tbuckley/cabot-search huggingface dataset:
Effectiveness and safety of multimodal analgesic management based on the ERAS concept in the perioperative period of TACE for patients with Intermediate and advanced hepatocellular carcinoma.
Authors: Yanqin Wu, Hang Liu, Wenzhe Fan, Jiaping Li
Journal: Journal of Clinical Oncology (2025)

12085 Background: To evaluate the effectiveness and safety of multimodal analgesic management based on the enhanced recovery after surgery (ERAS) concept in the perioperative period of transarterial chemoembolization (TACE) for patients with advanced hepatocellular carcinoma. Methods: A retrospective analysis was conducted on 90 patients who underwent TACE at the First Affiliated Hospital of Sun Yat-sen University from January 2022 to October 2023. Patients were divided into two groups: Group A received a multimodal analgesic regimen based on the ERAS concept, which included preoperative administration of 6 mg hydromorphone hydrochloride and 50 mg flurbiprofen axetil, diluted in normal saline to a total of 100 ml and infused via a patient-controlled intravenous analgesia (PCIA) pump. Group B received conventional perioperative management combined with traditional analgesic methods, using intravenous flurbiprofen axetil 50 mg or intramuscular tramadol 100 mg for postoperative pain. Pain levels were recorded using the Numeric Rating Scale (NRS) at various time points: intraoperatively, immediately postoperatively, and at 1, 6, 12, and 24 hours post-surgery, along with the incidence of adverse reactions within 24 hours. Inflammatory indicators were compared before and after TACE, and patient satisfaction and cost-effectiveness analyses were conducted. Results: The NRS scores for Group A at the five time points were 3.0 (3.0–2.0), 3.0 (4.0–2.0), 4.0 (5.0–3.0), 3.0 (3.5–2.0), and 1.0 (1.0–0.5), respectively. For Group B, the scores were 4.0 (5.0–3.0), 4.0 (5.0–3.0), 5.0 (6.0–3.5), 3.0 (4.0–2.0), and 1.0 (2.0–1.0) , respectively. Except for the NRS score at 12 hours post-surgery, all other time points showed statistically significant differences. There was no statistically significant difference in the levels of PCT and IL-6 before and after surgery between the two groups, but a trend of lower postoperative PCT and IL-6 levels in Group A compared to Group B was observed. The incidence of various adverse reactions 24 hours post-surgery did not differ significantly between the two groups (P &gt; 0.05). Patient satisfaction with analgesia at 48 hours post-surgery was significantly higher in Group A than in Group B, with a statistically significant difference (P = 0.001). Group A demonstrated better economic benefits. Conclusions: The results of this study indicate that multimodal analgesic management based on the ERAS concept has better analgesic effects during the perioperative period of TACE treatment, with comparable safety and improved economic benefits. This provides strong support for the clinical application of multimodal analgesic management based on the ERAS concept in TACE for liver cancer.
Prognostic factors associated with distant recurrence in patients with intimal sarcoma at a tertiary sarcoma referral center in Latin America.
Authors: Javier Antonio Méndez López, Cristian Vargas, Elí Emmanuel Santana Aguilar, Gabriela Alamilla-Garcia, Dorian Yarih Garcia Ortega
Journal: Journal of Clinical Oncology (2025)

e23565 Background: Intimal sarcoma (InS) is an extremely rare and aggressive subtype of soft tissue sarcoma, typically originating in large mediastinal vessels or the heart. This high-grade tumor carries a dismal prognosis, with reported median overall survival (OS) ranging from 8 to 13 months. Molecularly, MDM2 and CDK4 amplifications are hallmark alterations, suggesting potential therapeutic targets. However, data on prognostic factors, therapeutic strategies, and survival outcomes are scarce, particularly in Latin American populations. This study aims to identify prognostic factors associated with recurrence and survival in patients with intimal sarcoma treated at a tertiary sarcoma referral center. Methods: A retrospective cohort study was conducted at a Latin American sarcoma referral center, analyzing patients diagnosed with histologically confirmed intimal sarcoma between 2014 and 2024. Clinical, pathological, and treatment data were collected. Inclusion criteria were a confirmed diagnosis of intimal sarcoma, complete clinical staging, and follow-up information. The primary outcomes were overall survival (OS), progression-free survival (PFS), and recurrence patterns. Kaplan-Meier survival curves were used to estimate OS and PFS, and Cox proportional hazards regression was performed to evaluate prognostic factors. Results: A total of 12 patients (six males, six females) with a median age of 44.6 years (IQR 29-64) were included. Tumor locations included the right atrium (n = 4), pulmonary vein (n = 4), right ventricle (n = 1), and vena cava (n = 1). Six patients presented with early-stage disease (Stages I-II), 1 with locally advanced disease (Stage III), and 5 with metastatic disease (Stage IV). Multimodal treatment was performed in 9 patients, and 7 received anthracycline-based chemotherapy. The median PFS was 14.1 months (IQR 1-48), and the median OS was 19.1 months (IQR 1-52). Recurrence or disease progression occurred in 10 patients, with the most common recurrence sites being the lungs (n = 4), central nervous system (n = 2), and mixed sites (n = 1). No significant difference in OS and PFS was observed based on tumor location, size, or treatment. Conclusions: Intimal sarcoma remains a highly aggressive malignancy with a poor prognosis and high recurrence rates. This study highlights the frequent pulmonary and central nervous system recurrence patterns and emphasizes the critical role of surgical resection in initial disease control. However, recurrence is common, underscoring the need for multimodal approaches, including anthracycline-based chemotherapy, and exploring emerging therapies targeting MDM2 amplifications. These findings provide valuable insights into this rare malignancy in Latin America and reinforce the need for further research to improve outcomes.
Single-cell RNA sequencing atlas of intestinal injury induced by different clinical treatments in colorectal cancer patients.
Authors: Luoxi He, Hui Zhang, Peiyuan Mu, Ruone Xu, Yujun Liu, Yajie Chen, Wang Yang, Menglong Zhou, Juefeng Wan, Shujuan Zhou, Fan Xia, Zhen Zhang
Journal: Journal of Clinical Oncology (2025)

12039 Background: Colorectal cancer (CRC) patients often experience intestinal injury due to various treatment regimens, including chemotherapy (CT), chemoradiotherapy (CRT), and chemoradioimmunotherapy (ICRT). Despite advances in treatment, the underlying mechanisms of treatment-induced intestinal injury remain poorly understood. Methods: We performed single-cell RNA sequencing and histological staining on intestinal samples obtained from 18 colorectal cancer patients undergoing different treatment regimens, including untreated (CTRL), CT, CRT, and ICRT groups. We also employed bulk RNA sequencing to compare paired cancer and normal tissues from ICRT patients, identifying similarities and differences in gene expression patterns between the cancer and normal tissues. Results: Histological staining showed that there were no morphological changes in CT, while the damage in CRT was obvious, and the damage in ICRT was even more severe. Intestinal epithelial cells exhibit distinct differentiation trajectories into secretory and absorptive lineages. CRT-induced damage triggers reverse differentiation via revival stem cells (revSCs), driven by fetal-like genes like CLU, while ICRT disrupts this process. In CD8+T cells, effector T cells (TEFF) increase significantly in the ICRT group and differentially expressed genes (DEG) revealed unique patterns across different treatments, including upregulation of senescence-related genes in CRT and interferon- and TNF-related genes in ICRT, highlighting potential therapeutic targets for treatment-induced intestinal injury. In B cells, distinct differentiation pathways were observed, with CRT increasing atypical memory (Atm) B and ICRT promoting germinal center (GC) B, the latter correlating with follicular helper T (TFH) cells and potentially indicating tertiary lymphoid structure (TLS) formation, similar to the patterns of tumor response after ICRT. So we conducted bulk RNA sequencing analysis between paired tumor and normal tissues, which revealed a correlated expression of effector markers, suggesting a shared biological pattern between tissue damage and tumor killing. Also, patients in the ICRT group showed a significant correlation between clinical intestinal injury scores (LARS) and tumor regression grade (TRG), which means we can predict the treatment efficacy of ICRT by a more direct and convenient way. We also performed metabolism analysis and found tryptophan metabolism was significantly altered following CRT and ICRT treatments, closely linked to epithelial repair and inflammation, highlighting tryptophan metabolism can be used as treatment of intestinal injury. Conclusions: Our study presents a comprehensive single-cell atlas of treatment-induced intestinal injury in CRC patients, offering insights for future strategies to reduce treatment-related intestinal damage.
Whole-genome sequencing of biliary tract cancer: Uncovering the genomic origins of evolutionary trajectories.
Authors: Felix Beaudry, Nicholas Light, Duhan Yendi, Anudari Zorigtbaatar, Maggie Hildebrand, Anna Dodd, Roxana Bucur, Julie Wilson, Enrique Sanz Garcia, Xin Wang, Erica S. Tsang, Grainne O'Kane, Steven Gallinger, Arndt Vogel, Jennifer J. Knox, Faiyaz Notta, Gonzalo Sapisochin, Robert C. Grant
Journal: Journal of Clinical Oncology (2025)

4116 Background: Biliary tract cancers (BTC) are rare, highly aggressive malignancies with limited treatment options, leading to consistently poor outcomes. An improved understanding of BTC tumor evolution could inform enhanced screening strategies, identify useful prognostic markers, and discover novel therapeutic targets. Methods: We performed whole genome and transcriptome sequencing (WGTS) at high depth ( &gt; 80X) on a prospective cohort of BTC tumors. After detecting mutations and mutational signatures, we developed two novel methods for driver identification and evolutionary reconstruction. First, we created new oncogene and tumor suppressor-specific models that integrate copy number profiles, structural variant breakends, and expression changes to distinguish structural drivers from neutral chromosomal rearrangements. Second, we applied population genetics techniques to fit demographic models to tumor allele frequencies across 20 paired primary and metastatic samples. Results: We analyzed 130 tumor samples from 110 patients, representing the largest BTC whole-genome cohort to date. We identified hypermutated tumors (50-150 mutations/mb) with distinct etiologies, including mismatch repair deficiency, platinum exposure, tobacco use, and aristolochic acid-related damage, the latter of which was associated with response to immunotherapy. Ourintegrated-driver approach identified an association between selection on RAD23A and an increased structural variant load, resulting in a tandem-duplicator-like mutational phenotype. This also revealed an underappreciated impact of SMAD4 in BTC, which is inactivated through multiple mutation types in 12%. Notably, BAP1 mutations occurred in 24% of cases, including 4% that were inactivated through deletion of the BAP1 promoter that lowered transcript expression, a previously undescribed mechanism. By pairing clinical data to the genomics, we observed a co-occurrence of BAP1 mutations and FGFR2 fusions in small-duct, mass-forming intrahepatic cholangiocarcinomas. These mutations were mutually exclusive with TP53 mutations, which were enriched in patients with primary sclerosing cholangitis. Finally, our novel method for subclonal population reconstruction on paired samples illuminated recent tumor evolutionary dynamics and identified an ARID1B fusion with a potential role in metastasis. Conclusions: This study uncovered novel genomic mechanisms underlying the evolutionary origins of BTC beyond those previously identified with exome and panel sequencing, highlighting the value of WGTS. These results highlight the complex genomic heterogeneity of BTC, with potential implications for precision therapy.
Outpatient palliative care consultation and end-of-life outcomes among a retrospective cohort of patients treated with immunotherapy for non-small cell lung cancer.
Authors: Chance Bloomer, John Hunting, Morgan Lehman, Kenneth Paik, Andrew Thomas Faucheux, Eric Olson, Thomas William Lycan
Journal: Journal of Clinical Oncology (2025)

12082 Background: Immune checkpoint inhibitors (ICIs) have been shown to be effective against a wide range of cancers and are available to most patients due to their favorable side effect profile. Studies have shown that palliative care consultation prolongs overall survival (OS) in patients with advanced cancer, but most of these studies assessed cytotoxic chemotherapy and not ICIs. Other studies have shown that outpatient palliative care consultation (OPCC) has a greater effect on a variety of end-of-life outcomes than in the inpatient setting. Our study aims to analyze the association between OPCC and survival in patients with lung cancer treated with an ICI. Methods: We designed a retrospective registry of all patients at a comprehensive cancer center and its outreach clinics who received one or more doses of an ICI. The investigators created a secure, cloud-based registry (REDCap), validated it with data quality rules, resolved all discrepancies, and obtained data on palliative care encounters; clinical research specialists at Vasta Global (New York, NY) captured most of the data. Comparisons were made using chi-square or Fisher’s exact for categorical variables. Cox proportional hazards model was built controlling for confounders. Survival time for patients with palliative visits was only considered after initial OPCC. Statistical significance was defined as p &lt; 0.05. The study had institutional IRB approval. Results: Our cohort consisted of 1,114 patients with non-small cell lung cancer, 55% of whom were metastatic at diagnosis. 6% (n = 70) of the patients had an OPCC at some point after their diagnosis. When controlling for stage at diagnosis and age, OPCC was associated with an adjusted hazard ratio of 0.57 (95% CI 0.34-0.98). None of the patients with OPCC received ICI within 14 days of death compared to 6.5% of those without OPCC (p = 0.018). Similarly, only 2.9% of those with OPCC received ICI within 30 days of death, compared to 16.4% of those without OPCC (p = 0.003). Conclusions: In patients with lung cancer treated with ICI, OPCC was associated with improved OS regardless of age or stage at diagnosis. Our analysis also showed that patients who received OPCC were less likely to receive ICI near the end of life. It is possible that OPCC may prolong survival by decreasing the ineffective use of aggressive care at the end of life. Further research is needed to clarify the relationship between OPCC and cancer outcomes.
Care needs and considerations for implementing a community-based palliative care program for women with breast or cervical cancer in three Nigerian states.
Authors: Igoche David Peter, Sussan Israel-Isah, Ambi Ibrahim, Victoria D. Igbinomwanhia, Temitope Olukomogbon, Emeka Odiaka, Joseph Ashaolu, Elima Jedy-Agba
Journal: Journal of Clinical Oncology (2025)

12068 Background: Breast and cervical cancer pose a significant public health burden in most sub-Saharan African countries including Nigeria. With ~70% of cases presenting at late stages (III &amp; IV), high mortality is often a characteristic feature. This underscores the critical need for comprehensive palliative care services to improve the quality of life for Nigerian women with breast and cervical cancers. Despite the growing recognition of this need, there is limited evidence for integrating community resources into cancer-directed palliative care services in Nigeria, hence this study explored the needs of Nigerian women with breast or cervical cancer, and their caregivers, and sort to identify resources necessary for developing a robust palliative care initiative across the community and healthcare facility settings. Methods: We conducted a qualitative study including 45 purposively sampled adult female caregivers of women with breast or cervix cancers, from 3 states in Nigeria: Abuja-Federal Capital Territory, Nasarawa, and Rivers states respectively. Focus Group Discussions using semi-structured interview guide were carried out and included questions about cancer care needs of both caregivers and the patients, including considerations for implementing a community-based palliative care program. Data were analysed using thematic analysis for deductive identification of key themes, while allowing for new themes to emerge inductively, and then we phenomenologically investigated respondents' palliative care needs perceptions and their meaning. Results: Four overarching themes were identified namely, i) needs of women with breast or cervical cancer, ii) needs of caregivers, iii) human resources for community-based palliative care, and iv) feasibility of a community-based palliative care program. Respondents revealed that to attain wholistic wellbeing for women with breast or cervical cancer, their peculiar needs and those of their caregivers which were largely unrecognised deserve attention. Adequate human resources, including trained healthcare workers and support staff, and clearly defined feasibility criteria for palliative care, were identified as crucial for the successful implementation of a community-based palliative care program. Conclusions: A community-based palliative care program for Nigerian women with breast or cervical cancer will be acceptable and feasible if it is designed to address the peculiar medical and non-medical needs of both the cancer patients and their caregivers.
Androgen deprivation therapy and quality of life: A concept map analysis.
Authors: David Lazris, Yael Schenker, Shane Belin, Jennifer Jones, Jessica Burke, Risa Liang Wong
Journal: Journal of Clinical Oncology (2025)

12067 Background: Androgen deprivation therapy (ADT) is the backbone of systemic treatments for prostate cancer (PC), but is associated with side effects that decrease quality of life (QOL). There lacks a robust qualitative exploration of the nuanced entirety of physical, mental, and social changes men experience during ADT. While interventions typically focus on metabolic and cardiovascular effects, it is unclear if these are the most impactful contributors to QOL as experienced by men themselves. Methods: We conducted concept mapping, a participatory mixed-methods research approach, involving item generation, pile sorting, and rating to identify and categorize side effects of ADT. Thirty men who started ADT for PC in the past 3-12 months and reported undesirable changes from ADT participated. Men on oral androgen axis inhibitors were included, but those receiving other systemic therapies or with comorbidities that could confound results were excluded. Men who had surgery or radiation for PC were enrolled after ≥3 months post-treatment. We conducted semi-structured brainstorming interviews to generate lists of undesirable changes participants experienced. Study team members reviewed each list for completeness, then combined all 676 items into 79 unique items. Fifteen participants sorted these items into named groups and rated each item on a 1-5 Likert scale for the following questions (5 representing maximal response): “After starting ADT, how much did this change negatively affect your life?” and “After starting ADT, how much additional support would you have liked to receive for the following change?” GroupWisdom Concept Mapping software generated a cluster map and calculated mean Likert scale ratings for each cluster. Results: Based on participant sorting, items were grouped into four main clusters: Physical Manifestations; Sexual Changes; Mental Health Changes &amp; Concerns of Stigma; and Motivational Changes (13 iterations, stress value 0.29). The Table presents sample items and mean Likert scale cluster ratings. Conclusions: While men on ADT reported expected physical and sexual changes, qualitative interviews uncovered changes in motivation, mental health, and concerns of stigma. Men reported sexual changes as having the largest negative impact on QOL. The concept mapping can be utilized to provide anticipatory guidance to men starting ADT, as well as guide the development of supportive interventions. Cluster Example Items Negative Affect on Life Rating (1-5; 5=Most Negative) Additional Support Wanted Rating (1-5; 5=Most Support Wanted) Physical Manifestations - Physical Strength Decreased 2.6 2.1 Sexual Changes - Sex Drive/Libido Diminished 2.9 2.0 Motivational Changes - Wanting to Sit and Do Nothing/Watch TV; Being Less Active; Feeling "Lazy" 2.2 1.7 Mental Health Changes &amp; Concerns of Stigma - Not Wanting to Share Information About Diagnosis/Treatment with Others-More Pessimistic/Less Optimistic 1.8 1.5
Prospective observational study on health resource utilization and patterns of care for skeletal-related events in patients with bone metastases secondary to solid tumors.
Authors: Mahmoud Abdelsatar Elshenawy, Aisha Siddique, Faaez Uddin Syed, Ayman Tarek Omar, Ayman Elshentenawy, Noura Alzannan, Fatma Maraiki, Noha Jastaniyah, Tusneem Elhassan, Shouki Bazarbashi
Journal: Journal of Clinical Oncology (2025)

12052 Background: Bone metastases are a common complication of advanced solid tumors, leading to significant morbidity through skeletal-related events (SREs). This study evaluates health resource utilization (HRU), treatment patterns, and clinical outcomes associated with SREs, with a focus on bone-modifying agents (BMAs) such as zoledronic acid and denosumab. Methods: This single-center, prospective, observational study included 199 patients with bone metastases secondary to solid tumors who experienced at least one SRE. Eligible patients were adults (≥18 years) with an Eastern Cooperative Oncology Group (ECOG) performance status of 0–3. Data collected included demographics, primary cancer type, comorbidities, treatment patterns, type and timing of SREs, and HRU. The impact of BMAs on SRE-free survival and overall survival (OS) was assessed using Kaplan-Meier analysis and multivariate Cox regression models. Results: The median age at the first SRE was 56 years, with 51.8% of patients being female. Breast cancer was the most common primary tumor site (30.2%), followed by genitourinary (22.1%) and gastrointestinal (18.6%) cancers. Visceral metastases were present in 56.3% of patients. Radiation therapy accounted for 80.9% of first SREs, followed by cord compression (8.5%), pathological fractures (7%), and surgical fixation (3.5%). Only 16.5% of patients received BMAs before their first SRE, increasing to 38.2% after the first SRE. Patients who received BMAs before the first SRE had significantly prolonged SRE-free survival (median 9.9 vs. 2.03 months, p = 0.001) and OS (median 45.6 vs. 29.8 months, p = 0.05). Similarly, BMA use after the first SRE improved SRE-free survival (median 18.9 vs. 10.3 months, p &lt; 0.001) and OS (median 25.9 vs. 13.6 months, p = 0.001). The most common BMA-related adverse event was hypocalcemia (44.7%). Conclusions: This study highlights the underutilization of BMAs before the first SRE despite their significant impact on SRE-free survival and OS. Post-SRE BMA use was associated with improved outcomes, underscoring the need for earlier initiation of BMA therapy. Future research should focus on identifying barriers to early BMA utilization, optimizing management of therapy-related complications, and assessing the cost-effectiveness of BMAs in real-world settings.