tbuckley/cabot-search huggingface dataset:
Socioeconomic disparities in palliative care utilization among children with late-stage bone and soft tissue sarcomas: A National Cancer Database analysis.
Authors: Paul Phan, Charbel Chidiac, Jaime Shalkow, Daniel S. Rhee
Journal: Journal of Clinical Oncology (2025)

12066 Background: Palliative care seeks to improve the quality of life for many children living with cancer, but it remains underused. Racial and socioeconomic disparities have been identified in the receipt of palliative care among adult patients with advanced soft-tissue sarcomas and metastatic renal cell carcinoma. Our study seeks to determine if similar barriers exist in palliative care receipt among pediatric patients with late-stage bone and soft tissue sarcomas. Methods: We used the National Cancer Database (NCDB) to perform a retrospective review of children aged 0-25 with Stages III and IV bone and soft tissue sarcomas from 2004 to 2022. We used a 1:1 propensity score matching algorithm to compare the utilization of palliative treatment by race and ethnicity and to balance potential confounding covariates. Kaplan-Meier estimation was utilized for survival analysis. Results: A total of 8,030 patients were included in this analysis. Of these patients, 375 (4.7%) received at least one form of palliative treatment, including surgery (n=31), radiation (n=99), chemotherapy (n=55), pain management (n=98), multiple modalities (n=77), and others (n=15). The median age was 16 years (IQR: 12-20). Osteosarcoma (29.2%) was most common, followed by Ewing’s sarcoma (28.1%), non-rhabdomyosarcoma soft tissue sarcoma (21.6%), and rhabdomyosarcoma (21.0%). The 5-year overall survival rate was 14.7% (95% CI 11.2%-19.3%) for patients receiving palliative care versus 44.7% (95% CI 43.6%-45.9%) for those who did not. After propensity score matching, non-Hispanic Black children were found to be less likely to receive palliative care than non-Hispanic White children (3.4% vs. 5.9%, p = 0.047). Hispanic children were also less likely to receive palliative treatment than non-Hispanic White children (2.5% vs. 5.5%, p = 0.007). Conclusions: Hispanic and Black children with sarcomas were less likely to receive palliative care compared to White children. Further research is warranted to understand the impact of other factors contributing to palliative care receipt and how they may be addressed to optimize the quality of life in sarcoma treatment in children. Post-propensity score matching univariate analysis for palliative care use by race and ethnicity. Palliative Care Utilization* RACE ETHNICITY Total (n=1286) Non-Hispanic White (n=643) Non-Hispanic Black (n=643) p-value Total (n=1418) Non-Hispanic White (n=709) Hispanic (n=709) p-value No 1226 (95.3%) 605 (94.1%) 621 (96.6%) 0.047 1361 (96.0%) 670 (94.5%) 691 (97.5%) 0.007 Yes 60 (4.7%) 38 (5.9%) 22 (3.4%) 57 (4.0%) 39 (5.5%) 18 (2.5%) *Patients were matched based on age at diagnosis, sex, insurance status, median income of county of residence, high school graduation percentages of county of residence, mean tumor size, primary tumor sjte, AJCC stage, and presence of metastases at diagnosis.
The efficacy of atezolizumab plus bevacizumab for advanced hepatocellular carcinoma in relation to tumor-infiltrating lymphocytes: Histological assessment of CD8+ T cell spatial features as predictive biomarkers.
Authors: Hiroaki Kanzaki, Takamasa Ishino, Sadahisa Ogasawara, Midori Sawada, Ryo Izai, Takuya Yonemoto, Sae Yumita, Ryuta Kojima, Keisuke Koroki, Masanori Inoue, Naoya Kanogawa, Yuka Takano, Kaho Takata, Masahito Kawazu, Junichiro Ikeda, Masayuki Ohtsuka, Yujin Hoshida, Mina Komuta, Yosuke Togashi
Journal: Journal of Clinical Oncology (2025)

4103 Background: The combination of atezolizumab and bevacizumab (Atez/Bev) has improved prognosis in advanced hepatocellular carcinoma (HCC), though its therapeutic mechanisms remain unclear. While the tumor microenvironment (TME) holds promise for biomarker discovery, current studies rely on archived diagnostic samples. We aimed to elucidate molecular determinants of treatment efficacy and identify predictive biomarkers through comprehensive TME analysis of pre-treatment samples. Methods: We analyzed biopsy samples from 94 advanced HCC patients immediately before initiating Atez/Bev treatment using immunohistochemistry (IHC), RNA-sequencing, flow cytometry, and multiplexed imaging. Our analysis focused on spatial characteristics of CD8+ T cells and effector regulatory T (eTreg) cells, with longitudinal assessment of immune responses during treatment. Results: High programmed death-1 (PD-1) positivity in CD8+ T cells was significantly associated with favorable progression-free survival (PFS) (HR 0.24, 95% CI 0.11-0.52), while CD8+ T cell density showed no significant correlation (HR 1.12, 95% CI 0.64-1.95). Through multiplexed imaging analysis using PD-1 positivity as a key indicator, we identified two critical determinants of response: CD8+ T cells localizing within tumor parenchyma rather than fibrous stroma, and maintaining diffuse distribution throughout the tumor parenchyma. These features, assessable with routine hematoxylin and eosin and CD8 IHC staining, stratified patients into four prognostic groups (p = 0.019), with median PFS ranging from 14.3 months (both favorable features) to 3.5 months (neither feature). The PD-1 positivity in eTreg cells was not associated with prognosis (HR 0.75, 95% CI 0.34-1.62). Notably, bevacizumab counteracted the potential negative effects of programmed death-ligand 1 blockade by suppressing eTreg cell activation, as demonstrated through analysis of patients who discontinued bevacizumab and in vitro experiments showing reduced expression of eTreg activation markers. Conclusions: We demonstrate that routine histological assessment of CD8+ T cell localization and distribution patterns can predict Atez/Bev efficacy in advanced HCC. The identified synergistic mechanism of bevacizumab-mediated eTreg suppression provides a framework for future combination immunotherapy development.
Neuroendocrine marker expression in dendritic cell sarcoma.
Authors: Margaret Fink, Katherine E. Schwetye
Journal: Journal of Clinical Oncology (2025)

e23557 Background: Dendritic cell sarcoma (DCS) is a rare type of cancer that can involve lymph nodes (“follicular”) or occur outside of lymph nodes (“interdigitating”). These tumors are often challenging to diagnose on small biopsies. On a recent case at our institution, a biopsy of a left neck soft tissue mass showed a lesion with expression of neuroendocrine markers, which suggested the possibility of a primary neuroendocrine tumor. However, when the entire tumor was resected (left level 4 lymph node), it became clear that it was a 5.8 cm DCS, exposing this potential pitfall of interpretation of neuroendocrine markers in small biopsy cases. A literature search at the time (May 2024) revealed no significant academic studies characterizing the expression of neuroendocrine markers in these rare DCS tumors. Methods: IRB approval was granted and a search for in-house cases was conducted for a final diagnosis of “dendritic cell sarcoma” signed out between 8/27/2004 and 8/28/2024. A total of twelve archived in-house cases were identified in addition to the initial DCS case that inspired the search. All microscope slides and blocks for each case were acquired and reviewed. One block best representing the tumor was selected from each identified case. The selected blocks were stained with the Ventana immunohistochemical protocol for synaptophysin and chromogranin and the stained slides were reviewed. Results: Twelve cases with a diagnosis of dendritic cell sarcoma were identified. Of these twelve cases, five cases showed positive staining for synaptophysin. All twelve cases were negative for chromogranin. The sites of the cases positive for synaptophysin were lung (2), rectum (1), left upper quadrant soft tissue mass (1), and rib (1). The strength and distribution of positive staining was different for each case, with the strongest staining occurring in one lung case and rib, with the most sparse and weak positive staining occurring in the soft tissue mass. Conclusions: Dendritic cell sarcomas can variably express synaptophysin in varying proportions and levels. A potential pitfall exists when neuroendocrine expression in DCS possibly leads a pathologist to a different and potentially incomplete diagnosis. Interpretation of positive neuroendocrine expression including synaptophysin should not exclude DCS from the differential, especially on small biopsies where diagnosis of these tumors is difficult. Future studies are needed to determine the potential prognostic and predictive potential of neuroendocrine markers in DCS.
Pegylated liposomal doxorubicin in advanced, anthracycline pre-treated liposarcoma patients: Report of a single reference center experience.
Authors: Andrea Franza, Chiara Fabbroni, Elena Fumagalli, Elena DiBlasi, Carlo Morosi, Francesca Gabriella Greco, Alessandro Gronchi, Angelo Paolo Dei Tos, Paolo Giovanni Casali, Roberta Sanfilippo
Journal: Journal of Clinical Oncology (2025)

e23543 Background: Liposarcomas (LPS) encompass a heterogeneous group of soft-tissue sarcomas (SD), including well differentiated/dedifferentiated liposarcoma (WD/DDLPS), myxoid liposarcoma (MLPS), and pleomorphic liposarcoma. These subtypes show variable sensitivity to anthracyclines (AC), commonly used in advanced or metastatic settings. Pegylated liposomal doxorubicin (PLD) is frequently administered in later lines of treatment, usually when no other active drugs are available, even in first-line (1L) AC pre-treated patients (pts). PLD effectiveness in extending progression-free survival (PFS) across anthracycline-pre-treated LPS subtypes is not well documented. Methods: We retrospectively collected 27 consecutive pts (8 males, 19 females) with advanced LPS and treated with PLD at our institution from September 2004. Among them, 18 pts previously received AC either for localized or advanced disease and were included in our analysis. Descriptive statistics analyses were made. PFS was defined as time from the first cycle of PLD to progression (PD) or death and was calculated separately across LPS subtypes. Results: 9 out of 18 pts were diagnosed with WD/DDLPS, 6 had MLPS and 3 had PLPS. Median cumulative dose of previously administered AC was 240 mg/sqm (IQR 205-350). 7 pts received AC in advanced disease setting: 4 pts had stable disease (SD) as best response (BR), while one gained a partial response (PR) and 2 had progressive disease (PD) as BR. Only 1 patient received PLD as 2L therapy, while 8 received PLD in 3L , 5 in 4L and the remaining 4 pts in further lines. PLD was administered at a starting dose of 40 mg/sqm as per clinical practice. A median of 5 (IQR 3-11) PLD cycles were administered in our cohort: 2 PR were registered (1 in DDLPS and 1 in MLPS patient), while 11 pts gained SD as best response and 5 pts had PD at the first evaluation. The two AC primary resistant pts had SD and PD as BR. Median PFS (mPFS) was 5 months (95% CI 3.88 – N.R) in WD/DDLPS pts, 9 months ( 95% CI 4.7 – N.R) in WDLPS pts, 7.6 months (95% CI 6 – N.R) in MLPS pts and 8 months (95% CI 1 – N.R) in PLPS pts. 13 out of 16 progressing to PLD received at least another line of treatment. No severe (G3/G4) adverse events were registered. Conclusions: PLD showed some activity in a retrospective cohort of advanced, anthracycline pre-treated LPS patients across all LPS subtypes. It may represent a therapeutic option for patients with few alternatives.
Using consideRATE to evaluate patient experience in a cancer center: Psychometric and healthcare assessments.
Authors: Joseph Nano, Gabrielle Stevens, Glyn Elwyn, Leeza Petrov, Saahithya Gowrishankar, Shaday Robitaille, Aricca D. Van Citters, Eugene Nelson, Garrett Thomas Wasp, Kathryn B. Kirkland, Meredith MacMartin, Catherine Saunders
Journal: Journal of Clinical Oncology (2025)

e23203 Background: conside RATE is a patient- and care-partner-reported measure of care experience during serious illness. We used consideRATE with patients and care partners at the Dartmouth Cancer Center to assess patient experience, evaluate psychometric properties, and explore scoring approaches. Methods: Patients and care partners aged 18+ and English proficient participated in a cross-sectional survey. Participants completed consideRATE (8 items), CANHELP-Lite (21 items), and demographic questions. Reliability was assessed using Cronbach’s α, and validity was evaluated with Pearson’s correlations. Continuous and top-box scoring approaches were used. Psychometric properties were analyzed for patients, care partners, and subgroups with lower educational attainment or income. Results: 244 participants (114 patients,128 care-partners, 2 unspecified) completed the survey. consideRATE has internal reliability (α = 0.86); the correlation (r) between consideRATE continuous scoring and CANHELP Lite scores for all participants was 0.5; p &lt; 0.001, for patients 0.5; p &lt; 0.001, for care-partners 0.5; p &lt; 0.001, for patients (n = 71) with lower educational attainment 0.5, p &lt; 0.001, and for patients (n = 50) with lower income 0.7, p &lt; 0.001. We also found correlations between consideRATE top-box scoring and CANHELP Lite scores for all participants (r pb = 0.4, p &lt; 0.001), with stronger associations among the patient (r pb = 0.5, p &lt; 0.001) and lower income (r pb = 0.6, p = 0.005) subgroups. We found discriminant validity between consideRATE and Single-item Health Literacy (SILs) measures for continuous scoring (r = -0.05 to 0.09, p &gt; 0.05) and top-box scoring (r = -0.02 to 0.09, p &gt; 0.05). We found no significant difference in overall experience between patients with breast and blood cancer. Conclusions: We demonstrated in this sample of patients attending a cancer center that consideRATE has good internal reliability and is well correlated with CANHELP-Lite.
Knowledge and practice of geriatric oncology among cancer care providers in Africa: A CROSS-sectional survey.
Authors: Abeid Athman Omar, Verna D. Vanderpuye, Daniel Afolayan, Wilma M. Hopman, Naa Adorkor Aryeetey, Haydee Verduzco, Omar Abdihamid, Vandrome Nakundi Kakonga, Fidel Rubagumya, Enrique Soto Pérez de Celis, Nazik Hammad
Journal: Journal of Clinical Oncology (2025)

e13848 Background: Africa is witnessing an increase in its older population and in cancer incidence, but little is known about the regional status of geriatric oncology. We conducted a cross-sectional survey among African physicians managing older adults with cancer to understand African geriatric oncology practices. Methods: A 30-item survey on the utilization of geriatric assessment (GA) and on the management of older adults with cancer, based on previously published surveys from the United States and Latin America, was distributed electronically via snowball sampling to physicians practicing oncology in Africa. Answers were collected between April and November 2024. Descriptive statistics were utilized to describe participant answers using SPSS software. Results: 179 participants started the survey and 84 completed it. Participants worked in 14 countries across 5 African regions, and most (76%) were aged &lt; 45Seven percent of participants were surgeons, 13% medical oncologists, 61% clinical/radiation oncologists, and 13% trainees. Seventy-one percent knew the correct definition of older age. Most participants (88%) worked in academic and public institutions, with older adults accounting for 10-40% of treated patients. Most agreed (82%) that older patients should be treated differently, and 92% stated they assessed them differently, but &lt; 20% did so using validated GA tools. Only 7% had a geriatrician at their institution while 21% knew a geriatrician in their city or healthcare system. Among those with a geriatrician at their institution, 83% involved them in managing patients. All respondents agreed that GA is necessary, but only 58% were aware of international geriatric oncology guidelines. The most evaluated domains included instrumental activities of daily living (41%), comorbidities (31%), toxicity risk (27%), and life expectancy (23.8%). Barriers to GA included lack of geriatricians (92%), lack of services available to perform GA (84%), lack of access to interventions (71%), and lack of reimbursement (39%). Most participants strongly agreed that treatment toxicities (84%), comorbidities (84%), patient prognosis (83%), and nutritional status (86%) strongly mattered in making the treatment decisions, while age (65%), was not considered as important. Only 20% believed there is enough information from clinical trials to treat older adults with cancer. Nearly all (97%) agreed that cancer care for older patients should be improved and were interested in receiving training. Conclusions: Geriatric oncology is an unmet need in Africa, and its implementation is limited by a lack of resources and personnel. Training African healthcare workers in geriatric oncology should be a future priority to increase the capacity to provide care for this growing population.
Incidence and outcomes of rejection in solid organ transplant recipients treated with immune checkpoint inhibitors: A systematic review and meta-analysis.
Authors: Muhammad Awidi, Osama Mustafa Younis, Layan Muwafaq Alzoubi, Mohammad Alkasji, Yazan Hamadneh, Muntaser Al Zyoud
Journal: Journal of Clinical Oncology (2025)

11068 Background: Immune checkpoint inhibitors (ICIs) are a cornerstone in the treatment of many solid tumors; however, their use in cancer patients with solid organ transplants (SOTs) poses unique challenges due to the risk of allograft rejection. We conducted a systematic review and meta-analysis of retrospective studies to determine the incidence of rejection and associated outcomes in SOT patients treated with ICIs. Methods: We searched PubMed, Embase, and Scopus to identify retrospective studies examining ICI therapy in SOT patients with cancer. Primary endpoints were the incidence of rejection and its clinical outcomes. Statistical analyses were performed using the "meta" package in R. Results: Seventeen studies encompassing 587 patients were included. The most frequent malignancies were hepatocellular carcinoma (HCC), melanoma, and cutaneous squamous cell carcinoma (cSCC). The overall rejection incidence was 16% (95% CI: 9%-24%), with variation across cancer types: multiple cancers (18%, 95% CI: 5%-36%), HCC (22%, 95% CI: 15%-29%), and cSCC (4%, 95% CI: 0%-21%). Rejection incidence was higher among liver transplant recipients (18%, 95% CI: 10%-26%) compared to kidney recipients (16%, 95% CI: 5%-32%). Geographic differences were observed, with rejection rates of 15% (95% CI: 1%-37%) in U.S.-based studies, 25% (95% CI: 18%-33%) in China, and 9% (95% CI: 0%-25%) in Korea. Pre-transplant ICI exposure was associated with a higher rejection rate (18%, 95% CI: 9%-28%) compared to post-transplant exposure (15%, 95% CI: 7%-26%). Outcomes of rejection varied, with 44% (95% CI: 24%-65%) achieving stabilization or resolution. Liver transplant recipients demonstrated higher resolution rates (67%, 95% CI: 46%-85%) compared to kidney recipients (27%, 95% CI: 7%-52%). Regional differences in resolution were notable, with higher rates reported in China (65%, 95% CI: 45%-83%) compared to the U.S. (26%, 95% CI: 13%-42%). Conclusions: This meta-analysis reveals a 16% overall rejection rate in SOT recipients treated with ICIs, higher in liver allografts and HCC, with regional disparities. Nearly half of patients who experienced rejection improved or stabilized, especially liver recipients. These findings underscore the need for personalized approaches to balance oncologic efficacy and graft survival in this complex population. Category Rate (% [95% CI]) Overall Rejection Rate 16 [9-24] Rejection by Cancer Type Multiple: 18 [5-36], HCC: 22 [15-29], cSCC: 4 [0-21] Rejection by Transplant Type Liver: 18 [10-26], Kidney: 16 [5-32] Rejection by Geography USA: 15 [1-37], China: 25 [18-33], Korea: 9 [0-25] Rejection by Timing Pre-Transplant: 18 [9-28], Post-Transplant: 15 [7-26] Overall Reversibility 44 [24-65] Reversibility by Transplant Type Liver: 67 [46-85], Kidney: 27 [7-52] Reversibility by Geography China: 65 [45-83], USA: 26 [13-42]
Heterogeneity in the expression of GPRC5D between patients with multiple myeloma.
Authors: Harsh Parmar, Maher Albitar, Sally Agersborg, Ahmad Charifa, Pooja Phull, Noa Biran, David H. Vesole, Andrew L. Pecora, Andrew Ip, Andre Goy, David Samuel DiCapua Siegel
Journal: Journal of Clinical Oncology (2025)

7511 Background: G-protein-coupled receptor class C group 5 member D (GPRC5D) is a protein inducible by all-trans retinoic acid with expression levels that vary depending on cellular differentiation. This protein receptor is targeted by several therapeutic modalities including chimeric-antigen receptor T-cell therapy (CAR-T), T-cell engagers (TCEs) and antibody-drug conjugates (ADCs). However, our understanding of GPRC5D expression levels in multiple myeloma cells and patient-to-patient heterogeneity remains limited. We investigated the expression levels of GPRC5D in the plasma cells of patients with multiple myeloma and compared its level of expression with those of CD38, CD138 and BCMA (TNFRSF17). Methods: Plasma cells from the bone marrow aspirates of 290 patients with multiple myeloma were enriched using CD138 column. RNA was extracted from the CD138 enriched population and sequenced by next generation sequencing (NGS) using a targeted RNA panel of 1600 genes. The RNA expression levels of various genes were quantified and expressed as transcript per million (TPM). Results: There was significant variation in the expression of GPRC5D between myeloma samples. The median and standard deviations for CD38, CD138, BCMA, and GPRC5D were 89 and 113, 69 and 134, 58 and 132, and 10 and 166, respectively. There was significant correlation (P &lt; 0.00001) between CD38, CD138 and BCMA. However, there was no correlation between the levels of GPRC5D and CD38 (R=-0.05, P= 0.4), CD138 (R=0.3, P= 0.6 ) or BCMA (R=0.1, P=0.02). Ten samples (3%) had zero TPM expression of GPRC5D despite relatively high CD138 (between 33 TPM and 487 TPM). The ratio of GPRC5D: BCMA varied from 0 to 39 with one sample with an exceptionally high ratio of 459 due to very low BCMA with high CD138 due to anti-BCMA therapy. Conclusions: Analysis of these data suggests that unlike BCMA, there is a significant patient-to-patient heterogeneity in GPRC5D expression. GPRC5D expression levels show a wide variation with approximately 3% of patients showing an absence of GPRC5D expression. Clinical trials exploring anti-GPRC5D therapy should consider measuring GPRC5D expression levels and potentially explore other therapies that may induce its increased expression given our findings. RNA Expression Levels (TPM) Variable Median Lower Quartile Upper Quartile CD38 89 63 135 CD138 69 44 134 BCMA 58 35 106 GPRC5D 10 2 50 Spearman Correlations Pair of Variables R t(N-2) p-value CD38 &amp; CD138 0.362809 6.60727 0.0000000 CD38 &amp; BCMA 0.383742 7.05224 0.0000000 CD138 &amp; BCMA 0.63282 13.86974 0.0000000 CD138 &amp; GPRC5D 0.028007 0.47548 0.6348020 CD38 &amp; GPRC5D -0.045081 -0.76583 0.4444070 BCMA &amp; GPRC5D 0.138314 2.37004 0.0184450