tbuckley/cabot-search huggingface dataset:
Analysis of trends in race and gender disparities in incidence-based mortality in patients diagnosed with soft tissue sarcomas from 2000 to 2021.
Authors: Colby Germann, Meghana Rao, Fazel Khan, Achuta Kumar Guddati
Journal: Journal of Clinical Oncology (2025)

e23553 Background: The incidence of soft tissue sarcomas has been observed to be higher in males compared to females and more in African Americans compared to Caucasians. Variability of incidence-based mortality in low grade and high-grade soft tissue sarcomas with respect to race and gender for the period 2000 to 2016 has been previously reported. This study analyzes the rates of incidence-based mortality from the years 2000 to 2021 in groups divided by grades, gender and race. Methods: The Surveillance, Epidemiology, and End Results (SEER) Database was queried to conduct a nation-wide analysis for the years 2000 to 2021. Incidence-based mortality for all stages of low grade and high-grade soft tissue sarcomas was queried and the results were grouped by race (Caucasian/White vs. African American/Black) and gender. All stages and ages were included in the analysis and rates from 2000 to 2021 were analyzed. Results: Incidence-based mortality rates (per 1000,000) for low grade and high-grade soft tissue sarcomas for both races and genders are shown in the table below. The incidence-based mortality rates for Caucasian males and African American females was higher in the high grade group and had a roughly 2:1 gender ratio in the low grade group. Rates were not analyzed for American Indian and Asian/Pacific Islanders due to small sample size. As expected, the mortality rates of high-grade soft tissue sarcomas were significantly higher compared to low grade tumors. A higher rate of mortality is noted in Caucasian males compared to African Americans males despite past observations of higher incidence in African Americans. This data represents a summation of the rates for the past two decades. Conclusions: This study highlights the higher rate of incidence-based mortality in Caucasian males with high grade sarcoma compared to African American males with similar grade in the past two decades despite a lower reported incidence in Caucasians. The opposite trend for mortality is noted in African-American females. This study implies that Caucasian males and African-American females with high soft tissue sarcomas likely have worse outcomes. This disparity may be worth further investigation in terms of differences in the tumor biology and associated risk factors. Incidence-based mortality rate for soft tissue sarcoma, 2000-2021. Low Grade High Grade Caucasian/White Male 2.74 8.65 Female 1.37 6.09 African American/Black Male 3.05 7.63 Female 1.70 8.25
Improving pain management knowledge among hospice family caregivers: A randomized controlled trial.
Authors: Masako Mayahara, Joellen Wilbur, Louis Fogg, Mary Clare Houlihan, Debra Parker Oliver, Arlene Miller
Journal: Journal of Clinical Oncology (2025)

12032 Background: Poor pain management in home hospice settings is often due to family caregivers not adhering to analgesic regimens. Healthcare technology, like digital applications, can improve caregivers' access to education and communication with nurses, though it has been underutilized in home hospice. We developed and tested a digital pain management app called e-PainSupport in an NIH-funded randomized controlled trial with 44 hospice patient and caregiver dyads. The purpose of this study was to examine mediating effects of caregiver pain management knowledge on change in pain intensity, controlling for study condition and patient gender. Methods: We developed and tested a digital pain management app called e-PainSupport in an NIH-funded randomized controlled trial with 44 hospice patient and caregiver dyads. Utilizing a two-group, two-week, randomized controlled trial with dyads (N = 44) of Hospice patients (52% female, mean age 74.1 years) and their caregivers (75% female, mean age 55.2 years), dyads were randomly assigned to either the e-PainSupport intervention or usual care control condition. Outcome measures included caregiver knowledge and patient-reported pain intensity. Results: In the study, 60.87% of caregivers used the app's educational element at least once, with an average use of 5.43 times. Pain assessments were recorded by 91.30% of caregivers, averaging 3.74 assessments per caregiver. Additionally, 87.00% of caregivers reported pain management activities, averaging 46.05 entries. Patient pain intensity was tracked by 87.00% of caregivers, who completed the end-of-day summaries an average of 4.9 out of 14 days. Patients in the intervention condition were 2.50 times more likely to have a decrease in pain for worst pain than patients in the control condition over the two-week study period. Although we observed a positive effect of the app on caregivers' pain management knowledge, the improvement was limited, likely due to the brevity of the educational modules designed to minimize caregiver burden. To enhance caregiver knowledge without increasing their burden, we propose converting the written educational materials into videos. The enhanced intervention will be tested in a larger, full-scale RCT in the future. Conclusions: The use of the e-PainSupport app by caregivers is feasible and may contribute to improved caregiver knowledge and reduced hospice patient pain. Clinical trial information: NCT04869085 .
Prevalence of sexual dysfunction among men with cancer before the initiation of systemic treatment.
Authors: Mario Machado Lopes, Leonardo Gil Santana, Mariana Carvalho, Matheus Coimbra Barroso, Juliana de Oliveira Souza, João Victor de Souza, Luigi Bernardo Valladares, Diego Furiato Gomes da Cruz, Lucas Gouvêa, Carmita Abdo, Aldo A. Dettino, Vladmir Cordeiro Lima
Journal: Journal of Clinical Oncology (2025)

12049 Background: Sexual health significantly impacts the quality of life, yet its relationship with systemic cancer treatments in men remains underexplored, particularly outside prostate cancer-focused studies. In Brazil, the prevalence of moderate to complete sexual dysfunction among men is approximately 14.5%. This prospective cohort study conducted at a Brazilian Cancer Center evaluated the prevalence of sexual dysfunction before the initiation of systemic therapy in men diagnosed with solid tumors using the Male Sexual Quotient (MSQ) tool. Methods: Sexually active, treatment-naïve male patients with solid tumors were enrolled, excluding those with prostate cancer, active brain metastases, spinal compression, or prior pelvic irradiation/extensive pelvic surgery for rectal or bladder cancer. Baseline sexual function was assessed using the MSQ, which evaluates five domains: premature ejaculation, erectile dysfunction, hypoactive sexual desire, orgasm frequency, and dissatisfaction with sexual activity. An MSQ global score ≤60 defined moderate to complete sexual dysfunction. Hormonal profiles, including testosterone, FSH, and LH, were measured. The Hospital Anxiety and Depression Scale (HADS) was used to identify risks of anxiety or depression. All participants provided informed consent, and the local ethics committee approved the protocol. Results: Between October 2023 and December 2024, 73 male patients were recruited (median age 58 years, IQR 47.5–68.0); 78% were married, and 75% had an ECOG performance status of 0. At diagnosis, 34% presented with metastasis, including 19% with visceral involvement. Primary cancer sites included head and neck (25%), colorectal (19.1%), lung (15%), melanoma (8.2%), and kidney (8.2%). Treatment regimens comprised chemotherapy (76%), immunotherapy (31.5%), and targeted therapy (9.5%). Most patients (83%) had no risk of anxiety or depression per HADS, with one patient showing a high risk. Moderate to complete sexual dysfunction was observed in 22.2% of patients, higher than the general Brazilian male population. The most affected domains were hypoactive sexual desire, premature ejaculation, and erectile dysfunction. Despite these findings, median hormone levels were within the normal range: testosterone (356 ng/dL, IQR 300–468), FSH (64 mIU/mL, IQR 29–93), and LH (39 mIU/mL, IQR 28–52). Conclusions: The prevalence of moderate to complete sexual dysfunction was 22.2% in this cohort. This rate is higher than that observed in the general male population in Brazil. The evaluation of sexual quality of life in men with cancer undergoing systemic treatment is often overlooked. This data points to the need to develop new policies and studies to increase awareness about this critical issue.
Economic impact and mortality outcomes of palliative care integration among cancer patients: Analysis of National Inpatient Sample 2018-2022.
Authors: Shiva Jashwanth Gaddam, Benedict Amalraj, Mariana Marrero Castillo, Kavitha Beedupalli
Journal: Journal of Clinical Oncology (2025)

12031 Background: While palliative care integration into oncology represents a quality metric, its relationship with mortality outcomes and cost implications remains incompletely characterized. This study evaluates the association between palliative care consultation and healthcare utilization across major cancer types. Methods: We conducted a retrospective analysis using the National Inpatient Sample (2018-2022). Eligible patients included adults with primary diagnoses of lung, breast, prostate, or colon cancer. Palliative care utilization was identified (ICD-10 code Z51.5). Primary endpoints included in-hospital mortality, length of stay (LOS), and total charges. Propensity score matching (1:1 nearest neighbor, caliper 0.2) was used to account for selection bias. Confounding variables included age, race, insurance status, hospital characteristics, and comorbidity burden. Missing data were handled using complete case analysis. Temporal trends were assessed using Cochran-Armitage test. Results: Among 1,104,888 eligible hospitalizations (469,831 lung, 203,857 breast, 204,837 colon, 226,065 prostate), 70,863 in-hospital deaths occurred. Palliative care consultation was associated with reduced LOS (adjusted mean difference: -1.2 days; 95% CI: -1.4 to -1.0; p&lt;0.001) and lower total charges (adjusted mean difference: -$31,947; 95% CI: -$34,521 tor o -$29,373; p&lt;0.001) among deceased patients. Cancer-specific mortality rates with without were: lung (31.26% vs 4.16%, p&lt;0.001), breast (26.72% vs 2.16%, p&lt;0.001), colon (25.60% vs 2.27%, p&lt;0.001), and prostate (27.07% vs 1.98%, p&lt;0.001). Overall palliative care utilization increased from 13.50% to 15.91% (2018-2022; APC: +0.68%; p-trend&lt;0.001). DNR status strongly predicted palliative care utilization (adjusted OR: 4.50; 95% CI: 4.41-4.60; p&lt;0.001). Conclusions: In this large nationwide analysis, palliative care consultation was associated with significant reductions in healthcare utilization and costs among deceased cancer patients. Universal implementation could potentially save 27,744 hospital days and $996.4 million annually, suggesting substantial opportunities for healthcare system optimization. Healthcare utilization outcomes by cancer type and palliative care status. Cancer Type Deaths (N) PC Rate (%) Adjusted Cost Difference* ($) Adjusted LOS Difference* (Days) Lung 41,808 61.45 -32,655 (-35,124, -30,186) -0.94 (-1.12, -0.76) Breast 9,981 60.80 -31,382 (-34,276, -28,488) -0.97 (-1.18, -0.76) Colon 9,667 56.95 -47,079 (-50,612, -43,546) -1.32 (-1.56, -1.08) Prostate 9,407 56.61 -37,099 (-40,388, -33,810) -0.81 (-1.02, -0.60) *Values represent adjusted differences (95% CI) between palliative care and non-palliative care groups. PC = Palliative Care; LOS = Length of Stay.
Disparities in cachexia and anorexia in hospitalized female patients with breast cancer: A national population-based study.
Authors: Amro Awad, Abdulsabur Sanni, Zeina Assaf
Journal: Journal of Clinical Oncology (2025)

12097 Background: Breast cancer is the most common cancer in females in the US. Cachexia and anorexia are common complications from either the disease itself or the treatment regimen. Specific disparities in the prevalence of anorexia and cachexia in female breast cancer patients is not known. This study seeks to address this gap in knowledge by comparing the prevalence of this issue among different demographic factors. Methods: The National Inpatient Sample (NIS) databases (2016–2021) of the Healthcare Cost and Utilization Project (HCUP) was used. We applied discharge weight (DISCWT) provided in the database to generate the national estimates. Pearson Chi-square test for categorical variables and Student’s t-tests/one-way ANOVA for continuous variables were applied to compare the baseline demographics and hospital characteristics between the groups. The objective of the study was to determine demographic factors associated with increased cachexia, specifically race (African American vs all races), income (lowest quarterlies vs highest), Insurance type (private vs all types) and age (older than 65 years old vs younger). Multivariate linear and logistic regression models were used to adjust for confounders such as demographics, tobacco use, hypertension, COPD, Ischemic heart disease, prior CVA, and prior diagnosis of anorexia nervosa. Results: Anorexia, cachexia or malnutrition were documented in 12% of 1,037,185 hospitalizations of females with breast cancer. After adjusting for confounders, there were higher odds of anorexia and cachexia in patients of the African American race (aOR:1.28; CI 1.11 - 1.52; p-value &lt; 0.001) and patients who are 65 years old or older (aOR:1.18; CI 1.06 - 1.35; p-value 0.015). Having a private insurance was associated with lower odds of anorexia and cachexia (aOR:0.69; CI 0.62 - 0.78; p-value &lt; 0.001). There were no significant differences between patients of different levels of income. Conclusions: Female breast cancer patients of certain demographics have higher odds of developing cachexia or anorexia, a very common complication of breast cancer. Further considerations for these vulnerable populations should be studied and focused efforts should be made to ensure adequate healthcare access for all demographics. Demographic studied Prevalence of anorexia/cachexia (aOR, P-value, CI) African American race vs all races 1.28, &lt;0.001*, 1.11 - 1.52 Age ≥ 65 vs &lt;65 1.18, 0.015*, 1.06 - 1. 35 Private insurance vs all insurance types 0.69, &lt;0.001*, 0.62 - 0.78 Income (lowest quarterile vs highest) 1.05, 0.45, 0.81 - 1.23 *Statistically significant.
Effectiveness of alternating magnetic field therapy on quality of life among cancer survivors with chemotherapy-induced peripheral neuropathy: Insights of SMILE study.
Authors: Emi Kubo, Eriko Satomi, Toru Mukohara, Nozomu Fuse, Masashi Wakabayashi, Yuichiro Tsukada, Hiroto Ishiki, Shin Takayama, Yukihide Kanemitsu, Iwao Kishita, Keiko Kobayashi, Chiaki Kurihara, Nami Hirano, Takashi Ikeno, Tomofumi Miura, Akihiro Sato, Akihiro Sato
Journal: Journal of Clinical Oncology (2025)

12034 Background: Chemotherapy-induced peripheral neuropathy (CIPN) reduces patients' quality of life (QoL) due to consistent sensory and motor disturbances. SMILE study investigated the safety and efficacy of an alternating magnetic field therapy device (AT-04) for CIPN. Methods: This was a multicenter, randomized, sham device-controlled, double-blind study. Patients were eligible if they had CIPN symptoms with a pain Numeric Rating Scale score of 4/10 or more, at least 12 weeks after perioperative chemotherapy, and there was no recurrence. Patients were randomly assigned to use AT-04 or a sham device for 84 days. We showed the primary endpoint, the change in pain NRS at day 85, and notable effect sizes of AT-04 in patients whose last chemotherapy was over a year ago for tingling and numbness NRS. Herein, we report one of the secondary endpoints, EORTC QLQ-CIPN20 (CIPN20), asked at baseline and days 15, 29, 57, 85, and 113. Results: Fourteen patients were allocated to each group. At day 85, there were no significant differences in the mean changes of the CIPN20 sensory scale (-5.25 ± 15.4 in AT-04 vs. -5.72 ± 19.5 in sham; p = 0.95, effect size = 0.03), the motor scale (-8.18 ± 16.6 vs. -1.68 ± 10.2; p = 0.28, effect size = 0.47), or the autonomic scale (-1.85 ± 27.5 vs. -1.52 ± 5.0; p = 0.97, effect size = 0.02). However, the CIPN20 motor scales showed a significant decrease in AT-04 at day 29 (-9.82 ± 13.8 vs. -0.74 ± 8.7; p = 0.04, effect size = 0.92) and day 57 (-11.81 ± 10.6 vs. -0.54 ± 6.7; p &lt; 0.01, effect size = 1.26). Furthermore, among patients whose last chemotherapy was completed more than one year earlier (n = 8 in each group), CIPN20 motor scale significantly decreased from day 29 (-12.43 ± 10.3 vs. 2.38 ± 8.9; p &lt; 0.01, effect size = 1.55) to day 85 (-11.76 ± 10.1 vs. -0.07 ± 11.5; p &lt; 0.05, effect size = 1.08), and this effect persisted at day 113 (28 days after the end of the study treatment). Additionally, both sensory and autonomic scales showed improvement (sensory scale, -8.33 ± 13.5 vs. -0 ± 18.4, p = 0.32, effect size = 0.52; autonomic scale, -10.42 ± 23.5 vs. -2.08 ± 5.9, p = 0.35, effect size = 0.49). Conclusions: In patients whose last chemotherapy occurred more than one year prior, mean changes in the CIPN20 scores showed improvement across the sensory, motor, and autonomic scales. Clinical trial information: jRCT2032220295 .
Granisetron transdermal delivery system for nausea and vomiting prophylaxis in HER2-positive metastatic breast cancer patients receiving pyrotinib and capecitabine: A single-arm phase II study.
Authors: Jun Cao, Xichun Hu, Biyun Wang, Zhonghua Tao, Leiping Wang, Ting Li, Juan Jin, Mingchuan Zhao, Chengcheng Gong, Haitao Miao, Yannan Zhao
Journal: Journal of Clinical Oncology (2025)

12069 Background: The efficacy of granisetron transdermal delivery system (GTDS) in managing nausea and vomiting caused by intravenous chemotherapy is well-established; however, its effectiveness for emesis induced by oral antineoplastic agents remains unclear. This study aimed to evaluate the efficacy and safety of GTDS for the prophylaxis of nausea and vomiting in patients receiving daily oral anticancer agents with moderate emetic risk, specifically pyrotinib combined with capecitabine for HER2-positive metastatic breast cancer (mBC). Methods: A single-arm, single-center phase II trial was conducted, enrolling 77 patients with HER2-positive mBC. Patients received 2 consecutive doses of GTDS (with a 7-day interval between the doses) during the first treatment cycle (21 days) of pyrotinib (400 mg daily, days 1–21) and capecitabine (1000 mg/m² twice daily, days 1–14). The dual primary endpoints were the complete response (CR) rate of nausea and vomiting (no emesis and no rescue medication) and the incidence of ≥grade 3 diarrhea. Secondary endpoints included complete control (CC) rate, daily emesis/nausea frequency and adverse events (AEs). Results: During the first treatment cycle, 62.3% of patients achieved CR, and the CC rate was 54.5%. Weekly CR rates were 79.2%, 70.1%, and 79.2% in weeks 1, 2, and 3, respectively, while CC rates were 72.7%, 61.0%, and 70.1%, respectively. The mean daily number of emetic episodes ranged from 0.1 to 0.6, peaking in week 2. The mean daily nausea scores ranged from 0.6 to 1.1, with a slight increase starting from day 4. Grade 3 diarrhea occurred in 28.6% of patients, peaking on day 7. AEs were reported in 53.25% of patients, with the most common being gastrointestinal symptoms, fatigue, and rash. No QT prolongation was observed. Conclusions: Prolonged administration of GTDS demonstrated efficacy and safety in preventing nausea and vomiting in HER2-positive mBC patients receiving daily oral pyrotinib and capecitabine; however, it did not reduce the incidence of ≥ grade 3 diarrhea. Clinical trial information: NCT04472143 .
Economic outcomes of palliative care in colorectal cancer hospitalizations: A propensity-matched retrospective cohort study on resource utilization.
Authors: Elvis Obomanu, Justin Lam, Colton Jones, Dilichukwu Chudy-Onwugaje, Akshay Ratnani, Chidiebube Ugwu, Muluken Megiso, Sam King, Gabor Varadi
Journal: Journal of Clinical Oncology (2025)

12098 Background: The economic burden of colorectal cancer (CRC), a major cause of cancer-related death worldwide, is significant and is fueled by extended hospital stays, intensive treatments, and expensive end-of-life care, with costs expected to rise as the population ages. While clinical research has established the benefits of palliative care (PC) in improving patient outcomes, its economic impact within CRC care pathways remains underexplored. This study employs a large-scale, propensity-matched cohort analysis to evaluate the economic burden of PC integration during CRC hospitalization, addressing knowledge regarding the impact of early palliative interventions on healthcare expenditures and resource utilization. Methods: Utilizing data from the Global Collaborative Network-TriNetX, this retrospective cohort analysis evaluated the economic ramifications of early palliative care integration in adults (≥18 years) hospitalized with colorectal cancer. Using ICD-10 codes, we identified patients with malignant colorectal neoplasms, stratifying them into two cohorts: Cohort 1 (n=14,430) comprised individuals receiving palliative care within one month of diagnosis, while Cohort 2 (n=752,405) included those without palliative care exposure. Cohorts were balanced across sociodemographic and clinical variables via propensity score matching. Outcomes using surrogates for healthcare resource utilization and economic burden (inpatient, emergency department, and outpatient visits) were assessed over a 10-year follow-up period (beginning one day post-diagnosis). Results are reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Following propensity score matching, two balanced cohorts (n=13,991 each) were established, with comparable baseline characteristics. The palliative care cohort had a mean age of 75.8 years, predominantly white—58.7%—and 54.3% males and 45.7% females—while the non-palliative care cohort averaged 76.3 years, predominantly white—59.8%—53.8% males and 46.2% females. Compared to the non-palliative care cohort, the palliative care cohort demonstrated significantly lower risks of inpatient admissions (OR 0.371; 95% CI 0.333–0.413; p &lt; 0.001), emergency department visits (OR 0.342; 95% CI 0.311–0.377; p &lt; 0.001), and outpatient visits (OR 0.397; 95% CI 0.357–0.441; p &lt; 0.001). Conclusions: Our study found that early integration of palliative care (PC) in colorectal cancer (CRC) hospitalizations is associated with significant cost savings, achieved through reduced utilization of resource-intensive services, including inpatient, outpatient, and emergency department admissions. These findings suggest that PC could have a positive impact on financial sustainability and end-of-life quality while alleviating the economic burden on healthcare systems and individuals.