tbuckley/cabot-search huggingface dataset:
Similar Efficacy Observed for First-Line Immunotherapy in Racial/Ethnic Minority Patients With Metastatic NSCLC
Authors: Matthew Lee, Jianyou Liu, Emily Miao, Shuai Wang, Frank Zhang, John Wei, Julie Chung, Xiaonan Xue, Balazs Halmos, H. Dean Hosgood, Haiying Cheng
Journal: Journal of the National Comprehensive Cancer Network (2023)

Background: Limited data exist on the impact of immunotherapy use in ethnic minority patients with non–small cell lung cancer (NSCLC), because they have been underrepresented in immunotherapy trials. This study aims to evaluate race/ethnicity and other demographic, socioeconomic, and clinical factors of patients with metastatic NSCLC treated with first-line immunotherapy. Methods: A retrospective cohort study of 5,920 patients diagnosed with lung cancer treated at Montefiore Einstein Cancer Center from January 1, 2013, to June 1, 2022, was used to identify patients with metastatic NSCLC without EGFR , ALK , or ROS1 alterations who underwent first-line immunotherapy (n=248). The primary endpoint was overall survival (OS), with secondary endpoints of progression-free survival (PFS) and time to discontinuation (TTD) from the start of immunotherapy. Results: Among the 248 patients, median follow-up time was 12.0 months, median age at start of treatment was 66 years, and 39.1% were non-Hispanic Black, 30.2% were Hispanic, and 30.7% were non-Hispanic White. OS ( P =.39), PFS ( P =.29), and TTD ( P =.98) were similar among racial/ethnic groups. Patients with an ECOG performance status (PS) of &lt;2 at the start of immunotherapy had longer OS compared with those with ECOG PS of ≥2 ( P &lt;.0001). PD-L1 expression (&lt;50% vs ≥50%; P =.03) and body mass index (BMI) ( P =.01) were also found to be associated with PFS, and ECOG PS ( P &lt;.0001) and BMI ( P =.02) were associated with TTD. In a multivariate analysis of OS and PFS, ECOG PS was the only variable found to be significant. Conclusions: Our study observed similar benefits of immunotherapy in patients with metastatic NSCLC in different racial and ethnic groups. Furthermore, ECOG PS was associated with OS, and PD-L1 expression and BMI were associated with PFS and TTD. These findings help identify potential factors associated with outcomes and care while patients are undergoing immunotherapy.
Integrating Immune Therapies for the Treatment of Multiple Myeloma
Authors: Lekha Mikkilineni, Surbhi Sidana
Journal: Journal of the National Comprehensive Cancer Network (2023)

Patients with relapsed or refractory multiple myeloma (RRMM) that is refractory to a proteasome inhibitor, an immunomodulatory drug (IMiD), and an anti-CD38 antibody (triple-class refractory MM) have poor outcomes. Recently, 2 classes of T-cell engaging therapies—CAR T-cell therapy and bispecific T-cell engaging antibodies (BsAbs)—have resulted in unprecedented response rates and survival outcomes in these heavily pretreated patients. The most common targets are BCMA and GPRC5D, with other targets in development. The main classes of adverse effects include cytokine release syndrome, neurotoxicity, infections, and cytopenias, as well as adverse effects unique to specific products. As of September 2023, 2 BCMA-targeting CAR-T cell products, 2 BCMA-targeting BsAbs, and 1 GPRC5D-targeting BsAb, are FDA-approved for standard-of-care use in patients with RRMM who received at least 4 prior lines of therapy, including prior treatment with a proteasome inhibitor, an IMiD, and an anti-CD38 antibody. Earlier-line use is under investigation and has shown promising results. Several other investigational CAR-T constructs and bispecific antibodies are in clinical development. As these therapies become more widely used, including in earlier-line setting, efforts to understand optimal sequencing and mitigate toxicities remain critical.
Effect of Adapted Physical Activity in Patients With Advanced Pancreatic Cancer: The APACaP GERCOR Randomized Trial
Authors: Cindy Neuzillet, Olivier Bouché, Christophe Tournigand, Benoist Chibaudel, Lucile Bauguion, Leïla Bengrine-Lefevre, Daniel Lopez-Trabada Ataz, May Mabro, Jean-Philippe Metges, Denis Péré-Vergé, Thierry Conroy, Astrid Lièvre, Morgan Andre, Françoise Desseigne, François Goldwasser, Julie Henriques, Amélie Anota, Pascal Hammel
Journal: Journal of the National Comprehensive Cancer Network (2023)

Background: The impact of adapted physical activity (APA) on health-related quality of life (HRQoL) in patients with advanced pancreatic ductal adenocarcinoma (aPDAC) is unknown. This study evaluated whether APA in addition to standard care improved HRQoL in patients who have aPDAC who are receiving first-line chemotherapy. Patients and Methods: Patients with locally advanced/metastatic PDAC and an ECOG performance status of 0 to 2 were randomized (1:1) to receive standard care (standard arm) or standard care plus a home-based 16-week APA program (APA arm). The primary objective was the effect of the APA program on 3 dimensions of the EORTC QLQ-C30: global health status, physical function, and fatigue at week 16 (W16), with a one-sided type I error of 0.017 for each dimension. The primary HRQoL analysis was performed in patients with available baseline and W16 scores for the dimensions (ie, the modified intention-to-treat population 1 [mITT1]), and secondary longitudinal HRQoL analyses using the mixed model for repeated measures (MMRM) and time until definitive deterioration (TUDD) methods were performed in the mITT1 population and in patients with baseline and at least one follow-up questionnaire (mITT2 population). A difference of ≥5 points was considered to be clinically relevant. Results: Of 326 included patients, 313 were randomized to the standard (n=157) or APA (n=156) arms. In the mITT1 population (n=172), the mean differences in global health status, physical function, and fatigue at W16 adjusted from baseline were −0.98 (SD, 23.9; P =.39), −2.08 (SD, 21.3; P =.26), and 4.16 (SD, 29.2; P =.17), respectively, showing a non–statistically significant benefit with APA. In the mITT2 population (n=259), APA was associated with statistically significant and clinically relevant improvement in 5 and 8 dimensions of the HRQoL in the longitudinal MMRM and TUDD analyses, respectively. Conclusions: APA improved several dimensions of HRQoL in patients with aPDAC receiving first-line chemotherapy and standard care.
JAK2 R683S Mutation Resulting in Dual Diagnoses of Chronic Eosinophilic Leukemia and Myelodysplastic/Myeloproliferative Overlap Syndrome
Authors: Nathan M. Krah, Laura Miotke, Peng Li, Jay L. Patel, Anneli R. Bowen, Anthony D. Pomicter, Ami B. Patel
Journal: Journal of the National Comprehensive Cancer Network (2023)

A 66-year-old male presented with hypereosinophilia, thrombocytosis, extensive thrombosis refractory to direct oral anticoagulant therapy, and evidence of end-organ damage, including rash, splenic infarcts, and pulmonary infiltrates. Bone marrow biopsy revealed myeloid malignancy consistent with both chronic eosinophilic leukemia and myelodysplastic/myeloproliferative neoplasms (MDS/MPN) with SF3B1 mutation and thrombocytosis. Next-generation sequencing of the patient’s eosinophils and neutrophil compartments revealed pathologic variants in EZH2 and SF3B1 in addition to a noncanonical JAK2 R683S mutation that has not been previously described in myeloproliferative disorders or other chronic myeloid neoplasms. These mutations were not present in the patient’s lymphoid cell fraction, suggesting that the hematopoietic malignancy arose in a myeloid-committed progenitor cell. Based on this case and previous work from our group, we propose that noncanonical JAK2 mutations may permit signal transduction that biases toward eosinophilic differentiation in chronic myeloid neoplasms. Although the patient’s blood counts initially responded to ruxolitinib and hydroxyurea, the response was not durable. Early referral for allogenic bone marrow transplant appears necessary to prevent long-term complications and disease progression in myeloid neoplasms with clonal hypereosinophilia driven by noncanonical JAK2 mutations.
Pilot Trial of Streamlined Genetic Education and Traceback Genetic Testing in Prostate Cancer Survivors
Authors: Marc D. Schwartz, Beth N. Peshkin, Claudine Isaacs, Christopher Grisham, Nora J. Holmes, Lia J. Sorgen, Sean Collins, Nancy Dawson, Colleen McGuire, Tobechukwu Okobi, Kelsey Newell, Kavitha A. Kolla, Veronique Weinstein
Journal: Journal of the National Comprehensive Cancer Network (2023)

Background: Germline genetic testing is recommended for men with metastatic or high-risk prostate cancer to inform treatment and risk management for other cancers and inform genetic testing in at-risk relatives. However, relatively few patients with prostate cancer undergo genetic testing. Given the low rate of testing and increasing demands on genetic service providers, strategies are needed that reduce barriers to testing while conserving genetic counseling resources. The primary goal of this study was to determine whether a proactive and streamlined “traceback” approach could yield increased genetic testing participation among prostate cancer survivors. Methods: We randomized 107 survivors of metastatic and high-risk prostate cancer to streamlined testing (ST) versus enhanced usual care (EUC). ST participants were proactively provided with print genetic education materials and the option to proceed to genetic testing without pre-test genetic counseling. EUC participants were sent a letter from their physician advising them of their eligibility for genetic testing and recommending they schedule genetic counseling. The primary outcome was genetic testing participation. Secondary outcomes were distress, knowledge, decision satisfaction, and regret. Results: In the ST group, 41.5% of participants completed genetic testing compared with 27.8% in the EUC group. After adjusting for education and marital status, the odds of testing were more than twice as high for the ST group as for the EUC group (odds ratio, 2.57; 95% CI, 1.05–6.29). The groups did not differ on any of the psychosocial outcomes at the 3-month follow-up. Conclusions: Proactive outreach paired with streamlined genetic testing delivery may be a safe, effective, and resource-efficient approach to facilitate traceback genetic testing in prostate cancer survivors.
Trastuzumab deruxtecan in previously treated patients with HER2-positive metastatic breast cancer: updated survival results from a phase II trial (DESTINY-Breast01)
Authors: C. Saura, S. Modi, I. Krop, Y.H. Park, S.-B. Kim, K. Tamura, H. Iwata, J. Tsurutani, J. Sohn, E. Mathias, Y. Liu, J. Cathcart, J. Singh, T. Yamashita
Journal: Annals of Oncology (2023)

Primary analysis of the multicenter, open-label, single-arm, phase II DESTINY-Breast01 trial (median follow-up 11.1 months) demonstrated durable antitumor activity with trastuzumab deruxtecan (T-DXd) in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (mBC) previously treated with trastuzumab emtansine (T-DM1). We report updated cumulative survival outcomes with a median follow-up of 26.5 months (data cut-off 26 March 2021).
NCCN Guidelines® Insights: Cervical Cancer, Version 1.2024
Authors: Nadeem R. Abu-Rustum, Catheryn M. Yashar, Rebecca Arend, Emma Barber, Kristin Bradley, Rebecca Brooks, Susana M. Campos, Junzo Chino, Hye Sook Chon, Marta Ann Crispens, Shari Damast, Christine M. Fisher, Peter Frederick, David K. Gaffney, Stephanie Gaillard, Robert Giuntoli, Scott Glaser, Jordan Holmes, Brooke E. Howitt, Jayanthi Lea, Gina Mantia-Smaldone, Andrea Mariani, David Mutch, Christa Nagel, Larissa Nekhlyudov, Mirna Podoll, Kerry Rodabaugh, Ritu Salani, John Schorge, Jean Siedel, Rachel Sisodia, Pamela Soliman, Stefanie Ueda, Renata Urban, Emily Wyse, Nicole R. McMillian, Shaili Aggarwal, Sara Espinosa
Journal: Journal of the National Comprehensive Cancer Network (2023)

The NCCN Guidelines for Cervical Cancer provide recommendations for all aspects of management for cervical cancer, including the diagnostic workup, staging, pathology, and treatment. The guidelines also include details on histopathologic classification of cervical cancer regarding diagnostic features, molecular profiles, and clinical outcomes. The treatment landscape of advanced cervical cancer is evolving constantly. These NCCN Guidelines Insights provide a summary of recent updates regarding the systemic therapy recommendations for recurrent or metastatic disease.
Multiple Myeloma, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology
Authors: Shaji K. Kumar, Natalie S. Callander, Kehinde Adekola, Larry D. Anderson, Muhamed Baljevic, Rachid Baz, Erica Campagnaro, Jorge J. Castillo, Caitlin Costello, Christopher D’Angelo, Srinivas Devarakonda, Noura Elsedawy, Alfred Garfall, Kelly Godby, Jens Hillengass, Leona Holmberg, Myo Htut, Carol Ann Huff, Malin Hultcrantz, Yubin Kang, Sarah Larson, Hans C. Lee, Michaela Liedtke, Thomas Martin, James Omel, Timothy Robinson, Aaron Rosenberg, Douglas Sborov, Mark A. Schroeder, Daniel Sherbenou, Attaya Suvannasankha, Jason Valent, Asya Nina Varshavsky-Yanovsky, Rashmi Kumar, Jenna Snedeker
Journal: Journal of the National Comprehensive Cancer Network (2023)

The treatment of relapsed/refractory multiple myeloma (MM) has evolved to include several new options. These include new combinations with second generation proteasome inhibitors (PI); second generation immunomodulators, monoclonal antibodies, CAR T cells, bispecific antibodies, selinexor, venetoclax, and many others. Most patients with MM undergo several cycles of remissions and relapse, and therefore need multiple lines of combination therapies. Selecting treatment options for relapsed/refractory MM requires consideration of resistance status to specific classes, and patient-specific factors such as age and other comorbidities should be considered. The NCCN Guidelines for MM provide a framework on which to base decisions regarding workup, treatment, and follow-up of newly diagnosed and previously treated MM. This manuscript outlines the recommendations from NCCN Guidelines for MM specific to relapsed/refractory disease.
Perinatal morbidity among women with a previous caesarean delivery (PRISMA trial): a cluster-randomised trial
Authors: Nils Chaillet, Benoît Mâsse, William A Grobman, Allison Shorten, Robert Gauthier, Patrick Rozenberg, Marylène Dugas, Jean-Charles Pasquier, François Audibert, Haim A Abenhaim, Suzanne Demers, Bruno Piedboeuf, William D Fraser, Robert Gagnon, Guy-Paul Gagné, Diane Francoeur, Isabelle Girard, Louise Duperron, Marie-Josée Bédard, Mira Johri, Eric Dubé, Simon Blouin, Thierry Ducruet, Mario Girard, Emmanuel Bujold, Nils Chaillet, Benoît Mâsse, William A Grobman, Allison Shorten, Robert Gauthier, Patrick Rozenberg, Marylène Dugas, Jean-Charles Pasquier, François Audibert, Haim A Abenhaim, Suzanne Demers, Bruno Piedboeuf, William D Fraser, Robert Gagnon, Guy-Paul Gagné, Diane Francoeur, Isabelle Girard, Louise Duperron, Marie-Josée Bédard, Mira Johri, Eric Dubé, Simon Blouin, Thierry Ducruet, Mario Girard, Emmanuel Bujold, Chantal Roy, Josée Mailhot, Anne Samson, Cathie Bordeleau, Siham Aboulfadl, Gabrielle Nadeau, Catherine Arpin, Angèle Trudeau, Eugénie Champagne, Margaux Cassivi, Gentiane Rajaobelison, Francine Marsan, Cristelle Brière, Ana Gil Gimeno, Robert Platt, Shiliang Liu, Fernando Althabe, François Champagne, Jennifer Blake, Andrée Gagnon, Kim Dart, Luisa Ciofani, Marie-Eve St Laurent, Daniel Riverin, Arvind K Joshi, Isabelle Lévesque, Jacques Mailloux, François Beaudoin, Patricia Monnier, Laurent Tordjman, Natacha Bédard, Gaston Dorval, Caroline Carpentier, Réjean Lemieux, Suzanne Roberge, Martine Simard, Roupen Bedrossain, Gérard Landry, Gilles Perreault, Marie-Hélène Aubé, Jean-Guy Bibeau, Pascale Desautels, Eric Paradis, Josée Hébert, Marie-Claude Beaumont, Pascale Gaudet, Manon Turbide, Valérie Hétu, Brigitte Major, Marie-Eve Carette, Katrie Dupont-Chalaoui, Francine Blais, Dario Garcia, Amélie Gervaise, Lionel Poungui, Nathalie Boily, Emmanuelle Dubois, Annick Hamel, Lionel-André Isoard, Nathaël Leduc-Arbour, Alexandre Montini, Stéphanie Bossé, Elise Faucher, Serge Gravel, Isabelle Poirier, Robert Hemmings, Daniel Saxon, Francis Engel, Martine Goyet, Jérôme Cantin, Nicole Charest, Carolyne Gervais, Sylvain Malenfant, Chantal Raymond, Luc St-Pierre, Marie-Claude Lemieux, Laurent Torjman, Geneviève Labelle, Guy Waddell, Louise Miner, Togas Tulandi, Sonia Gagnon, Patricia Fisch, Suzanne Gagné, Alexandra Gagné, Pascale Guérin, Marlène Laforge
Journal: The Lancet (2023)
Primary health care in practice: usual source of care and health system performance across 14 countries
Authors: Kevin Croke, Mosa Moshabela, Neena R Kapoor, Svetlana V Doubova, Ezequiel Garcia-Elorrio, Damen HaileMariam, Todd P Lewis, Gloria N Mfeka-Nkabinde, Sailesh Mohan, Peter Mugo, Jacinta Nzinga, Dorairaj Prabhakaran, Ashenif Tadele, Katherine D Wright, Margaret E Kruk
Journal: The Lancet Global Health (2023)

Primary health care (PHC) is central to attainment of the Sustainable Development Goals, yet comparable cross-country data on key aspects of primary care have not been widely available. This study analysed data from the People's Voice Survey, which was conducted in 2022 and 2023 in 14 countries. We documented usual source of care across countries and examined associations of usual source of care with core PHC services, quality ratings, and health system confidence. We found that 75% of respondents had a usual source of care, and that 40% of respondents accessed usual care in the public sector at primary level. 44% rated their usual source of care as very good or excellent. Access to PHC-linked screenings and treatments varied widely within and across countries. Having any usual source of care was associated with higher take-up of preventive services, greater access to treatment including mental health services, and greater health system endorsement. Strengthening links between health system users and primary care providers could improve take-up of preventive care and increase user satisfaction with health system performance.
Mortality from leading cancers in districts of England from 2002 to 2019: a population-based, spatiotemporal study
Authors: Theo Rashid, James E Bennett, David C Muller, Amanda J Cross, Jonathan Pearson-Stuttard, Perviz Asaria, Hima Iyathooray Daby, Daniela Fecht, Bethan Davies, Majid Ezzati
Journal: The Lancet Oncology (2023)

BackgroundCancers are the leading cause of death in England. We aimed to estimate trends in mortality from leading cancers from 2002 to 2019 for the 314 districts in England.MethodsWe did a high-resolution spatiotemporal analysis of vital registration data from the UK Office for National Statistics using data on all deaths from the ten leading cancers in England from 2002 to 2019. We used a Bayesian hierarchical model to obtain robust estimates of age-specific and cause-specific death rates. We used life table methods to calculate the primary outcome, the unconditional probability of dying between birth and age 80 years by sex, cancer cause of death, local district, and year. We reported Spearman rank correlations between the probability of dying from a cancer and district-level poverty in 2019.FindingsIn 2019, the probability of dying from a cancer before age 80 years ranged from 0·10 (95% credible interval [CrI] 0·10–0·11) to 0·17 (0·16–0·18) for women and from 0·12 (0·12–0·13) to 0·22 (0·21–0·23) for men. Variation in the probability of dying was largest for lung cancer among women, being 3·7 times (95% CrI 3·2–4·4) higher in the district with the highest probability than in the district with the lowest probability; and for stomach cancer for men, being 3·2 times (2·6–4·1) higher in the district with the highest probability than in the one with the lowest probability. The variation in the probability of dying was smallest across districts for lymphoma and multiple myeloma (95% CrI 1·2 times [1·1–1·4] higher in the district with the highest probability than the lowest probability for women and 1·2 times [1·0–1·4] for men), and leukaemia (1·1 times [1·0–1·4] for women and 1·2 times [1·0–1·5] for men). The Spearman rank correlation between probability of dying from a cancer and district poverty was 0·74 (95% CrI 0·72–0·76) for women and 0·79 (0·78–0·81) for men. From 2002 to 2019, the overall probability of dying from a cancer declined in all districts: the reductions ranged from 6·6% (95% CrI 0·3–13·1) to 30·1% (25·6–34·5) for women and from 12·8% (7·1–18·8) to 36·7% (32·2–41·2) for men. However, there were increases in mortality for liver cancer among men, lung cancer and corpus uteri cancer among women, and pancreatic cancer in both sexes in some or all districts with posterior probability greater than 0·80.InterpretationCancers with modifiable risk factors and potential for screening for precancerous lesions had heterogeneous trends and the greatest geographical inequality. To reduce these inequalities, factors affecting both incidence and survival need to be addressed at the local level.FundingWellcome Trust, Imperial College London, UK Medical Research Council, and the National Institute of Health Research.
Health system quality and COVID-19 vaccination: a cross-sectional analysis in 14 countries
Authors: Catherine Arsenault, Todd P Lewis, Neena R Kapoor, Emelda A Okiro, Hannah H Leslie, Patrizio Armeni, Prashant Jarhyan, Svetlana V Doubova, Katherine D Wright, Amit Aryal, Sengchanh Kounnavong, Sailesh Mohan, Emily Odipo, Hwa-Young Lee, Jeonghyun Shin, Wondimu Ayele, Jesús Medina-Ranilla, Laura Espinoza-Pajuelo, Anagaw Derseh Mebratie, Ezequiel García Elorrio, Agustina Mazzoni, Juhwan Oh, Gillian K SteelFisher, Rosanna Tarricone, Margaret E Kruk
Journal: The Lancet Global Health (2023)

The social and behavioural determinants of COVID-19 vaccination have been described previously. However, little is known about how vaccinated people use and rate their health system. We used surveys conducted in 14 countries to study the health system correlates of COVID-19 vaccination. Country-specific logistic regression models were adjusted for respondent age, education, income, chronic illness, history of COVID-19, urban residence, and minority ethnic, racial, or linguistic group. Estimates were summarised across countries using random effects meta-analysis. Vaccination coverage with at least two or three doses ranged from 29% in India to 85% in Peru. Greater health-care use, having a regular and high-quality provider, and receiving other preventive health services were positively associated with vaccination. Confidence in the health system and government also increased the odds of vaccination. By contrast, having unmet health-care needs or experiencing discrimination or a medical mistake decreased the odds of vaccination. Associations between health system predictors and vaccination tended to be stronger in high-income countries and in countries with the most COVID-19-related deaths. Access to quality health systems might affect vaccine decisions. Building strong primary care systems and ensuring a baseline level of quality that is affordable for all should be central to pandemic preparedness strategies.