tbuckley/cabot-search huggingface dataset:
Development of equity, diversity, and inclusion competencies in residents and faculty in oncology through formal and informal learning.
Authors: Shivani Dadwal, Marjan Govaerts
Journal: Journal of Clinical Oncology (2024)

9053 Background: In recent years, a growing body of literature has suggested that patients need their clinicians to provide culturally competent care. A focus on integrated and longitudinal training within the domains of equity, diversity and inclusion (EDI) is needed to equip physicians to meet patients’ needs. Oncology is one such specialty that needs strong skillsets in EDI given its vulnerable and complex patient populations. This study explores how physicians within oncology learn about the domains of EDI through formal and informal learning. Methods: Using constructivist grounded theory (CGT), this study explores EDI competency formation at one academic center – the Juravinski Cancer Center in Hamilton ON, Canada. A purposive sample of 16 staff and resident physicians was taken to incorporate variation sampling - including a variety of ages, genders, and work/training experience. Participants were from both medical and radiation oncology. Semi-structured one-on-one interviews were conducted. Transcripts were generated, anonymized, and analyzed iteratively. Data analysis followed stages of open, axial, and selective coding through which themes were constructed. Interviews were continued until data saturation was reached. Results: Of the 16 participants, there was an even distribution between men (8) and women (8). Mean age was 43 (range 30-65). There were 5 residents and 11 faculty members. 9 were from medical oncology and 7 from radiation oncology. The major themes generated from the study were: the relationship between EDI competencies and professional identify formation, the role of culture and context in influencing exposure and learning about EDI, and the relationship between formal and informal learning opportunities. Conclusions: This study is the first to explore of how oncologists presently develop EDI competencies through formal and informal learning. The study has discovered the role of professional identify formation as a factor influencing learning, the impact of the culture and context of medicine, and the significant interplay between formal and informal learning in developing EDI skillsets. While much learning takes place informally, informed by clinical encounters and personal experiences, there is a need to marry the informal learning opportunities to more structured formal teaching in the training and clinical environment. [Table: see text]
AI in oncology: Resident perspectives by gender and tech literacy.
Authors: Fernanda Malucelli Favorito, Laura Collie, Thomas Kennedy, Jacqueline J. Nabhen, Amir Safavi, Giovanni G Cerri, Fabio Ynoe de Moraes
Journal: Journal of Clinical Oncology (2024)

9055 Background: The integration of AI and ML in oncology demands that physicians adapt and grasp the basics for responsible use. We evaluated AI knowledge and perspectives among Canadian oncology residents, noting differences by program, gender, and tech literacy, and pinpointing education gaps. Methods: An ethics-approved survey collected anonymous responses from Canadian oncology residents, analyzing gender, program, and tech skills. Descriptive statistics, cross-tabs, and chi-square tests assessed associations; t-tests and Mann-Whitney tests compared groups. Results: A total of 57 (31%) residents and fellows, out of an estimated 182, participated, with representation from each oncology training program in Canada. Most of participants were male (63.2%) and most participants self-identified as white (42.1%) or Asian (22.8%). RO programs were better represented than MO programs (68.5% vs 31.6%) with balanced representation across all years of training. In our survey, women equally favored Medical Oncology (MO) and Radiation Oncology (RO) at 50%, but were more in MO (55.6%) than RO (26.3%). Men preferred RO (77.8%) over MO (22.2%). Tech literacy showed a gender gap, with more men (91.7%) feeling tech-savvy than women (8.3%). Tech-savvy respondents leaned towards RO (84%) and were younger (30 vs 33 years). They also showed more willingness to use AI, with a significant difference in willingness scores (1.52 vs 2.06). Despite gender not influencing AI attitudes significantly, tech literacy correlated with better AI understanding. High awareness of AI in medicine was reported (91.2%), with a strong belief in AI's future prevalence (96%). The majority were willing to use AI (86%) and recognized the need to understand it (74%). RO participants were more inclined towards AI education and usage than MO counterparts. The study highlighted a significant interest in AI learning (73%), with a preference for workshops (79%). Only 29% could describe AI, indicating a gap in AI education, despite 63% acknowledging its importance in training. Formal AI training was rare (12.3%), with a desire for more education, especially among RO residents. All findings had p&lt;0.05. Conclusions: Canadian oncology residents anticipate AI's growing influence in medicine but face educational deficiencies. Gender, program preference, and tech literacy impact attitudes toward AI, highlighting the need for inclusive education to bridge gaps and foster diversity in AI's medical application.
Exploring the digital footprint: Social media use among hematology oncology fellowship programs in the U.S.
Authors: Charan Thej Reddy Vegivinti, Rahul Kumar Thakur, Shreeja Shikhrakar, M Bakri Hammami, Barun Ray, Kiranmayi Kakumani, Abhishek Kumar
Journal: Journal of Clinical Oncology (2024)

9048 Background: Social media platforms have emerged as pivotal tools for communication, outreach, and engagement. This study aims to assess the adoption and utilization of social media among Accreditation Council for Graduate Medical Education (ACGME) accredited Hematology Oncology (HO) fellowship programs, examining the correlation between program characteristics and social media presence. Methods: A comprehensive review was conducted of all ACGME-accredited HO fellowship programs to identify their presence on popular social media platforms, Twitter/X and Instagram. Collected metrics included the presence of official accounts, the date of creation, and follower counts as of February 2023. Additional details such as university affiliation, program size, and geographic location were also gathered to understand their influence on social media usage. Results: Out of 183 programs, 54 programs (29.5%) were found to be using Twitter, while 21 programs (11.5%) had an Instagram presence. Of these, 9 programs (4.9%) had a dual presence. Regional analysis revealed that the East North Central region had the highest Twitter/X presence, with 14 programs (25.9%), while on Instagram, the Pacific region led with 5 programs (23.8%). A significant association was observed between program type (university vs. community) and Twitter/X use. Programs with a higher number of fellowship positions (four or more) were more likely to use social media. In the period post-2021, approximately 20 programs adopted Twitter, and 15 began using Instagram. Descriptive statistics, including median values and interquartile ranges for posts, followers, and accounts followed, along with verification percentages, are detailed in the accompanying table. Conclusions: The use of social media within HO fellowship programs is a strategic tool for increasing program visibility and engaging with the next generation of medical professionals. The findings highlight a predominant use of social media in larger, possibly more resource-endowed programs, and suggest that these platforms may be an effective medium for recruitment in a digital age. This study emphasizes the significance of social media in the contemporary recruitment landscape and lays the groundwork for future research on its impact on program attractiveness and applicant selection processes in the medical field. [Table: see text]
Unraveling CASTOR1's tumor suppressive role: Genetic ablation of CASTOR1 and KRAS-driven mouse model of non-small cell lung cancer.
Authors: Xian Wang, Shenyu Sun, Suet Kee Loo, Luping Chen, Ling Ding, Tingting Li, Man-Tzu Wang, Timothy F. Burns, Laura P. Stabile, Shou-Jiang Gao
Journal: Journal of Clinical Oncology (2024)

8528 Background: Cytosolic Arginine Sensor for mTORC1 Subunit 1 (CASTOR1) has emerged as a potent suppressor of mTORC1 activity, playing a pivotal role in various cancer contexts. Previously implicated as a tumor suppressor in multiple cancers, CASTOR1 is tightly regulated in cancer, including inhibition by viral miRNAs in KSHV-induced cancer and degradation via AKT-phosphorylation and RNF167-mediated ubiquitination. Notably, CASTOR1's role extends beyond normal cellular contexts, as evidenced by its tumor-suppressive function in breast cancer xenograft models and its prognostic value in lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC). This study aims to elucidate CASTOR1’s role in a transgenic Kras-driven LUAD mouse model, shedding light on its tumor-suppressive potential. Methods: Utilizing a novel CASTOR1 knockout (KO) mouse model crossed with the Kras (LSL-KrasG12D/+) NSCLC model, we established a new mouse model with simultaneous Kras activation and homozygous CASTOR1 ablation. Tumor incidence and growth were monitored in Kras mice harboring wild-type (WT) and KO CASTOR1. Further investigations examined the proliferative dynamics and activation status of various oncogenic pathways, and assessed mTORC1 inhibitor sensitivities in human LUAD cell lines with altered CASTOR1 expression levels. Results: CASTOR1 deficiency markedly heightened lung tumor incidence and size, concomitant with an elevated proliferative index. Intriguingly, a novel antibody identified robust pCASTOR1 levels in CASTOR1 WT mouse LUAD tumors, positively correlated with tumor stage and inversely related to total CASTOR1 abundance, hinting at an active degradation mechanism promoting tumor progression. Elevated mTORC1 signaling, evidenced by increased levels of p4EBP and pS6, underscored the pathway's activation consequent to CASTOR1 loss, likely driving tumor development. Furthermore, heightened pERK levels in CASTOR1 KO tumors unveiled a novel feedback loop intertwining CASTOR1/mTORC1 and the Kras/ERK pathway. Notably, treatment with mTORC1 inhibitors sensitized organoids of Kras tumors with mTORC1 hyperactivation to Kras G12D inhibitor. Conclusions: Our findings elucidate CASTOR1's tumor-suppressive role in Kras-dependent mouse LUAD tumors, suggesting the potential efficacy of combined Kras and mTORC1 inhibition in LUAD subsets characterized by hyperactivated Kras and diminished CASTOR1 levels or mTORC1 hyperactivity.
Educational intervention to facilitate clinician-patient discussions of lung cancer biomarker testing at safety net and non-safety net centers.
Authors: Julia R. Trosman, Nikki A. Martin, Mary Pasquinelli, Frank Weinberg, Thomas William Lycan, Ruth Lauren Sacks, Jennifer Woodyard, Kevin Prescott, Paramjeet Grewal Khosla, Ashley Lile, Latha Shivakumar, Ann Ann Fish-Steagall, Marin Sorgi, Arliene Ravelo, Christine B. Weldon
Journal: Journal of Clinical Oncology (2024)

9023 Background: Biomarker testing is critical for optimal therapy selection in non small cell lung cancer, but it takes time and may delay treatment, causing patient anxiety and dissatisfaction. Patients want to understand the necessity and timing of biomarker testing and therapy decisions, but clinicians find these discussions challenging, especially with lower health literacy patients. As a solution, we deployed 4R Oncology model (4R = Right Info/Care/Patient/Time) at 10 centers (4 safety net, 6 non safety net). Under 4R, clinicians discuss with patients a Care Sequence, a predeveloped care checklist with visual timing of care, emphasizing biomarker testing within the overall care plan. It includes social and supportive care to address Social Determinants of Health (SDOH). Methods: Interviews with clinicians to examine whether / how Care Sequence helped discuss the need and timing for biomarker testing with patients, including lower health literacy patients. The cohort of clinicians (N=18) included oncologists, fellows and nurses; 10 worked at safety net centers. Results: All clinicians reported that Care Sequence helped explain timing of biomarker testing and the need to wait for results (Table). The majority reported that it helped discussions with lower literacy patients and to train fellows how to discuss these issues and place related referrals. These benefits and most of the rationale were reported at a similar rate by safety net and non safety net clinicians. Conclusions: The 4R Care Sequence is a promising educational tool that helps clinicians, including fellows, manage patients’ awareness and expectations for timing of biomarker testing and therapy decisions in lung cancer. The benefits in discussions with lower health literacy patients at both safety net and non safety net centers suggest that 4R can address disparities in patients’ understanding of these complex issues and may reduce anxiety while awaiting treatment. [Table: see text]
Efficacy and safety of sigvotatug vedotin, an investigational ADC, in NSCLC: Updated phase 1 results (SGNB6A-001).
Authors: Solange Peters, Antoine Hollebecque, Kartik Sehgal, Juanita Suzanne Lopez, Emiliano Calvo, Afshin Dowlati, Bruno Bockorny, Cesar Augusto Perez, Rachel E. Sanborn, Amita Patnaik, Elisa Fontana, Vladimir Galvao, Ed Kingsley, Gabriela Patilea-Vrana, Tianhua Wang, Scott Knowles, Sarina A. Piha-Paul
Journal: Journal of Clinical Oncology (2024)

8521 Background: Integrin beta-6 (IB6), a tumor-associated membrane protein, plays an important role in pathogenesis and invasiveness and its expression correlates with poor outcomes. Sigvotatug vedotin (SV), formerly called SGN-B6A, is an IB6-directed ADC with encouraging activity in NSCLC in the Ph 1 study SGNB6A-001 (NCT04389632) (Hollebecque 2023). Here, we report updated efficacy and safety of SV in NSCLC. Methods: SGNB6A-001 is an open-label, multicenter, Ph 1 study evaluating the safety, pharmacokinetics (PK), and antitumor activity (cORR, DOR, and PFS per RECIST v1.1, and OS) of SV in patients (pts) with advanced solid tumors. Multiple dose regimens were explored during dose escalation (Part A). Dose expansion (Part B) is ongoing with selected regimens in various tumors including NSCLC. Parts C and D will evaluate SV in combination with pembrolizumab in NSCLC and HNSCC. Eligible pts had no therapeutic options (Part A) or had received platinum-based and anti-PD-(L)1 therapy unless contraindicated (Part B) and were dosed with the SV expansion regimens on D1 and D8 in a 21-day cycle (2Q3W; 1.2/1.25 mg/kg total body weight [TBW]) or D1 and D15 in a 28-day cycle (2Q4W; 1.5 mg/kg TBW, 1.8 mg/kg adjusted ideal body weight [AiBW]). Results: As of 01-Dec-2023, 306 pts had received SV; 113 pts with NSCLC received expansion regimens in Parts A and B. Prior lines of therapy and efficacy data for all pts with NSCLC and select subgroups are summarized in the table; cORR was 19.5% (95% CI, 12.6-28.0) in all pts with NSCLC and 32.5% (95% CI, 18.6-49.1) in pts with non-squamous (non-Sq)/taxane-naive NSCLC. Additional time-to-event data will be presented. Rates of TEAEs, ≥G3 TEAEs, SAEs, and TEAEs leading to discontinuation were 98.2%, 46.0%, 33.6%, and 13.3% in pts with NSCLC, and were consistent in all treated pts. The most common ≥G3 TEAEs in pts with NSCLC were dyspnea (9.7%), fatigue (7.1%), and neutropenia (5.3%). One pt with NSCLC had a treatment-related death (pneumonitis). PK variability across weight groups was lowest with 1.8 mg/kg AiBW 2Q4W. Conclusions: SV continues to demonstrate encouraging antitumor activity and a manageable safety profile in pts with NSCLC. Data at 1.8 mg/kg AiBW 2Q4W support initiation of the Ph 3 SGNB6A-002 study in 2/3L NSCLC (NCT06012435) and combination with pembrolizumab in earlier settings. Clinical trial information: NCT04389632 . [Table: see text]
A randomized phase II trial of 8 months of afatinib switching to osimertinib (A) versus osimertinib alone (B) as first-line treatment in advanced NSCLC patients with common <i>EGFR</i> mutation: YAMATO study (TORG1939/WJOG12919L).
Authors: Atsushi Nakamura, Hiroshige Yoshioka, Toshihiro Misumi, Toshihide Yokoyama, Hidetoshi Itani, Motoko Tachihara, Kaoru Tanaka, Hiroaki Akamatsu, Akira Ono, Satoshi Ikeda, Takaaki Tokito, Yuki Sato, Masahide Mori, Takehiro Uemura, Akito Hata, Shinobu Hosokawa, Hideki Ishikawa, Nobuyuki Yamamoto, Hiroaki Okamoto, Takayasu Kurata
Journal: Journal of Clinical Oncology (2024)

8574 Background: NSCLC with common EGFR mutation (L858R or exon 19 deletion (Del19)) is known to originally comprise small portion of uncommon and compound EGFR variant cells including T790M-mutant ones albeit treatment-naïve. To overcome concomitant heterogeneous EGFR mutations, we planned a randomized phase II trial to assess the strategy of switching to osimertinib following 8 months of afatinib compared with osimertinib alone. Methods: YAMATO study is an open-label, multi-center, randomized phase II study. Patients with newly diagnosed stage III/IV/recurrent NSCLC harboring EGFR activating mutations (L858R or Del19) were randomized in a 1:1 ratio to receive up-front 8 months of afatinib (30 mg or 40 mg QD) followed by osimertinib (80 mg QD) (arm A) or osimertinib (80mg QD) alone (arm B) until disease progression or intolerable toxicity. The primary endpoint is 2-year progression free survival (PFS) rate with threshold rate of 22% and expected rate of 40% (one-tailed alpha of 0.1, beta of 0.2). Secondary endpoints are objective response rate (ORR), PFS, time to treatment failure, overall survival and adverse events. Results: Between May 2020 and Apr 2021, 113 patients were enrolled from 27 institutions (A/B 56/57). Patient characteristics were as follows: median ages, 73.5/71 years (range 41-85/41-92 years); proportion of males, 42.9/35.1%; EGFR mutation types, L858R/Del19 59/41% in A, 58/42% in B. The difference of two-year PFS rate was not observed statistically significant between groups (37.3% [80% CI, 29.0 to 45.5] in arm A vs 47.4% [80% CI, 38.5 to 55.7] in arm B; p=0.44; HR:1.28 [80% CI, 0.95-1.73]). The ORR was 82% in arm A and 87% in arm B. With the median follow-up of 27.5 months, median PFS was 16.8 months in arm A, and 22.2 months in arm B (HR: 1.280, p = 0.29). Severe pneumonitis occurred in 7% in arm A, most of which developed after switching to osimertinib, and 1.8% in arm B. Conclusions: YAMATO study failed to demonstrate the superiority of EGFR-TKI switching therapy of 8 months afatinib to osimertinib over osimertinib alone in terms of 2-year PFS rate in untreated advanced NSCLC patients with common EGFR mutations. Clinical trial information: 031200021 .
Precision medicine preceptorship in breast and lung cancer for Latin American oncologists.
Authors: Keerthi Gogineni, Ticiana Leal, Margie D. Dixon, Shaheen A. Rana, Rebecca D. Pentz
Journal: Journal of Clinical Oncology (2024)

9040 Background: Cancer is the second leading cause of death in Latin America. Integrating genomic discoveries into patient care could improve morbidity and mortality; however economic barriers to capacity development and access to therapeutics remain. In response to an RFP for a preceptorship for oncologists from Latin America, Emory’s Winship Cancer Institute (WCI) developed a 2-week immersion involving didactics, clinical exposures, and research meetings to increase knowledge and competence of breast and lung cancer genomics. Methods: Interviews with Latin American medical oncologists, Latin America Lung Cancer Association (LALCA) leadership, and literature review were conducted to understand areas of unmet need in oncology training. A gap in knowledge and practice of genomic management of breast and lung cancer was identified and informed development of didactic and clinical exposures. The WCI website, International Association for the Study of Lung Cancer (IASLC) and LALCA publicized the program. Medical oncologists within 6 years of final oncology training applied. Participants completed a baseline needs assessment, pre-program survey to assess goals and confidence in skills, and post-program interview to evaluate the program and reassess confidence in skills. Instruments were developed with WCI’s Intervention, Development, Dissemination and Implementation Shared Resource. WCI faculty were interviewed for feedback. Results: WCI hosted 12 Latin American oncologists over 3 two-week preceptorships between 2020-23, coinciding with local scientific meetings. All participants reported the program was a valuable use of time, valuable for career development and rated the program as excellent/very good. 92% reported the program met their goals and felt engaged all/most of the time. 75% rated attendance at breast and lung cancer clinics, didactics, research meetings, tumor boards as very/extremely valuable. Two-thirds intended to make changes (apply knowledge, improve communication, work with other providers like nurses, aid students in research, improve flow of activity when seeing patients, incorporate clinical research into daily practice, and add immunotherapy) in their practice at home institutions. Phase 1 and surgical oncology clinics were deemed least helpful. Themes emerged from faculty interviews: be strategic about the number of learners in clinic, characterize learner preferences and prior training/experience, articulate the preceptorship’s long-term goals, and include time to team-build. Conclusions: Participants gained exposure to the latest molecular diagnostics and systemic treatments, appreciation for optimal team-based cancer care, and how clinical research drives development of novel biomarkers and therapeutics. Future goals include expanding program access to oncologists from other low- and middle-income countries and promoting post-program collaborations.