tbuckley/cabot-search huggingface dataset:
Electronic patient reported outcome in Brazil: Insurance provider impact on adherence.
Authors: Thiago William Carnier Jorge, César Filho, Melina Campagnaro, Lorenzo Cartolano, Jean Singh, Kamila Sena, Luiz Felipe dos Prazeres, Juliana Guerrero, Simone Ansarah
Journal: Journal of Clinical Oncology (2021)

e13590 Background: Routine monitoring of cancer patients' symptoms during their journey can improve symptom management, quality of life, and survival. Wecancer App is an electronic patient-reported outcome tool, which also provides on-demand multidisciplinary digital support by nurses, psychologists and nutritionists. It also encompasses real time remote patient monitoring, symptoms diary to patient and medical staff, symptom monitoring, medication control and a content hub with reliable information. It is free to any patient who download the app. In this study, we aim to understand if insurance provider type (private, public or out of pocket) impact on app adherence. Methods: This study examined daily symptom reporting (with electronic patient-reported outcomes [e-PROs]) patterns in breast cancer patients, according to insurance provider. The following were observed: app adherence, numbers of reports, chat interactions, specific symptoms, symptoms alerts and wellness reports. Patients could report sixteen common symptoms through a mobile application, on their smartphones and tablets, for monitoring, symptom management and follow-up with a specialized nurse, determining care based on digital support clinical protocols through online chat. The nursing team action started at the moment of patient inclusion with the tutorial to download the App and training it with the patient/caregiver. The alerts made through the chat system guided the clinical actions of the nursing team in relation to online clinical management that can stratify the risk by crossing the intensity of symptoms by the CTCAE grading scale and PRO-CTCAE Measurement System and promote preventive educational conduct of vigilance and risk mitigation. Results: From January 2020 to January 2021, 543 female eligible patients downloaded the app. The e-PRO completion rates were superior to 90% at baseline, and 55.47% completed all on-treatment assessments. The app adherence for private insurance patients (PIP), 37.06% for public insurance patients (PIP) and 7.45% for out of pocket patients (OPP). 2,626 reports were made (46.41% IP; 28.58% OPP; 25% PHP); 1008 chat interactions (52.18% IP; 40.28% PHP; 7.54% OPP); 1144 number of symptoms reported (46,41% IP; 28.58% OPP; 25% PHP); specific symptoms most reported in all kind of service was tiredness, pain, nausea, tingling; 547 symptoms alerts (54.84% IP; 35.46% PHP; 9.7% OPP) and 451 wellness reports (55.43% IP; 35.03% PHP; 9.53% OPP). Conclusions: Private insurance patients are more adherent to ePROS than public insured or out of pocket patients. Lack of free internet access and digital literacy could be impacting on adherence and, ultimately, quality of life and survival. Further studies are warranted to understand how to improve equality for digital health tools.
Guidelines Insights: Acute Lymphoblastic Leukemia, Version 1.2019
Authors: Patrick A. Brown, Matthew Wieduwilt, Aaron Logan, Daniel J. DeAngelo, Eunice S. Wang, Amir Fathi, Ryan D. Cassaday, Mark Litzow, Anjali Advani, Patricia Aoun, Bhavana Bhatnagar, Michael W. Boyer, Teresa Bryan, Patrick W. Burke, Peter F. Coccia, Steven E. Coutre, Nitin Jain, Suzanne Kirby, Arthur Liu, Stephanie Massaro, Ryan J. Mattison, Olalekan Oluwole, Nikolaos Papadantonakis, Jae Park, Jeffrey E. Rubnitz, Geoffrey L. Uy, Kristina M. Gregory, Ndiya Ogba, Bijal Shah
Journal: Journal of the National Comprehensive Cancer Network (2019)

Survival outcomes for older adults with acute lymphoblastic leukemia (ALL) are poor and optimal management is challenging due to higher-risk leukemia genetics, comorbidities, and lower tolerance to intensive therapy. A critical understanding of these factors guides the selection of frontline therapies and subsequent treatment strategies. In addition, there have been recent developments in minimal/measurable residual disease (MRD) testing and blinatumomab use in the context of MRD-positive disease after therapy. These NCCN Guidelines Insights discuss recent updates to the NCCN Guidelines for ALL regarding upfront therapy in older adults and MRD monitoring/testing in response to ALL treatment.
Associations between patient knowledge of others' experiences and treatment choice in men with localized prostate cancer.
Authors: Aaron J. Katz, Ying Cao, Xinglei Shen, Deborah Usinger, Sarah Walden, Ronald C. Chen
Journal: Journal of Clinical Oncology (2021)

6578 Background: Men with localized prostate cancer must select from multiple treatment options, without one clear best choice. Consequently, personal factors, such as knowing other prostate cancer patients who have undergone treatment, may influence patient decision-making. However, associations between knowledge about others’ experiences and treatment decision-making among localized prostate cancer patients has not been well characterized. We used data from a population-based cohort of localized prostate cancer patients to examine whether patient-reported knowledge of others’ experiences is associated with treatment choice. Methods: The North Carolina Prostate Cancer Comparative Effectiveness &amp; Survivorship Study (NC ProCESS) is a population-based cohort of localized prostate cancer patients enrolled from 2011-2013 throughout the state of North Carolina in collaboration with the North Carolina Central Cancer Registry. All patients were enrolled prior to treatment and followed prospectively. Patient decision-making factors including knowledge of others’ experiences with prostate cancer treatment options were collected through patient report. Patient treatment choice was determined through medical record abstraction and cancer registry data. Results: Among 1,202 patients, 17% reported knowing someone who pursued active surveillance (AS) while 28%, 46%, and 59% reported knowing someone who received brachytherapy, external beam radiation (EBRT), or radical prostatectomy (RP), respectively; 26% underwent AS, 9% brachytherapy, 21% EBRT, and 39% RP as their initial treatment. In unadjusted analyses, patients with knowledge of others’ experiences with brachytherapy, EBRT or RP had more than twice the odds of receiving that treatment compared to patients who did not. Knowledge of others’ experience with AS was not associated with choice to undergo AS. Multivariable analysis adjusting for age, race, risk group, and patient-reported goals of care showed knowledge of others’ experiences with brachytherapy (OR 4.60, 95% confidence interval [CI] 2.76 to 7.68), EBRT (OR 2.38, 95% CI 1.69 to 3.34), or RP (OR 4.02, 95% CI 2.84 to 5.70) was significantly associated with odds of receiving that treatment. The odds of receiving a particular treatment option were further increased among patients who reported knowing someone who had a “good” experience with the treatment in question. Conclusions: This is the first population-based study to directly demonstrate the impact of a patient’s knowledge of others’ experiences on treatment choice in prostate cancer. These data provide a new consideration to clinicians in their counseling of patients with newly diagnosed prostate cancer, and also impacts research into the informed decision-making process for this disease.
Real-world overall survival of patients diagnosed with recurrent versus de novo metastatic pancreatic ductal adenocarcinoma (PDAC).
Authors: Eileen Mary O'Reilly, Kenneth H. Yu, Neil Lamarre, Andy Surinach, Paul Cockrum
Journal: Journal of Clinical Oncology (2021)

e16250 Background: PDAC is a lethal malignancy which accounted for the third most cancer related deaths in 2020. Patients (pts) who are initially diagnosed with stage I-III PDAC have a 5-year relative survival of 13.3 – 39.4%; those with metastatic disease at diagnosis have a 5-year relative survival of 2.9%. Limited data are published comparing the outcomes of pts with stage I-III who develop metastases (recurrent) compared to pts with de novo mPDAC (de novo). This analysis seeks to compare demographic, clinical characteristics, and survival outcomes of pts with recurrent versus de novo mPDAC in a community oncology setting. Methods: Using the Flatiron Health database, a retrospective observational study was conducted abstracting deidentified data from ≥280 US cancer clinics. Pts with mPDAC diagnosed from 01/2016 to 08/2020 with a known stage at initial diagnosis were included. Pts were stratified based on initial stage at diagnosis. Median overall survival (OS) from time of metastasis was derived using Kaplan-Meier analysis. Unadjusted and multivariable Cox proportional hazards models were used to compare survival between recurrent and de novo cohorts. Results: N = 6,543 pts analyzed; 70.1% (n = 4,586) had de novo mPDAC and 29.9% (n = 1,957) had recurrent mPDAC. Median age at time of metastasis was similar for both cohorts: 69 years (IQR: 62 – 76). The most common site of primary tumor location was head for both cohorts (recurrent mPDAC: 69.8%; de novo mPDAC: 40.3%). Approximately 45% of pts with recurrent mPDAC underwent a Whipple procedure (pre diagnosis of metastasis). A similar proportion of pts in both cohorts received treatment in the metastatic setting (recurrent mPDAC: 74.3%; de novo mPDAC: 77.3%). Pts with recurrent mPDAC had a longer median OS compared to the de novo cohort: 8.0 months (95% CI: 7.5 – 8.6) versus 6.1 (95% CI: 5.7 – 6.4) [unadjusted hazard ratio (HR): 0.79 (95% CI: 0.74 – 0.84); adjusted HR: 0.73 (0.68 – 0.78), p &lt; 0.0001]. Conclusions: The results of this real-world study indicate that pts with recurrent mPDAC are more likely to have a head primary and to experience longer OS from time of metastasis than those with de novo mPDAC. These data suggest stratification for clinical trial enrollment for recurrent vs de novo is necessitated.
The timeliness of lung cancer care: A systematic review of systematic/scoping reviews on time intervals and their impacts on cancer outcomes.
Authors: Jianrong Zhang, Jasmeen Oberoi, Napin Karnchanachari, Paige Druce, Maarten J. IJzerman, Jon D. Emery
Journal: Journal of Clinical Oncology (2021)

e18572 Background: Lung cancer is characterized by the aggressive nature and lack of early noticeable symptoms, highlighting the importance of timely care for lung cancer. This systematic review of systematic and scoping reviews provides the summary of review-level results related to the length of time intervals and the impact of these intervals on oncological outcomes. Methods: Eligible articles included published systematic or scoping reviews and meta-analyses that used systematic searching to investigate the length of time intervals and their impact on patient survival and disease stage at diagnosis in original studies on lung cancer, based on at least one interval involving the date of diagnosis as the start/endpoint. Articles were searched via PubMed, Embase, Web of Science, and the Cochrane Library (date range: from database inception to 6 August 2020) (PROSPERO identifier: CRD42020203530). Results: From 1395 identified publications, we included a total of 8 systematic/scoping reviews published in 2002-2018 (7 on length of intervals, 5 on survival/stage impact). For the length of intervals, these reviews found that intervals across countries/medical facilities are heterogeneous and often longer than recommended by guidelines. For the survival/stage impact, the results from these reviews indicated mixed (positive, negative, or no) associations between time intervals and patient survival/disease stage at diagnosis. We further summarized study-level results and confirmed the finding of mixed associations based on 36 eligible original studies from over 100 studies included in these reviews. Methodologically, review authors pointed out large variations in time intervals (96 unique variations) and methods used to measure intervals. Based on the reviews, we found that the intervals in studies were normally investigated cross-sectionally, rather than temporarily (to demonstrate the trend of intervals’ length over time). Conclusions: Current evidence indicates that patients with lung cancer may experience diagnosis and treatment delays, however, the association results between the length of intervals and lung cancer survival and stage are paradoxical. To minimize avoidable delays, future studies should keep updating the length of intervals and provide the trend analysis of the intervals over time, as part of cancer surveillance to guide future policy making and clinical practice. To improve the quality of future original studies and systematic reviews, specific guidelines and corresponding studies related to study design and methodology (e.g. types of time intervals, measures of time intervals, statistical analysis strategy) are warranted, especially underscoring the effect of “waiting time paradox” when investigating the impact of time intervals on patient outcomes.
EpoR-tdTomato-Cre mice enable identification of EpoR expression in subsets of tissue macrophages and hematopoietic cells
Authors: Huan Zhang, Shihui Wang, Donghao Liu, Chengjie Gao, Yongshuai Han, Xinhua Guo, Xiaoli Qu, Wei Li, Shijie Zhang, Jingyu Geng, Linlin Zhang, Avital Mendelson, Karina Yazdanbakhsh, Lixiang Chen, Xiuli An
Journal: Blood (2021)
Non-coding RNAs in cardiac inflammation: key drivers in the pathophysiology of heart failure
Authors: Marida Sansonetti, Leon J De Windt
Journal: Cardiovascular Research (2021)

Heart failure is among the most progressive diseases and a leading cause of morbidity. Despite several advances in cardiovascular therapies, pharmacological treatments are limited to relieve symptoms without curing cardiac injury. Multiple observations point to the involvement of immune cells as key drivers in the pathophysiology of heart failure. In particular, there is a growing recognition that heart failure is related to a prolonged and insufficiently repressed inflammatory response leading to molecular, cellular, and functional cardiac alterations. Over the last decades, non-coding RNAs are recognized as prominent mediators of cardiac inflammation, affecting the function of several immune cells. In the current review, we explore the contribution of the diverse immune cells in the progression of heart failure, revealing mechanistic functions for non-coding RNAs in cardiac immune cells as a new and exciting field of investigation.
Eradication of neoplastic Barrett’s esophagus in patients with esophageal varices with a modified endoscopic mucosal resection technique and radiofrequency ablation
Authors: Hugo Uchima, Michel Blé, David Busquets, Isabel Serra, Carmen López, Xavier Aldeguer, Carlos Huertas
Journal: Endoscopy (2021)

Most patients with cirrhosis and portal hypertension eventually require liver transplantation. Esophageal neoplasia in this population (especially in patients who use alcohol and tobacco) might contraindicate liver transplantation. Early Barrett's neoplasia should be treated with endoscopic resection if there are no signs of advanced adenocarcinoma, and complete eradication of all remaining Barrett's epithelium should be striven for, preferably with radiofrequency ablation (RFA) [1]. However, these treatments may become challenging in patients with portal hypertension and esophageal varices, due to the risk of variceal bleeding and hepatic decompensation. Some reports have been published of endoscopic resection after a session of endoscopic variceal ligation, but without RFA for eradication therapy [2] [3]. We present a case series of three patients with esophageal varices and Barrett's neoplasia successfully treated with a modified endoscopic resection technique and RFA ([Table 1]).
Examining racial disparities in male breast cancer.
Authors: Elizabeth Shurell Linehan, Navendu D. Samant, Juleon W Rabbani
Journal: Journal of Clinical Oncology (2021)

6555 Background: Male breast cancer (MBC) accounts for approximately 1% of all breast cancers. Racial disparities have not been examined in MBC. Methods: Within a large, integrated health delivery system, all adult female and male patients who were diagnosed with breast cancer from 01-01-2010 to 12-31-2018 were examined. Bivariate analysis was performed to examine clinical and demographic factors associated with breast cancer-related mortality. We conducted more detailed chart review in the MBC-only group (data period 01-01-2010 to 12-31-2019) to assess the mean time to treatment (from diagnosis to surgery, surgery to chemotherapy, and surgery to radiation) stratified by race using bivariate (t-test, one way ANOVA) analyses. Results: 32,848 female breast cancer and 226 MBC patients were evaluated; MBC patients represented 0.63% of all breast cancer patients. Between males and females, there was no statistically significant difference in race, with an overall distribution of 62% White, 19% Asian, 8% Black, and 11% Hispanic. To our knowledge, this is the largest and most racially diverse sample of MBC patients to date. MBC patients at diagnosis were significantly older (p &lt;.0001), more obese (p &lt; 0.0018), and sicker according to the Charlson Comorbidity Index (CCI) (p &lt; 0.0001) compared to female breast cancer patients. Males were more likely to be diagnosed at an advanced stage (19.2%) compared to females (12.5%) (p = 0.0037). With a mean follow up of 5 years, overall mortality was statistically significantly worse in MBC (23.0%) compared to female breast cancer patients (12.0%) (p &lt; 0.0001). Furthermore, breast cancer-related mortality was significantly higher in males (8.1%) than in females (4.5%) (p = 0.0124). In the MBC-only analysis, stage at diagnosis was not influenced by patient race. Asian and White MBC patients had the shortest mean time from diagnosis to surgery (27 and 29 days, respectively), with Hispanic MBC patients experiencing the longest time to surgery (46 days). Black MBC patients experienced the shortest mean time to chemotherapy after surgery (39 days), whereas Asian MBC patients experienced the longest time to chemotherapy (50 days). In survivorship, Black and Asian patients were least likely to undergo screening mammography (33.3%, and 43.3%, respectively), compared to 52% of White and 50% of Hispanic MBC patients. Ultimately, 13% of Asian and 11% of Hispanic MBC patients died of breast cancer, compared to 6.7% of Black and 6.2% of White MBC patients. Conclusions: While we found no statistically significant differences in mortality by race among MBC patients, our findings indicate that non-white patients had longer time to treatments, less survivorship screening, and worse disease related mortality than their white counterparts. Future study can elucidate these racial inequalities, enabling more equitable breast cancer treatment among patient subgroups.
Germline testing and somatic tumor testing for <i>BRCA1/2</i> pathogenic variants in ovarian cancer: What is the optimal sequence of testing?
Authors: Janice S. Kwon, Anna Tinker, Jennifer Santos, Katie Compton, Sophie Sun, Kasmintan A. Schrader, Aly Karsan
Journal: Journal of Clinical Oncology (2021)

10585 Background: In 2020 ASCO recommended that all women with epithelial ovarian cancer have germline testing (GT) for BRCA1/2 mutations, and those without a germline pathogenic variant (PV) should have somatic tumor testing (TT), to determine eligibility for PARP inhibitor (PARPi) therapy (GT-TT strategy). An alternate strategy is to start with tumor testing first, and to conduct germline testing only in those with a PV in the tumor, or a significant family history (TT-GT strategy). The objective was to conduct a cost-effectiveness analysis comparing the 2 testing strategies. Methods: A Markov Monte Carlo simulation model compared the costs (USD) and benefits of the 2 testing strategies. According to local empiric data, a sufficient tissue sample for TT was available in 99% of cases, otherwise the patient would only have GT. Sensitivity of TT was 99% for detecting germline PV. Only those with BRCA1/2 PV were eligible for PARPi. Primary outcomes included the number of women eligible for PARPi, with progression-free years of life (PFLY) gained based on SOLO1 data, and the incremental cost-effectiveness ratio (ICER). Monte Carlo simulation estimated the number of women who would have GT and TT, and the total with germline or somatic BRCA1/2 PV eligible for PARPi. Sensitivity analyses accounted for uncertainty around various parameters. Results: The GT-TT strategy was more effective but more costly than TT-GT in identifying patients eligible for PARPi. Table summarizes the average lifetime costs, benefits, and Monte Carlo simulation estimates for 10,000 women diagnosed with advanced epithelial ovarian cancer annually in the USA. The incremental benefit from the GT-TT strategy would be achieved at substantial cost to the health care system, with an ICER of $119,340 per PFLY gained relative to the TT-GT strategy. The results were highly sensitive to the sensitivity of TT to detect germline PV, and the costs of GT and TT. Assuming that GT was less than 50% of the cost of TT, the sensitivity of TT had to exceed 98% for the TT-GT strategy to be cost-effective. Conclusions: Although the ASCO recommended strategy of BRCA germline testing followed by tumor testing for those without a pathogenic variant may be more effective in identifying ovarian cancer patients for PARP inhibitor therapy, it is more costly. The ASCO strategy is justified if the sensitivity of tumor testing is not sufficiently high. However, assuming high tumor testing performance rates, tumor testing first followed by germline testing if there is a PV in the tumor and/or family history is a cost-effective strategy.[Table: see text]
Impact of aging on selenium and glutathione levels in different lobes of the rat prostate
Authors: Arunangshu Das, Ana Calcagnotto, Cesar Aliaga, John Richie, Karam El-Bayoumy
Journal: Cancer Research (2008)

1249  In the USA prostate cancer (PC) is the 2nd leading cause of cancer related death in men. Aging is a major risk factor for PC development; however, the mechanisms responsible for this relationship are unclear. Deficiencies in trace elements including the antioxidant selenium are common during old age and preclinical and clinical investigations support the protective role of selenium against PC. Oxidative stress may be involved in the mechanisms linking selenium deficiency, aging, and PC as reduction in the major cellular antioxidant glutathione (GSH) commonly occur in aging tissues. In the present study we have compared the levels of selenium, GSH and protein-bound GSH (GSSP) in blood and prostate tissues in young (4-months), mature (12-months) and old (18-24 months) male F344 rats, fed Teklad 2014 diet. Of particular importance, each prostate lobe including dorsolateral (DL), anterior (AL) and ventral (VL) lobes were analyzed separately based upon their differing potential for PC development. At all ages, selenium levels were lowest in DL
Selected issues in sport-related concussion (SRC|mild traumatic brain injury) for the team physician: a consensus statement
Authors: Stanley Herring, W Ben Kibler, Margot Putukian, Gary S Solomon, Lori Boyajian-O'Neill, Katherine L Dec, R Robert Franks, Peter A Indelicato, Cynthia R LaBella, John J Leddy, Jason Matuszak, E Barry McDonough, Francis O'Connor, Karen Michelle Sutton
Journal: British Journal of Sports Medicine (2021)

Selected Issues in Sport-Related Concussion (SRC|Mild Traumatic Brain Injury) for the Team Physician: A Consensus Statement is title 22 in a series of annual consensus documents written for the practicing team physician. This document provides an overview of selected medical issues important to team physicians who are responsible for athletes with sports-related concussion (SRC). This statement was developed by the Team Physician Consensus Conference (TPCC), an annual project-based alliance of six major professional associations. The goal of this TPCC statement is to assist the team physician in providing optimal medical care for the athlete with SRC.