tbuckley/cabot-search huggingface dataset:
Empowering tomorrow's oncologists: Establishing an oncology student interest group to propel careers in cancer care.
Authors: Abhishek Singh, Nidhi Jain, Aditya Chauhan, Sri Usha Jeevani Obulareddy, Kala Seetharaman
Journal: Journal of Clinical Oncology (2024)

e21014 Background: In cancer care, smaller academic community hospitals play a crucial role in serving local and underserved populations. However, these institutions often need help providing comprehensive mentorship opportunities for internal medicine residents interested in pursuing careers in oncology. Limited resources, smaller clinical teams, and a focus on delivering patient care often precede research and scholarly activity. To help with this goal, ASCO has a program known as OSIG, which stands for Oncology Student Interest Group, which provides resources for medical students and residents to meet regularly, network with academic faculty, learn about cancer care, and learn about opportunities in oncology. Methods: This observational study employed a cross-sectional survey design to investigate the perceived benefits of establishing an oncology interest group among internal medicine residents. The survey aimed to collect quantitative and qualitative data on residents' opinions regarding the potential advantages, challenges, and overall impact of initiating an ASCO affiliated oncology-focused student interest group [OSIG] within an academic community hospital internal medicine residency program in Worcester, MA. Results: Of the total strength of 75 residents, a total of 17 residents were surveyed for this project, with 7 [41%] female, and 10 [59%] male residents. 6 [35%] PGY1, 2 [11%] PGY2, and 9 [52%] PGY3 residents participated in the survey. 15 [88%] residents were 'very likely' interested in a career in oncology. 16 [94%] residents replied that participating in the oncology interest group meetings enhanced their understanding of cancer care and treatment options. 17 [100%] replied that networking with oncology professionals was 'very important' for their career development. 15 [88%] replied that the support provided by the OSIG helped find them mentorship opportunities 'to a large extent'. 15 [88%] replied that the oncology interest group could assist in clarifying their career goals within oncology by 'a lot'. The survey included two questions with room for subjective answers aboutpotential challenges or concerns, and additional thoughts, suggestions, or comments. Conclusions: The results indicate that residents recognize the potential of an ASCO-affiliated interest group to significantly enhance their understanding of cancer care and treatment options, providing a valuable supplement to their internal medicine training. The prospect of networking with established oncologists by spurring collaboration among residents, attending national and local conferences in the field is deemed crucial for career development, as is the belief that mentorship opportunities within the interest group could play a pivotal role in shaping future careers in oncology.
Unveiling disparities: Metastatic lung cancer incidence across income strata in metropolitan residencies.
Authors: Jerry Kenmoe, Maxwell Oluwole Akanbi, Nwonukwuru I Amadi, Ayobami Gbenga Olafimihan, Elizabeth Mikhail, Borys Hrinczenko
Journal: Journal of Clinical Oncology (2024)

e20616 Background: Over recent years, there has been growing interest in the field of lung cancer. Great efforts have been invested in recent years to improve screening and mortality outcomes with respect to lung cancer, particularly metastatic lung cancer (mLC). In the dynamic landscape of metropolitan residencies (MR), this study delves into the impact of household income (HI) on the occurrence of mLC. Unraveling the intricacies of these disparities is crucial for advancing our understanding of healthcare access and outcomes in urban settings. Methods: Appropriating data from the Surveillance, Epidemiology, and End Results (SEER) database, we looked at the incidence rates of mLC among adults aged 55-80 years by HI levels ( &lt; $35,000, $45,000-49,999, $55,000-$59,999, $65,000-69,999 and $75,000+) in MR from 2004 to 2017. Age-adjusted rates were calculated, and joinpoint regression models were used to estimate the average annual percentage change (AAPC) in incidence across different subgroups. Results: The study population included a total of 321,281 individuals diagnosed with mLC. The incidence of mLC declined rapidly from 2004 to 2017 across all HI groups in metropolitan residence; the AAPC for HIs $45,000-49,999 was -0.70%, $55,000-59,999 was -2.11%, $65,000-69,999 was -4.32% and $75,000+ was -3.72%. Of note, there was not enough data to characterize the trend for HIs &lt; $35,000. Conclusions: Our study revealed an overall decline in the incidence of mLC since 2004 across all HI groups in MRs. Although the trend is one of diminution across all groups, there is however, still some differences in incidence rates amongst different HI groups. This study elucidates the vital role HI plays in influencing the landscape of mLC in metropolitan areas. Recognizing and addressing these disparities is crucial for developing comprehensive public health strategies aimed at reducing the burden of advanced lung cancer and promoting equal access to quality healthcare.
Analyzing the gut microbiome in adolescent and young adult patients with melanoma receiving immune checkpoint blockade.
Authors: Faraz Afridi, Eleanor Fallon, Reed I Ayabe, Ashish Damania, Jennifer Ann Wargo, Michael Roth
Journal: Journal of Clinical Oncology (2024)

9563 Background: Melanoma is the third most common cancer in adolescent and young adults (AYA), a unique cohort defined as patients between 15-39 years of age per the National Cancer Institute. Immune checkpoint inhibitors (ICI) have changed the landscape for advanced melanoma treatment, and the gut microbiota has been shown to remodel the tumor microenvironment to improve ICI efficacy. There is a paucity of research in this cohort, however studies show that AYA patients, in general, have historically not seen the same survival gains as other age groups. Furthermore, literature shows that survival was much worse for AYA's with stage IV melanoma than observed among older adults. Methods: The AYA cohort in this retrospective review is from the 2021 Science publication entitled "Dietary fiber and probiotics influence the gut microbiome and melanoma immunotherapy response". This cohort was matched on a 2:1 basis with older non-AYA patients 50-70 years of age. We controlled for sex, BMI, race, treatment naivety, stage of disease, as well as smoking, drug, and alcohol status. Results: Our AYA cohort of 23 patients is comprised of 15 females, 22 Caucasians, 20 with primary cutaneous melanoma, 12 with stage III at the start of treatment and 11 with stage IV, 17 were BRAF positive, 8 received combined immunotherapy, 20 were treatment naïve, and 11 were responders. We found no difference in alpha or beta diversity in AYA and older non-AYA patients, however alpha diversity increased with age. This is consistent with literature regarding aging gut microbiomes. Furthermore, we noted the most common microbes found between these groups varied considerably. Using differential analyses, we found, for example, a higher abundance of Ruminococcaceae, at the family level, in older non-AYA patients and a higher abundance of Bacteroides stercoris in AYA patients. Literature shows the relative abundance of Ruminococcaceae increased with age and was significantly higher in older patients. Furthermore, Bacteroides stercoris correlates positively with fiber, grain, and vegetable intake. Additionally, Blautia massiliensia, Blautia obeum, and Dorea longicatena were found to be significantly more prevalent (p=0.010, p=0.34, and p=0.035, respectively)) in older non-AYA patients. These species are all known to be obesity biomarkers. Conclusions: We found that the gut microbiota of AYA and older non-AYA melanoma patients differ. Older non-AYA patients have bacterial species associated with negative biomarkers which may be due to an aging gut microbiome. Establishing microbial features in the AYA population can help with microbiome modulation as a therapeutic strategy. Enriching modalities include fecal microbiota transplantation, probiotics, and improving diet as well as fiber intake. Further research should explore if the gut microbiome influences worse outcomes in AYA's with late stage melanoma.
Triplet combination treatments with pembrolizumab (pembro) for anti–PD-(L)1–refractory advanced melanoma: Preliminary results of the phase 1/2 KEYMAKER-U02A study.
Authors: Reinhard Dummer, Jean-Jacques Grob, Caroline Robert, Ronnie Shapira-Frommer, Celeste Lebbe, Paolo Antonio Ascierto, Stéphane Dalle, Omid Hamid, Nicolas Meyer, Muhammad Adnan Khattak, Andrew Graham Hill, Jonathan Cohen, Giuseppe Curigliano, Anna Maria Di Giacomo, Michele Del Vecchio, Sekwon Jang, Rohini Singh, Xuan Peng, Scott J. Diede, Georgina V. Long
Journal: Journal of Clinical Oncology (2024)

9506 Background: Anti–PD-(L)1–refractory melanoma is a major challenge, and immunotherapy combination treatment may be useful in this patient population. The phase 1/2 KEYMAKER-U02A (NCT04305041) is a multi-arm, open-label, adaptive umbrella study designed to evaluate pembro + investigational agents for the treatment of anti–PD-(L)1–refractory melanoma. We report results from arm 1 (pembro + quavonlimab [qmab] (anti-CTLA4) + vibostolimab [vibo] (anti-TIGIT)), arm 2 [pembro + qmab + lenvatinib [len] (TKI)), and arm 3 (pembro + ATRA [all-trans retinoic acid]) of KEYMAKER-U02A. Methods: In all arms, adults had stage III/IV melanoma, ≥1 measurable lesion per RECIST v1.1, an Eastern Cooperative Oncology Group performance status score of 0 or 1, and disease progression on anti–PD-(L)1 therapy alone or in combination. Pts were randomized equally to open arms. In arm 1, pts received pembro 200 mg IV Q3W + qmab 25 mg IV Q6W + vibo 200 mg IV Q3W. In arm 2, pts received pembro 400 mg IV Q6W + qmab 25 mg IV Q6W + len 20 mg PO QD. In arm 3, pts received pembro 400 mg IV Q6W + ATRA 150 mg/m 2 /day PO for 3 days Q3W. Pts received treatment for up to 2 y or until intolerable toxicity, disease progression, or pt withdrawal. Primary end points were safety and ORR per RECIST v1.1 by blinded independent central review (BICR). DOR per RECIST v1.1 by BICR was the secondary end point. PFS per RECIST v1.1 by BICR and OS were exploratory end points. Enrollment was planned for a maximum of 20 pts in each arm and enrollment could continue to up to 40 pts if an ORR of &gt; 20% (5/20) was observed. Enrollment would then continue up to 100 pts if an ORR of ≥35% (14/40) was observed. Results: At data cutoff (Oct 18, 2022), 40 pts had been assigned to arms 1 and 2 and 20 pts to arm 3. Median (range) follow-up was 18.4 (1.7-24.5) mo in arm 1, 18.5 mo (1.6-25.4) in arm 2, and 2.7 mo (0.8-3.5) in arm 3. Efficacy is reported in the table. Treatment-related adverse events (TRAEs) occurred in 35 pts (88%) in arm 1, 38 pts (95%) in arm 2, and 15 pts (75%) in arm 3. Grade 3-5 TRAEs occurred in 11 pts (28%) in arm 1, 23 pts (58%) in arm 2, and 3 pts (15%) in arm 3; 1 pt in arm 2 died from a grade 5 TRAE (immune-mediated nephritis). Conclusions: Although objective responses were observed in some pts with anti–PD-(L)1–refractory melanoma, protocol-prespecified criteria for enrollment expansion were not met in any arm. The safety profile was manageable. Additional arms will be reported for this pt population with a high unmet need. Clinical trial information: NCT04305041 . [Table: see text]
Impact of a 1-day disease overview session on knowledge and preparedness for incoming hematology/oncology fellows.
Authors: Cameron Pywell, Andrew Gahagan, Rita Daniell Paschal
Journal: Journal of Clinical Oncology (2024)

e21011 Background: The start of hematology/oncology fellowship involves an abrupt transition in disease management and a steep learning curve. Many fellowship programs have introductory lecture series over the first weeks or months, but fellows often need specialty knowledge prior to the completion of these. Methods: A 1-day session for incoming first year fellows at our institution was developed to provide brief overviews of common conditions in classical hematology, malignant hematology, and oncology, subdivided into a total of 12 topics. Fellows were surveyed before and after the session regarding their feelings of preparation for fellowship and having good disease frameworks for each of the 3 major content areas. Fellows also evaluated the content and length of each topic. Pre- and post-course knowledge assessments were conducted. Feedback was sought later in the year as well. Results: The session was well-received by fellows. Post-course assessments increased by a mean of 32% (SD 6%). The majority of topics were well-reviewed for length and content. Fellow responses to feelings of preparedness and disease frameworks were improved or unchanged from pre-course surveys. All fellows agreed that it was a good use of their time and would recommend it being a part of future orientation sessions. Fellows recommended splitting the session into 2 days. Conclusions: A 1-day introductory course for incoming hematology/oncology fellows is feasible and rapidly improves baseline knowledge to prepare fellows for clinics, consults, and being on call.
A retrospective study of tislelizumab combined with bevacizumab, pemetrexed, and carboplatin in driver-gene mutated advanced non-squamous non-small cell lung cancer after tyrosine kinase inhibitors failure.
Authors: Sisi He, Hu Ma, Mi Meng, Yang Tang, Wendong Qu, Xu Han, Cheng Chen
Journal: Journal of Clinical Oncology (2024)

e20620 Background: Overcoming resistance to tumor targeted therapies is a major challenge in the management of driver-gene mutated non-small cell lung cancer (NSCLC). Recent clinical trials suggested that the combination approach of immunotherapy, bevacizumab and platinum-based chemotherapy was effective for driver-gene mutated NSCLC after tyrosine kinase inhibitors (TKIs) failure. Our retrospective study was aimed to examine the efficacy and safety of tislelizumab (TIS) combined with bevacizumab plus chemotherapy for advanced driver-gene mutated non-squamous NSCLC (nsq NSCLC) who had failed to TKIs therapies. Methods: We retrospectively collected medical records of driver-gene mutations advanced nsq NSCLC who had failed to TKIs therapies in the Affiliated Hospital of Zunyi Medical University and Second Affiliated Hospital of Zunyi Medical University from January 2021 to December 2023. The participants were sorted into two groups. Pts in TBCP group received TIS combined with bevacizumab, carboplatin and pemetrexed (BCP) for six cycles, followed by TIS with pemetrexed as maintenance therapy. Pts in BCP group received BCP regimen for six cycles, followed by pemetrexed as maintenance therapy. The primary endpoint was progression-free survival (PFS). The secondary endpoints were objective response rate (ORR), disease control rate (DCR), overall survival (OS) and safety. Results: A total of 12 pts were enrolled (6 pts in TBCP group and 6 pts in BCP group). In TBCP group, there was one patient with EGFR exon 19del, KRAS, BRAF V600 mutation and RET fusion, respectively. 2 pts harbored EGFR exon 21 L858R mutations. In BCP group, 4 pts harbored EGFR exon 19del, 1 patient with exon 21 L858R, and 1 patinet with BRAF V600 mutation. All pts were failed to previous TKI therapy. 3 pts (50%) had progression after two systemic treatment lines in ABCP group. 4 pts(66.7%) had progressive disease after at least two systemic regimen. As of 6 February 2024 (median follow-up, 18.6 months), significantly longer PFS was observed in TBCP group compared with BCP group (HR = 0.269 [95% CI: 0.068-1.065], p = 0.0080). Median PFS was 14.20 months (95% CI: 0.5010-5.379) and 8.65 months (95% CI: 0.1859-1.996) in TBCP group and BCP group, respectively. A higher ORR assessed was observed with TBCP group (66.7%) compared with BCP group (33.3%). The DCR were both 100% in two groups. Median OS was not reached. Grade 3-4 TRAEs occurred in 1 and 2 pts in TBCP group and BCP group, respectively. Conclusions: TIS combined with bevacizumab, carboplatin and pemetrexed has shown a promising anti-tumor efficacy with manageable safety profile for TKI failure driver-gene mutations advanced nsq NSCLC. However, these findings still need to be further confirmed by prospective clinical trials with larger sample sizes.
The efficacy and safety of toripalimab combined with anlotinib in the first-line treatment of Chinese patients with metastatic melanoma.
Authors: Ting Ye, Linqing Li, Li Fan, Rubo Cao, Xianan Li, Jing Chen
Journal: Journal of Clinical Oncology (2024)

9560 Background: Acral, mucosal and non-CSD melanoma are the major subtypes in Chinese melanoma patients, with poor response to antiprogrammed cell death-1 (PD-1) monotherapy. Anti PD-1 monoclonal antibodies combined with anti-angiogenesis agent have showed synergistic effects mechanically and a promising response rate. Here, we report efficacy and safety of toripalimab combined with anlotinib in Chinese patients with metastatic melanoma. Methods: Patients with metastatic acral, mucosal and non-CSD melanoma received toripalimab 240mg intravenously every 3 weeks combined with anlotinib 12 mg orally once a day for first 2 weeks every 3 weeks as first-line treatment, until disease progression or unacceptable toxicity. All patients were enrolled from the Cancer Center of Union Hospital, affiliated to Tongji Medical College of Huazhong University of Science and Technology and Hunan Cancer Hospital. Results: From January 2021 to January 2024, a total of 47 patients were enrolled in this study. Subtypes were 16 patients with acral melanoma, 21 patients with mucosal melanoma, and 10 patients with non-CSD melanoma. Average age was 59.7 ±10.1 years old. The median follow-up was 26.5 months (95% CI: 20.6, 32.4 months). Among the 46 efficacy evaluable patients, the objective response rate (ORR) and disease control rate (DCR) were 23.9% and 80.4%, respectively. Median duration of response was 14.4 months (95% CI: 7.5, 21.3). The median progression-free survival (PFS) of all 47 patients was 5.7 months (95% CI 4.2 to 7.2 months); and the median OS was 14.4 months (95% CI 7.3 to 21.5 months). The median PFS of patients with M1a stage is 24.4 months, statistically longer than M1b (5.1 months), M1c (6.6 months) and M1d (4.0 months). The median PFS of acral, mucosal and non-CSD melanoma were 6.6m, 5.1m, 5.2m respectively with no statistical difference, and these is no difference of PFS between gender and age. In terms of safety, treatment-related adverse events (TRAEs) for all grades occurred in 76.6% (36/47) of patients, and grade 3 or 4 occurred in 4.3% (2/47) of patients. The incidence of immune-related adverse reactions (irAE) was 23.4% (11/47) for all grades, the most common irAEs (≥2%) included hypothyroidism, immune-associated hepatitis and rash. Conclusions: Toripalimab combined with anlotinib displays good efficacy and well-tolerant safety profiles in the treatment of patients with metastatic melanoma. Further biomarker analysis was ongoing.
Time-to-treatment for metastatic non-small cell lung cancer in the era of biomarker testing.
Authors: Maxwell Oluwole Akanbi, Jerry Kenmoe, Samuel O Adekolujo, Muhammad Saleem, Ujwala Koduru, Borys Hrinczenko
Journal: Journal of Clinical Oncology (2024)

e20623 Background: In 2011, the National Comprehensive Cancer Network (NCCN) recommended biomarker testing in patients with metastatic non-small cell lung cancer (mNSCLC) based on improved survival with targeted therapies and immunotherapy reported in clinical trials. The requirement for biomarker testing before the commencement of treatment could inadvertently contribute to delays in treatment initiation. We investigated the time to treatment for mNSCLC in the US general population in the era of advanced therapies for lung cancer. Methods: We obtained data from 32,518 adults with mNSCLC between 2004 and 2019 from the Surveillance, Epidemiology, and End Results (SEER) database. We categorized time to treatment to &lt; 1 month or ≥ 1 month, and period of diagnosis to 2004-2011 and 2012-2020. We used separate logistic regression models to investigate the relationship between time to treatment, period of diagnosis, and year of diagnosis, adjusting for age, sex, household income, residence, and race. Results: The mean age of the study population was 66 (SD 10) years, 41% Female and 76% White. The majority (84%) were Metropolitan dwellers. A total of 23,322 (76%) were diagnosed between 2004 and 2011, and 9,186 (28%) from 2012 to 2019. Overall, 40% of patients initiated cancer therapy within a month of diagnosis, with no significant difference between patients who commenced treatment between 2004-2011 (40.2%) and 2012-2019 (39.9) (chi 2 = 0.3492 P = 0.555). In both logistic regression analyses, there was no significant relationship between time to treatment and period or year of diagnosis. However, race/ethnicity and age independently predicted the time to treatment. Compared to Whites, Blacks (Odds ratio (OR) 1.08, 95% CI 1.01- 1.16, p = 0.04) and Hispanics (OR 1.26, 95% CI 1.03-1.24, p 0.01) were more likely to initiate treatment ≥ 1 month from the time of diagnosis. The odds of initiating treatment ≥ 1 month also increased with age (Age/year OR 1.01 (95% CI 1.01-1.01). Conclusions: We did not identify delays in treatment initiation for mNSCLC in the current era of biomarker testing. Biomarker testing has become an essential diagnostic tool for mNSCLC, guiding targeted therapies that have been shown to improve treatment outcomes. However, some vulnerable populations continue to experience delays in treatment initiation, which could lead to poorer survival. Improvements in cancer therapeutics must be complemented by service delivery improvements to optimize treatment outcomes.