efficacy of camrelizumab (SHR-1210) plus apatinib with or without stereotactic body radiotherapy (SBRT) as higher-line therapy for advanced <i>EGFR</i>-mutant non-small cell lung cancer (NSCLC).
Authors: Rui Meng, Lu Wu, Kai Zhang, KuiKui Zhu, Gang Wu, Li Liu
Journal: Journal of Clinical Oncology (2021)

e21128 Background: Despite the dramatic response of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) as first-line treatment for EGFR-mutant NSCLC, the development of resistance is inevitable. The application of third-generation EGFR TKIs is increasing, of which the resistance mechanism is unknow. To date, the optimal strategy has not been defined after failure of EGFR TKIs. Several studies reported the tumor immunogenicity is higher in patients with poor response to EGFR TKIs, suggesting that they may benefit from immunotherapy. Moreover, other studies showed that apatinib (a VEGFR2 TKI) and radiotherapy might augment anti-tumor activity of immunotherapy. In the present study, we reported the efficacy of camrelizumab (an anti-PD-1 antibody) plus apatinib with or without SBRT as higher-line therapy for EGFR-mutant NSCLC. Methods: In this single-arm trial, immunotherapy-naive, NSCLC patients aged 18-75 years, with EGFR-sensitizing mutations, and progression after at least one kind of EGFR TKI were enrolled. All patients received intravenous camrelizumab (200 mg, D1) plus oral apatinib (250mg daily, 5 days on, 2 days off) for a 21-day cycle until disease progression or intolerable toxicity. SBRT (24-30 Gy in three fractions) to at least one metastatic site was completed in some patients. SBRT was decided by the investigator, and patients should have at least one unirradiated lesion to monitor out-of-field response. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall response rate (ORR), and safety. Results: Up to Feb 1, 2021, 24 eligible patients were enrolled. Seven patients were excluded because of treatment discontinuation. Thirteen evaluable patients were included in the efficacy analysis. One had received osimertinib and three had received osimertinib after gefitinib resistance. All patients were previously treated with at least one lines of chemotherapy after EGFR TKI resistance. Eight patients received radiotherapy before enrollment. The median follow-up was 3.5 months (range: 0.7-7.8 months). The median number of cycles was 5 (3-11) PFS and OS data were immature. ORR and disease control rate was 15% (2/13) and 62% (8/13), respectively. Three received SBRT, with ORR of and no disease progression. Conclusions: Camrelizumab plus apatinib with or without SBRT as higher-line therapy showed benefit to patients with EGFR-mutant NSCLC. For patients treated with SBRT, the regimen may have better efficacy. Further investigation is warranted. Clinical trial information: ChiCTR1900028363.
The benefits and burdens of patient advocacy.
Authors: Shelley Fuld Nasso, Laura Diane Porter, Kristen K. McNiff Landrum
Journal: Journal of Clinical Oncology (2021)

204 Background: Patient advocates share their time and experience to improve cancer research, care, and support. Advocacy can be rewarding and empowering, and survivors and caregivers express a variety of reasons for engaging in advocacy. Yet, advocacy can also come with mental and emotional costs. Challenges include the grief of losing friends to cancer, the related “survivors’ guilt”, and the burden of repeatedly reliving their experience. The National Coalition for Cancer Survivorship (NCCS) conducted a survey to better understand the experience of patient advocates, and actions that organizations can take to recognize and support advocates. Methods: NCCS convened two focus groups with 10 advocates (the “working group”) to understand factors that contribute to advocates feeling rewarded or burned out from advocacy. We reviewed the transcripts to identify themes and reviewed the literature. We developed a survey and included a validated, non-proprietary, single-item burnout measure used for health care professionals. We built the survey online and tested with select working group members. We disseminated the survey to NCCS’ advocacy network, and working group members shared with their networks. Results: As of June 1, we received 176 responses, with the survey will open for another week. The initial data show that the vast majority of respondents find their advocacy work rewarding (97%), empowering (93%), and a positive impact on their lives (96%). At the same time, 29.5% of respondents indicated they have symptoms of burnout, including emotional and physical exhaustion. Respondents report that their advocacy work results in exhaustion (50.7%), sadness (41.1%), and anxiousness (28.7%). More than a third (36.7%) said that grief makes it hard to maintain their work as advocates. A majority manage the demands of their advocacy work by practicing self-care (66.6%) and using coping strategies (62.5%). Advocates shared the specific practices and strategies they used. Less than half (42.5%) said they set boundaries between their advocacy work and their personal life. The final analysis of the survey data will be complete by the end of June 2021. Conclusions: The phrase, “Nothing about us, without us,” has guided the inclusion of patient and caregiver voices in the design of research, care delivery, research grant review, quality measurement, and other aspects of cancer care and cancer research. Yet organizations that ask for the mental and emotional labor of advocates, including patient organizations, researchers, health care professionals, government institutions, and pharmaceutical companies, should understand the costs to advocates and how to best support them. As one respondent said, “Perhaps organizations could set the stage for this work by openly validating the toll that cancer itself takes, and acknowledge that advocacy takes energy and commitment, which may not always be possible to sustain in the face of ongoing treatment or other life complications.”
New predictive factors for prolonged operation time of laparoscopic posterior retroperitoneal adrenalectomy; retrospective cohort study
Authors: Cheong-Sil Rah, Won Woong Kim, Yu-mi Lee, Ki-Wook Chung, Jung-Min Koh, Seung Hun Lee, Suck Joon Hong, Tae-Yon Sung
Journal: International Journal of Surgery (2021)
Cancer backlog could take till 2033 to clear without more consultants, says report
Authors: Gareth Iacobucci
Journal: BMJ (2021)

Clearing the backlog of cancer cases missed during the covid pandemic could take the NHS more than a decade without an ambitious recovery plan and an increase in the number of consultant oncologists, policy experts have warned.

A report from the think tank the Institute for Public Policy Research and CF, a health consultancy and data analytics company, estimated that even if hospitals could maintain activity levels 5% above pre-pandemic levels it would still take until 2033 to clear the backlog of patients across the cancer care pathway.1

The report forecasts that cancer backlogs could be cleared by next year if activity levels were increased and maintained at 15% …
OS11.5.A PATZ1 fusions define a novel molecularly distinct CNS tumor entity with a broad histological spectrum
Authors: K T Al Halabi, P Sievers, D Stichel, A C Sommerkamp, M Sill, N Jäger, A Wittmann, C Kramm, M Snuderl, S M Pfister, A von Deimling, F Sahm, D T W Jones
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND DNA methylation profiling has emerged as a useful tool for robust classification of rare CNS tumors with a broad morphological spectrum. Routine diagnostic molecular profiling performed in Heidelberg and at international collaborating centers revealed a small but recurring number of CNS tumors with fusions of the PATZ1 gene coupled to either MN1 or EWSR1, displaying a distinct genome-wide methylation profile; indicating that these tumors could form a seperate biological entity. MATERIAL AND METHODS We obtained genome-wide DNA-methylation array profiling of 68 primary CNS tumors. RNA-sequencing was perfomed on (n=23/68, 34%) of the tumor samples, including (n=6) from fresh frozen tissue used for gene expression profiling. For n=3 cases, whole exome sequencing (WES) data was generated, and gene panel sequencing data was available for n=13 cases, We systematically reevaluated the histopahthological features of 14 tumors, while immunohistochemical (IHC) staining with Ki-67, GFAP, MAP2, NeuN, Olig-2, Synaptophysin, S-100 and Vimentin was performed for (n=12) tumors. We finally collected clinical data to preliminarily characterize this novel tumor entity. RESULTS A selected analysis of the tumors in this novel cohort (n=68), compared with a reference cohort consisting of 15 other low- and high-grade glial and glioneuronal tumor classes, confirmed a clearly distinct grouping. No similarity was seen with the MN1:BEND2 and MN1:CXXC5-fused CNS-tumors. Analysis of Copy number profiles derived from the DNA-methylation data showed a mostly quite genome, with (n=64/65, 98%) of tumors showing copy number variations on Chromosome 22. RNA-sequencing detected PATZ1 fusions in all tumors sequenced (n=12; MN1:PATZ1, n=11; EWSR1:PATZ1). IGF2, PAX2 and GATA2, all genes involved in brain stem cell biology, were upregulated compared to a combined reference cohort of other glioma subtypes. DNA-sequencing showed no relevant alterations at the level of point mutations or small insertions/deletions. The tumors in our cohort showed polyphenotypic histologies along the glial spectrum, with a subset of tumors being diagnosed as Gliobastoma, WHO Grade 4 and bi- and multiphasic differentaion patterns being evident. IHC performed on tissue available did not favor a particular lineage, with most tumors showing immunopositivity to GFAP. Reverse translation of the gene expression data showed a potential role for NG2 as immunostaining marker. The median age was 11.0 years (0–80), (MN1:PATZ1 manifested at a younger age (median = 4 years) vs EWSR1:PATZ1 (median = 14 years)). Median PFS was 12 months. CONCLUSION We describe here a novel, molecularly distinct CNS tumor class with strikingly variable histopathologic morphology. We postulate that the PATZ1 fusions are a key driver of tumor initiation. Preliminary indications suggest an intermediate prognosis.
Epigenetic Rewiring of BCR Signaling as a Novel Mechanism of Ibrutinib Resistance in ABC-DLBCL
Authors: Laura Pasqualucci
Journal: Blood Cancer Discovery (2021)

Summary: In this issue of Blood Cancer Discovery, Schaffer and colleagues uncover a novel epigenetic mechanism of resistance to the Bruton tyrosine kinase inhibitor ibrutinib in activated B-cell–like diffuse large B-cell lymphoma (ABC-DLBCL), whereby tumor cells rewire the B-cell receptor (BCR)–driven NF-κB signaling cascade through the small GTPase RAC2. This circuit can be efficiently targeted by RAC1/2 small-molecule inhibitors, suggesting a promising new therapeutic approach to overcome acquired ibrutinib resistance in ABC-DLBCL and possibly other B-cell malignancies relying on active BCR signaling. See related article by Shaffer et al., p. 630.