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Background: The cumulative, health system‐wide survival benefit of immune checkpoint inhibitors (ICIs) is unclear, particularly among real‐world patients with limited life expectancies and among subgroups poorly represented on clinical trials. We sought to determine the health system‐wide survival impact of ICIs. Methods: We identified all patients receiving PD‐1/PD‐L1 or CTLA‐4 inhibitors from 2010 to 2023 in the national Veterans Health Administration (VHA) system (ICI cohort) and all patients who received non‐ICI systemic therapy in the years before ICI approval (historical control). ICI and historical control cohorts were matched on multiple cancer‐related prognostic factors, comorbidities, and demographics. The effect of ICI on overall survival was quantified with Cox regression incorporating matching weights. Cumulative life‐years gained system‐wide were calculated from the difference in adjusted 5‐year restricted mean survival times. Results: There were 27,322 patients in the ICI cohort and 69,801 patients in the historical control cohort. Among ICI patients, the most common cancer types were NSCLC (46%) and melanoma (10%). ICI demonstrated a large OS benefit in most cancer types with heterogeneity across cancer types (NSCLC: adjusted HR [aHR] 0.56, 95% confidence interval [CI] 0.54–0.58, p < 0.001; urothelial: aHR 0.91, 95% CI 0.83–1.01, p = 0.066). The relative benefit of ICI was stable across patient age, comorbidity, and self‐reported race subgroups. Across VHA, 15,859 life‐years gained were attributable to ICI within 5‐years of treatment, with NSCLC contributing the most life‐years gained. Conclusion: We demonstrated substantial increase in survival due to ICIs across a national health system, including in patient subgroups poorly represented on clinical trials. [ABSTRACT FROM AUTHOR]

Background: Young patients ≤ 50 years old with multiple myeloma (MM) account for about 10% of cases and are underrepresented in the literature. Methods: We explored disease characteristics, treatments, and outcomes following modern therapies of young MM patients using the Canadian Myeloma Research Group (CMRG) database. We included 493 patients ≤ 50 years old diagnosed with MM or plasma cell leukemia without concurrent amyloidosis or POEMS syndrome from January 1, 2010, to July 1, 2022. Results: The median age was 46 years old (range: 25.6–50). Most patients fell into the R‐ISS II category (72.7%), and 24.1% had high‐risk cytogenetics. The majority of patients (89.9%) received a proteasome inhibitor‐based first‐line treatment, 92.1% received a stem cell transplant, and 65.6% had maintenance therapy post–autologous stem cell transplant (ASCT). Median follow‐up from initial treatment to patients' last follow‐up was 48.5 (range: 0–155) months. Median progression‐free survival (PFS) was 45.0 months (95% CI: 40.2–50.0). Maintenance therapy post‐ASCT improved median PFS to 52.3 months (95% CI: 43.1–68.2), compared to 23.6 months (95% CI: 20.0–34.8) without maintenance [p < 0.001]. Conclusion: Although the overall survival has not yet been reached in this young population, our reported median PFS of only 45 months highlights the urgent need to develop innovative treatments to induce more profound and durable responses. [ABSTRACT FROM AUTHOR]

The document discusses the occurrence of indolent relapse after initial aggressive B-cell lymphoma treatment, focusing on the transformation of lymphoma types and the clinical outcomes of patients. It highlights the rarity of indolent relapse following initial aggressive lymphoma and the challenges in managing such cases. The study found that patients with indolent relapse had favorable outcomes, with a 10-year overall survival rate of 60%, and suggests the inclusion of these patients in clinical trials for relapsed/refractory indolent lymphomas. [Extracted from the article]

Summary: Favourable outcomes with CPX‐351 versus conventional 7 + 3 were demonstrated in the pivotal phase III trial in adults aged 60–75 years with newly diagnosed, highrisk/secondary acute myeloid leukaemia (AML). As a complement to the clinical trial and to address important data gaps, the CPX‐351 Real‐World Effectiveness and SafeTy (CREST‐UK; NCT05169307) study evaluated the use of CPX‐351 in routine clinical practice in the UK, in 147 patients with newly diagnosed therapy‐related AML or AML with myelodysplasia‐related changes. Best response of complete remission or complete remission with incomplete platelet or neutrophil recovery was achieved by 53% of evaluable patients. Kaplan–Meier median overall survival (OS) was 12.8 months (95% confidence interval 9.2–15.3). Fifty (34%) patients proceeded to haematopoietic cell transplantation (HCT); median OS landmarked from the HCT date was not reached. There were no new safety concerns with CPX‐351 identified in CREST‐UK. Patients treated with CPX‐351 in the outpatient setting spent an average of 24.4, 16.7, 28.2, and 27.7 fewer days on the ward compared with inpatients during first induction, second induction, first consolidation, and second consolidation, respectively. The results from CREST‐UK provide valuable insights into the effectiveness, safety, and outpatient delivery of CPX‐351 in routine clinical practice in the UK. [ABSTRACT FROM AUTHOR]

Background: The efficacy of coronavirus disease 2019 (COVID‐19) vaccines in preventing SARS‐CoV‐2 infection in patients with hepatocellular carcinoma (HCC) is not clear. Methods: From January 2022 to October 2022, patients diagnosed with HCC in a prospective, multicenter, observational cohort were analyzed. Results: One hundred and forty‐one patients with (n = 107) or without COVID‐19 vaccination (n = 34) were included. The number of patients with severe or very severe infection was relatively lower in the vaccinated group (3.7% vs. 11.8%, p = 0.096). Median infection‐free survival in the vaccinated group (14.0 vs. 8.3 months, p = 0.010) was significantly longer than that in the unvaccinated group. COVID‐19 vaccination (hazard ratio (HR) HR = 0.47), European Cooperative Oncology Group performance score = 0 (HR = 2.06), and extrahepatic spread (HR = 0.28) were found to be the independent predictive factors for infection‐free survival. Conclusion: COVID‐19 vaccines could effectively reduce the SARS‐Cov‐2 infection in patients with HCC. [ABSTRACT FROM AUTHOR]

Background: The 'FAST‐forward', study published in April 2020, demonstrated the effectiveness of an extremely hypofractionated radiotherapy schedule, delivering the total radiation dose in five sessions over the course of 1 week. We share our department's experience regarding patients treated with this regimen in real‐world clinical settings, detailing outcomes related to short‐term toxicity and efficacy. Methods: A descriptive observational study was conducted on 160 patients diagnosed with breast cancer. Between July 2020 and December 2021, patients underwent conservative surgery followed by a regimen of 26 Gy administered in five daily fractions. Results: The median age was 64 years (range: 43–83), with 82 patients (51.3%) treated for left‐sided breast cancer, 77 patients (48.1%) for right‐sided breast cancer, and 1 instance (0.6%) of bilateral breast cancer. Of these, 66 patients had pT1c (41.3%), 70.6% were infiltrative ductal carcinomas, and 11.3% were ductal carcinoma in situ. Most tumours exhibited intermediate grade (41.9%), were hormone receptor positive (81.3%), had low Ki‐67 (Ki‐67 < 20%; 51.9%) and were Her 2 negative (85%). The majority of surgical margins were negative (99.4%). Among the patients, 72.5% received hormonotherapy, and 23.8% received chemotherapy. Additionally, 26 patients (16.3%) received an additional tumour boost following whole breast irradiation (WHBI) of 10 Gy administered in five sessions of 2 Gy over a week. The median planning target volume (PTV) was 899 cm3 (range: 110–2509 cm3). Early toxicity was primarily grade I radiodermatitis, affecting 117 patients (73.1%). During a median follow‐up of 15 months (range: 3.9–28.77), only one patient experienced a local relapse, which required mastectomy. Conclusions: The implementation of this highly hypofractionated regimen in early‐stage breast cancer appears feasible and demonstrates minimal early toxicity. However, a more extended follow‐up duration would be required to evaluate long‐term toxicity and efficacy accurately. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Young patients ≤ 50 years old with multiple myeloma (MM) account for about 10% of cases and are underrepresented in the literature. Methods We explored disease characteristics, treatments, and outcomes following modern therapies of young MM patients using the Canadian Myeloma Research Group (CMRG) database. We included 493 patients ≤ 50 years old diagnosed with MM or plasma cell leukemia without concurrent amyloidosis or POEMS syndrome from January 1, 2010, to July 1, 2022. Results The median age was 46 years old (range: 25.6–50). Most patients fell into the R‐ISS II category (72.7%), and 24.1% had high‐risk cytogenetics. The majority of patients (89.9%) received a proteasome inhibitor‐based first‐line treatment, 92.1% received a stem cell transplant, and 65.6% had maintenance therapy post–autologous stem cell transplant (ASCT). Median follow‐up from initial treatment to patients' last follow‐up was 48.5 (range: 0–155) months. Median progression‐free survival (PFS) was 45.0 months (95% CI: 40.2–50.0). Maintenance therapy post‐ASCT improved median PFS to 52.3 months (95% CI: 43.1–68.2), compared to 23.6 months (95% CI: 20.0–34.8) without maintenance [p

ABSTRACT Background The cumulative, health system‐wide survival benefit of immune checkpoint inhibitors (ICIs) is unclear, particularly among real‐world patients with limited life expectancies and among subgroups poorly represented on clinical trials. We sought to determine the health system‐wide survival impact of ICIs. Methods We identified all patients receiving PD‐1/PD‐L1 or CTLA‐4 inhibitors from 2010 to 2023 in the national Veterans Health Administration (VHA) system (ICI cohort) and all patients who received non‐ICI systemic therapy in the years before ICI approval (historical control). ICI and historical control cohorts were matched on multiple cancer‐related prognostic factors, comorbidities, and demographics. The effect of ICI on overall survival was quantified with Cox regression incorporating matching weights. Cumulative life‐years gained system‐wide were calculated from the difference in adjusted 5‐year restricted mean survival times. Results There were 27,322 patients in the ICI cohort and 69,801 patients in the historical control cohort. Among ICI patients, the most common cancer types were NSCLC (46%) and melanoma (10%). ICI demonstrated a large OS benefit in most cancer types with heterogeneity across cancer types (NSCLC: adjusted HR [aHR] 0.56, 95% confidence interval [CI] 0.54–0.58, p

Peng-Yu Chen,1 Minxue Shen,2– 4 Sui-Qing Cai,1 Zhen-Wei Tang1 1Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of China; 2Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of China; 3Hunan Engineering Research Center of Skin Health and Disease; Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha, 410008, People’s Republic of China; 4Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078, People’s Republic of ChinaCorrespondence: Zhen-Wei Tang; Sui-Qing Cai, Email tangzhenwei@zju.edu.cn; 2191008@zju.edu.cnAbstract: As one of the most prevalent chronic inflammatory skin diseases, atopic dermatitis (AD) increasingly affects the aging population. Amid the ongoing global aging trend, it’s essential to recognize the intricate relationship between AD and aging. This paper reviews existing knowledge, summarizing clinical observations of associations between AD and aging-related diseases in various systems, including endocrine, cardiovascular, and neurological. Additionally, it discusses major theories explaining the correlation, encompassing skin-mucosal barriers, systemic inflammation and stress, genes, signal transduction, and environmental and behavioral factors. The association between AD and aging holds significant importance, both in population and basic perspectives. While further research is warranted, this paper aims to inspire deeper exploration of inflammation/allergy-aging dynamics and the timely management of elderly patients with AD.Keywords: atopic dermatitis, aging, age-related diseases, clinical observations, mechanical theories

Purpose To assess whether first-year radiography students observed differences between what they were taught in didactic and laboratory courses and how technologists perform chest imaging procedures during clinical experiences. Methods This study used a mixed-methods approach with a cross-sectional survey, consisting of 11 quantitative and 11 qualitative items, during the fall 2020 semester. The survey asked participants to evaluate survey statements based on their observations of radiographers' behaviors during chest imaging procedures in relation to the 11 American Registry of Radiologic Technologist clinical competency areas. Participants rated their evaluations based on the degree to which they agreed or disagreed with statements regarding radiographers' behaviors using a 5-point Likert scale, ranging from strongly disagree (1) to strongly agree (5). For each statement, a follow-up, open-ended question asked participants to provide reasons why they thought technologists did or did not exhibit certain behaviors. Data were analyzed quantitatively with differential statistics and qualitatively by thematically categorizing open-ended responses. Results A total of 19 first-year radiography students (N = 19) completed the survey. Most participants somewhat agreed or strongly agreed with 8 out of the 11 competency statements based on their observations of technologists when performing chest imaging procedures: room preparation (73.7%), patient identity verification (89.5%), examination order verification (79%), patient assessment (79%), equipment operation (52.6%), patient management (100%), technique selection (73.6%), and image evaluation (94.7%). Most participants somewhat disagreed, strongly disagreed, or were neutral with 3 out of the 11 categories: patient positioning, radiation safety, and image processing. Qualitatively, participants responded that technologists only provided lead shielding for pediatric patients, were not instructing patients to take 2 inspirations before making an exposure, and were cropping their images electronically before submitting them for diagnoses. Discussion Participants reported inconsistencies between what they were taught and what they saw technologists doing during chest imaging procedures related to patient positioning, radiation safety, and imaging processing. Participants' responses stated that these inconsistencies might be because of an increase in technologist responsibilities, patient volumes, and fear of not including relative anatomy on their images. Conclusion Participants reported the most disagreement with radiation safety during chest imaging procedures. Although lead shielding for abdominal and pelvic procedures is no longer recommended, shielding patients during chest imaging procedures is still recommended. Radiography programs can educate students that inconsistency between task order does not mean there is a gap between theory and practice. [ABSTRACT FROM AUTHOR]

Purpose: Evidence of the impact of the COVID‐19 pandemic on cancer prevention and control is growing, but little is known about patient‐level factors associated with delayed care. We analyzed data from a survey focused on Iowan cancer patients' COVID‐19 experiences in the early part of the pandemic. Methods: Participants were recruited from the University of Iowa Holden Comprehensive Cancer Center's Patients Enhancing Research Collaborations at Holden (PERCH) program. We surveyed respondents on demographic characteristics, COVID‐19 experiences and reactions, and delays in any cancer‐related health care appointment, or cancer‐related treatment appointments. Two‐sided significance tests assessed differences in COVID‐19 experiences and reactions between those who experienced delays and those who did not. Results: There were 780 respondents (26% response), with breast, prostate, kidney, skin, and colorectal cancers representing the majority of respondents. Delays in cancer care were reported by 29% of respondents. In multivariable‐adjusted models, rural residents (OR 1.47; 95% CI 1.03, 2.11) and those experiencing feelings of isolation (OR 2.18; 95% CI 1.37, 3.47) were more likely to report any delay, where experiencing financial difficulties predicted delays in treatment appointments (OR 5.72; 95% CI 1.96, 16.67). Health insurance coverage and concern about the pandemic were not statistically significantly associated with delays. Conclusion: These findings may inform cancer care delivery during periods of instability when treatment may be disrupted by informing clinicians about concerns that patients have during the treatment process. Future research should assess whether delays in cancer care impact long‐term cancer outcomes and whether delays exacerbate existing disparities in cancer outcomes. [ABSTRACT FROM AUTHOR]

Abstract Background The efficacy of coronavirus disease 2019 (COVID‐19) vaccines in preventing SARS‐CoV‐2 infection in patients with hepatocellular carcinoma (HCC) is not clear. Methods From January 2022 to October 2022, patients diagnosed with HCC in a prospective, multicenter, observational cohort were analyzed. Results One hundred and forty‐one patients with (n = 107) or without COVID‐19 vaccination (n = 34) were included. The number of patients with severe or very severe infection was relatively lower in the vaccinated group (3.7% vs. 11.8%, p = 0.096). Median infection‐free survival in the vaccinated group (14.0 vs. 8.3 months, p = 0.010) was significantly longer than that in the unvaccinated group. COVID‐19 vaccination (hazard ratio (HR) HR = 0.47), European Cooperative Oncology Group performance score = 0 (HR = 2.06), and extrahepatic spread (HR = 0.28) were found to be the independent predictive factors for infection‐free survival. Conclusion COVID‐19 vaccines could effectively reduce the SARS‐Cov‐2 infection in patients with HCC.

Abstract Background The ‘FAST‐forward’, study published in April 2020, demonstrated the effectiveness of an extremely hypofractionated radiotherapy schedule, delivering the total radiation dose in five sessions over the course of 1 week. We share our department's experience regarding patients treated with this regimen in real‐world clinical settings, detailing outcomes related to short‐term toxicity and efficacy. Methods A descriptive observational study was conducted on 160 patients diagnosed with breast cancer. Between July 2020 and December 2021, patients underwent conservative surgery followed by a regimen of 26 Gy administered in five daily fractions. Results The median age was 64 years (range: 43–83), with 82 patients (51.3%) treated for left‐sided breast cancer, 77 patients (48.1%) for right‐sided breast cancer, and 1 instance (0.6%) of bilateral breast cancer. Of these, 66 patients had pT1c (41.3%), 70.6% were infiltrative ductal carcinomas, and 11.3% were ductal carcinoma in situ. Most tumours exhibited intermediate grade (41.9%), were hormone receptor positive (81.3%), had low Ki‐67 (Ki‐67

AbstractBackgroundDaratumumab is a humanized monoclonal antibody approved for the treatment of adult patients with newly diagnosed or relapsed/refractory multiple myeloma (RRMM). Subcutaneous (SC) formulation proved to be non‐inferior in comparison with intravenous (IV) administration route. This study aimed at assessing the economic and time impact associated with the use of SC versus IV daratumumab in patients with RRMM from the perspective of the hematology center.MethodsThis was a 5‐month multicenter time‐and‐motion cross‐sectional micro‐costing study conducted in three Italian hematology centers among adult patients diagnosed with RRMM with ongoing treatment with IV or SC daratumumab. Measurements were performed by an ad hoc App. ResultsNineteen (20%) IV and 76 (80%) SC administration procedures were measured. Patients spent a mean of 4.85 ± 0.91 or 1.08 ± 0.56 h in the hematology center to receive IV or SC daratumumab, respectively. Healthcare professionals (HCPs) spent a mean of 49.38 ± 16.13 and 20.37 ± 7.88 min of active working time to manage IV and SC administrations, respectively. The infusion chair was occupied for a mean of 4.85 ± 0.91 and 0.99 ± 0.55 h during IV or SC administration, respectively. On average, considering the costs due to HCP and chair time, materials, and overhead costs, every IV and SC administration costed €80.33 and 34.90, respectively. ConclusionsIn conclusion, as compared with IV administration, SC daratumumab was associated with 78%, 59%, 80% savings in terms of patient time, HCP active working time, and infusion chair, respectively, and 56.6% budget savings.

Abstract Background Prostate cancer represents a significant global health issue, yet our understanding of its impact in the Middle East remains limited. This study aimed to assess the incidence and mortality of prostate cancer in the Middle East, and compare these rates to those in Europe and North America. Materials and Methods We utilized the 2020 Global Cancer Observatory data, compiling incidence and mortality rates of prostate cancer in 20 Middle Eastern countries. We calculated mortality‐to‐incidence ratios (MIR) and compared the age‐standardized incidence rate (ASIR) and MIR between the Middle East and the combined regions of North America and Europe. The countries were further stratified based on the Human Development Index (HDI) and income level for additional analysis. Results In 2020, the Middle East documented an estimated 51,649 new prostate cancer diagnoses, accounting for 3.7% of global cases. Despite a significantly lower ASIR in the Middle East compared with Europe and North America (10.50 vs. 21.50, p = 0.0087), the region had a higher MIR (12.35 vs. 3.00, p = 0.0476). When stratified based on HDI or income levels, there was no significant difference in MIRs; however, a significant trend of increasing MIR with decreasing HDI (p = 0.028) and income levels (p = 0.016) was observed. Conclusions Despite a lower incidence, our analysis showed a significantly higher MIR for prostate cancer in the Middle East compared with Europe and North America. These findings underscore the unique challenges posed by prostate cancer in the Middle East and emphasize the necessity of tailored strategies to address this pressing public health issue.

Purpose: Endothelial keratoplasty (EK) is the conventional treatment to improve visual acuity of corneal endothelium decompensation (CED) patients, with other therapies mainly for symptomatic relief. However, the shortage of corneal grafts and other limitations to EK urge the development of novel alternative treatments. In the last decade, novel options have been proposed, yet only a limited number of reviews have systematically reported on outcomes. Therefore, this systematic review evaluates the existing clinical evidence of novel surgical approaches for CED. Method: We identified 24 studies that illustrated the clinical observations of the surgical approaches in interest. We included Descemet stripping only (DSO), Descemet membrane transplantation (DMT) where Descement membrane alone instead of corneal endothelium with cells is transplanted, and cell-based therapy. Results: In general, these therapies may provide visual outcomes comparable with EK under specific conditions. DSO and DMT target CED with relatively healthy peripheral corneal endothelium like Fuchs' corneal endothelial dystrophy, while cell-based therapy offers more versatile applications. Side effects of DSO would decrease with modifications to surgical techniques. Moreover, Rho-associated protein kinase inhibitor adjuvant therapy could enhance clinical results in DSO and cell-based therapy. Conclusion: Long-term controlled clinical trials with larger sample size on the therapies are needed. The simplicity of DSO and the high translational potential of cell-based therapy to treat CED of most etiologies made these two treatment strategies promising. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the associations between the use of statins concurrent with androgen deprivation therapy (ADT) and the risks of mortality in Asian patients diagnosed with prostate cancer (PCa). Methods: Adult patients (≥18 years old) diagnosed with PCa who were receiving any form of ADT and were being treated at public hospitals in Hong Kong from December 1999 to March 2021 were retrospectively identified, with follow-up conducted until September 2021. Patients who had received medical castration for <180days without subsequent bilateral orchidectomy, those who had used statins concurrently with ADT for <180days, and those with missing baseline total cholesterol levels were excluded. Statin users were defined as individuals who had used statins for ≥180days concurrent with ADT, while non-users were those who had not used any statins. PCa-related mortality was the primary outcome, while all-cause mortality served as the secondary outcome. Inverse probability treatment weighting was employed to balance the covariates.Results: A total of 4920 patients were included, consisting of 2578 statin users and 2342 non-users (mean age 76.1±8.2 years). Over a mean follow-up period of 4.2±3.3 years, it was observed that statin users had significantly lower risks of both PCa-related mortality (weighted hazard ratio [wHR] 0.56 [95% confidence interval (CI) 0.48, 0.65], p<0.001) and all-cause mortality (wHR 0.57 [95% CI 0.51, 0.63], p<0.001), regardless of the type of ADT used. Notably, these associations were more pronounced among patients with less advanced PCa, as indicated by the absence of androgen receptor antagonist or chemotherapy usage (p value for interaction <0.001 for both outcomes). Conclusion(s): The use of statins concurrent with ADT was associated with reduced mortality risks among Asian patients with PCa. These findings suggest the need for additional research to explore the potential role of statins in the treatment of PCa patients. [ABSTRACT FROM AUTHOR]

Acute myeloid leukemia (AML) is a malignant hematological neoplastic disease. Autocrine or paracrine cytokines released by leukemic cells regulate the proliferation of AML cells. It is uncertain whether cytokines can indicate whether patients with AML are in remission with chemotherapy. The goal of this study was to evaluate the levels of Th1/Th2/Th17 cytokines in AML patients before and after chemotherapy to determine whether the cytokine levels could predict disease remission after chemotherapy. It was found that the levels of IL-5, IL-6, IL-8, IL-10, TNF-α, TNF-β, IL-17F, and IL-22 were significantly increased at the time of AML diagnosis in patients who achieved remission after two chemotherapy treatments (P < 0.05). After chemotherapy, the cytokine levels were reduced in patients with remission, while the levels of IL-6 and IL-8 were raised in patients without remission (P < 0.05). A comparison of cytokine levels before and after chemotherapy in patients who achieved remission showed areas under the curve (AUCs) of 0.69 for both IL-6 and IL-8. In addition, a comparison of the remission and non-remission groups after chemotherapy showed an AUC of 0.77 for IL-6. We then calculated the cutoff value using receiver operating characteristic curves. Values of IL-6 < 9.99 and IL-8 < 8.46 at the time of diagnosis were predictive of chemotherapy success and remission, while IL-6 > 14.89 at diagnosis suggested that chemotherapy would not be successful and remission would not be achieved. Multifactorial analysis showed that age, Neu, IL-6, and IL-8 were independent risk factors for AML prognosis, and IL-6 (OR = 5.48, P = 0.0038) was superior to age (OR = 3.36, P = 0.0379), Neu (OR = 0.28, P = 0.0308), IL-8 (OR = 0.0421, P = 0.0421). In conclusion, IL-6 levels were found to be predictive of the likelihood of remission. [ABSTRACT FROM AUTHOR]

Background: Daratumumab is a humanized monoclonal antibody approved for the treatment of adult patients with newly diagnosed or relapsed/refractory multiple myeloma (RRMM). Subcutaneous (SC) formulation proved to be non‐inferior in comparison with intravenous (IV) administration route. This study aimed at assessing the economic and time impact associated with the use of SC versus IV daratumumab in patients with RRMM from the perspective of the hematology center. Methods: This was a 5‐month multicenter time‐and‐motion cross‐sectional micro‐costing study conducted in three Italian hematology centers among adult patients diagnosed with RRMM with ongoing treatment with IV or SC daratumumab. Measurements were performed by an ad hoc App. Results: Nineteen (20%) IV and 76 (80%) SC administration procedures were measured. Patients spent a mean of 4.85 ± 0.91 or 1.08 ± 0.56 h in the hematology center to receive IV or SC daratumumab, respectively. Healthcare professionals (HCPs) spent a mean of 49.38 ± 16.13 and 20.37 ± 7.88 min of active working time to manage IV and SC administrations, respectively. The infusion chair was occupied for a mean of 4.85 ± 0.91 and 0.99 ± 0.55 h during IV or SC administration, respectively. On average, considering the costs due to HCP and chair time, materials, and overhead costs, every IV and SC administration costed €80.33 and 34.90, respectively. Conclusions: In conclusion, as compared with IV administration, SC daratumumab was associated with 78%, 59%, 80% savings in terms of patient time, HCP active working time, and infusion chair, respectively, and 56.6% budget savings. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer represents a significant global health issue, yet our understanding of its impact in the Middle East remains limited. This study aimed to assess the incidence and mortality of prostate cancer in the Middle East, and compare these rates to those in Europe and North America. Materials and Methods: We utilized the 2020 Global Cancer Observatory data, compiling incidence and mortality rates of prostate cancer in 20 Middle Eastern countries. We calculated mortality‐to‐incidence ratios (MIR) and compared the age‐standardized incidence rate (ASIR) and MIR between the Middle East and the combined regions of North America and Europe. The countries were further stratified based on the Human Development Index (HDI) and income level for additional analysis. Results: In 2020, the Middle East documented an estimated 51,649 new prostate cancer diagnoses, accounting for 3.7% of global cases. Despite a significantly lower ASIR in the Middle East compared with Europe and North America (10.50 vs. 21.50, p = 0.0087), the region had a higher MIR (12.35 vs. 3.00, p = 0.0476). When stratified based on HDI or income levels, there was no significant difference in MIRs; however, a significant trend of increasing MIR with decreasing HDI (p = 0.028) and income levels (p = 0.016) was observed. Conclusions: Despite a lower incidence, our analysis showed a significantly higher MIR for prostate cancer in the Middle East compared with Europe and North America. These findings underscore the unique challenges posed by prostate cancer in the Middle East and emphasize the necessity of tailored strategies to address this pressing public health issue. [ABSTRACT FROM AUTHOR]

Abstract Purpose Evidence of the impact of the COVID‐19 pandemic on cancer prevention and control is growing, but little is known about patient‐level factors associated with delayed care. We analyzed data from a survey focused on Iowan cancer patients' COVID‐19 experiences in the early part of the pandemic. Methods Participants were recruited from the University of Iowa Holden Comprehensive Cancer Center's Patients Enhancing Research Collaborations at Holden (PERCH) program. We surveyed respondents on demographic characteristics, COVID‐19 experiences and reactions, and delays in any cancer‐related health care appointment, or cancer‐related treatment appointments. Two‐sided significance tests assessed differences in COVID‐19 experiences and reactions between those who experienced delays and those who did not. Results There were 780 respondents (26% response), with breast, prostate, kidney, skin, and colorectal cancers representing the majority of respondents. Delays in cancer care were reported by 29% of respondents. In multivariable‐adjusted models, rural residents (OR 1.47; 95% CI 1.03, 2.11) and those experiencing feelings of isolation (OR 2.18; 95% CI 1.37, 3.47) were more likely to report any delay, where experiencing financial difficulties predicted delays in treatment appointments (OR 5.72; 95% CI 1.96, 16.67). Health insurance coverage and concern about the pandemic were not statistically significantly associated with delays. Conclusion These findings may inform cancer care delivery during periods of instability when treatment may be disrupted by informing clinicians about concerns that patients have during the treatment process. Future research should assess whether delays in cancer care impact long‐term cancer outcomes and whether delays exacerbate existing disparities in cancer outcomes.

Abstract Background Early skeletal muscle loss has been observed in adolescent and young adult (AYA) sarcoma patients undergoing treatment. Identification of individuals within the AYA populace that are at greatest risk of anthracycline‐induced skeletal muscle loss is unknown. Moreover, investigations which seek out underlying causes of skeletal muscle degradation during chemotherapy are critical for understanding, preventing, and reducing chronic health conditions associated with poor skeletal muscle status. Methods Computed tomography (CT) scans were used to investigate changes in skeletal muscle of 153 AYA sarcoma and Hodgkin lymphoma patients at thoracic vertebra 4 after anthracycline treatment. Images were examined at three time points during the first year of treatment. In parallel, we used translational juvenile mouse models to assess the impact of doxorubicin (DOX) in the soleus and gastrocnemius on muscle wasting. Results Significant reductions in total skeletal muscle index and density were seen after chemotherapy in AYA cancer patients (p

Abstract Background The use of Anti-PD-1 therapy has yielded promising outcomes in hepatocellular carcinoma (HCC). However, limited research has been conducted on the overall survival (OS) of patients with varying tumor responses and treatment duration. Methods This retrospective study analyzed HCC patients who received sintilimab between January 2019 and December 2020 at four centers in China. The evaluation of tumor progression was based on Response Evaluation Criteria in Solid Tumors version 1.1. The study investigated the correlation between tumor response and OS, and the impact of drug use on OS following progressive disease (PD). Results Out of 441 treated patients, 159 patients satisfied the inclusion criteria. Among them, 77 patients with disease control exhibited a significantly longer OS compared to the 82 patients with PD (median OS 26.0 vs. 11.3 months, P

Abstract Background CPX‐351 is approved for the treatment of therapy related acute myeloid leukemia (t‐AML) and AML with myelodysplastic related changes (MRC‐AML). The benefits of this treatment over standard chemotherapy has not been addressed in well matched cohorts of real‐life patients. Methods Retrospective analysis of AML patients treated with CPX‐351 as per routine practice. A propensity score matching (PSM) was used to compare their main outcomes with those observed in a matched cohort among 765 historical patients receiving intensive chemotherapy (IC), all of them reported to the PETHEMA epidemiologic registry. Results Median age of 79 patients treated with CPX‐351 was 67 years old (interquartile range 62–71), 53 were MRC‐AML. The complete remission (CR) rate or CR without recovery (CRi) after 1 or 2 cycles of CPX‐351 was 52%, 60‐days mortality 18%, measurable residual disease

Abstract Background High‐grade serous ovarian carcinoma (HGSOC) is the deadliest ovarian cancer subtype, and survival relates to initial cytoreductive surgical treatment. The existing tools for surgical outcome prediction remain inadequate for anticipating the outcomes of the complex relationship between tumour biology, clinical phenotypes, co‐morbidity and surgical skills. In this genotype–phenotype association study, we combine phenotypic markers with targeted DNA sequencing to discover novel biomarkers to guide the surgical management of primary HGSOC. Methods Primary tumour tissue samples (n = 97) and matched blood from a phenotypically well‐characterised treatment‐naïve HGSOC patient cohort were analysed by targeted massive parallel DNA sequencing (next generation sequencing [NGS]) of a panel of 360 cancer‐related genes. Association analyses were performed on phenotypic traits related to complete cytoreductive surgery, while logistic regression analysis was applied for the predictive model. Results The positive influence of complete cytoreductive surgery (R0) on overall survival was confirmed (p = 0.003). Before surgery, low volumes of ascitic fluid, lower CA125 levels, higher platelet counts and relatively lower clinical stage at diagnosis were all indicators, alone and combined, for complete cytoreduction (R0). Mutations in either the chromatin remodelling SWI_SNF (p = 0.036) pathway or the histone H3K4 methylation pathway (p = 0.034) correlated with R0. The R0 group also demonstrated higher tumour mutational burden levels (p = 0.028). A predictive model was developed by combining two phenotypes and the mutational status of five genes and one genetic pathway, enabling the prediction of surgical outcomes in 87.6% of the cases in this cohort. Conclusion Inclusion of molecular biomarkers adds value to the pre‐operative stratification of HGSOC patients. A potential preoperative risk stratification model combining phenotypic traits and single‐gene mutational status is suggested, but the set‐up needs to be validated in larger cohorts.

Background: Early skeletal muscle loss has been observed in adolescent and young adult (AYA) sarcoma patients undergoing treatment. Identification of individuals within the AYA populace that are at greatest risk of anthracycline‐induced skeletal muscle loss is unknown. Moreover, investigations which seek out underlying causes of skeletal muscle degradation during chemotherapy are critical for understanding, preventing, and reducing chronic health conditions associated with poor skeletal muscle status. Methods: Computed tomography (CT) scans were used to investigate changes in skeletal muscle of 153 AYA sarcoma and Hodgkin lymphoma patients at thoracic vertebra 4 after anthracycline treatment. Images were examined at three time points during the first year of treatment. In parallel, we used translational juvenile mouse models to assess the impact of doxorubicin (DOX) in the soleus and gastrocnemius on muscle wasting. Results: Significant reductions in total skeletal muscle index and density were seen after chemotherapy in AYA cancer patients (p < 0.01 & p = 0.04, respectively). The severity of skeletal muscle loss varied by subgroup (i.e., cancer type, sex, and treatment). Murine models demonstrated a reduction in skeletal muscle fiber cross‐sectional area, increased apoptosis and collagen volume for both the soleus and gastrocnemius after DOX treatment (all p < 0.05). After DOX, hindlimb skeletal muscle blood flow was significantly reduced (p < 0.01). Conclusion: Significant skeletal muscle loss is experienced early during treatment in AYA cancer patients. Reductions in skeletal muscle blood flow may be a key contributing factor to anthracycline doxorubicin induced skeletal muscle loss. [ABSTRACT FROM AUTHOR]

Background: The use of Anti-PD-1 therapy has yielded promising outcomes in hepatocellular carcinoma (HCC). However, limited research has been conducted on the overall survival (OS) of patients with varying tumor responses and treatment duration. Methods: This retrospective study analyzed HCC patients who received sintilimab between January 2019 and December 2020 at four centers in China. The evaluation of tumor progression was based on Response Evaluation Criteria in Solid Tumors version 1.1. The study investigated the correlation between tumor response and OS, and the impact of drug use on OS following progressive disease (PD). Results: Out of 441 treated patients, 159 patients satisfied the inclusion criteria. Among them, 77 patients with disease control exhibited a significantly longer OS compared to the 82 patients with PD (median OS 26.0 vs. 11.3 months, P < 0.001). Additionally, the OS of patients with objective response (OR) was better than that of patients with stable disease (P = 0.002). Among the 47 patients with PD who continued taking sintilimab, the OS was better than the 35 patients who discontinued treatment (median OS 11.4 vs. 6.9 months, P = 0.042). Conclusions: In conclusion, the tumor response in HCC patients who received sintilimab affects OS, and patients with PD may benefit from continued use of sintilimab. [ABSTRACT FROM AUTHOR]

Abstract Background Patients with alveolar rhabdomyosarcoma (ARMS) have inferior outcomes compared to patients with embryonal rhabdomyosarcoma (ERMS) and more effective chemotherapy options are needed for these patients. Vinorelbine is a semisynthetic vinca alkaloid that has clinical activity in relapsed rhabdomyosarcoma (RMS) when used alone or in combination with cyclophosphamide. Aims The goal of our study was to evaluate whether RMS histology subtype influences response rate to vinorelbine alone or in combination. Materials & Methods Five Phase 2 trials that enrolled RMS patients were included in the meta‐analysis. Two studies evaluated vinorelbine alone, two studies evaluated vinorelbine in combination with low dose oral cyclophosphamide, and one study evaluated vinorelbine and intravenous cyclophosphamide in combination with temsirolimus or bevacizumab. All RMS patients had relapsed or refractory disease and had received at least one prior therapy. Response was reported according to RECIST1.1 and was defined as a complete or partial response. Response data was obtained from published results or from trial principal investigator. RMS NOS patients were grouped with ERMS patients for this analysis. Summary estimates comparing differences between ARMS and ERMS response rates were generated using a random‐effects model to account for heterogeneity among the studies. Results One hundred fifty‐six enrolled patients evaluable for response were included in the meta‐analysis, 85 ARMS, 64 ERMS and 7 RMS‐NOS. The combined effect generated from the random‐effects model demonstrated a 41% increase (p = 0.001, 95% CI; 0.21–0.60) in response to vinorelbine as a single agent or in combination in patients with ARMS compared to patients with ERMS. There was no significant difference in the rate of progressive disease between patients with ARMS compared to ERMS (p = 0.1, 95%CI; −0.26–0.02). Discussion Vinorelbine is an active agent for the treatment of relapsed or refractory RMS and a meta‐analysis of Phase 2 studies shows that radiographic responses in patients with ARMS were significantly higher than ERMS or RMS‐NOS. Conclusion These data support further investigation of vinorelbine in newly diagnosed patients with RMS particularly those with alveolar histology.

Abstract Background Significant advances in multiple myeloma (MM) over the past 15 years led to exciting changes in the management of MM patients in China, which in turn brought about the early diagnoses, precise risk stratifications, and improved prognoses. Methods We summarized the dynamic changes in the management of newly diagnosed (ND) MM in a national medical center, crossing the old and novel drug era. Demographics, clinical characteristics, first‐line treatment, response rate, and survival were retrospectively collected among NDMMs diagnosed in Zhongshan Hospital Fudan University from January 2007 to October 2021. Results Of the 1256 individuals, median age was 64 (range 31–89) with 45.1% patients >65 years. About 63.5% were male, 43.1% were at ISS stage III and 9.9% had light‐chain amyloidosis. Patients with abnormal ratio of free light chain (80.4%), extramedullary disease (EMD, 22.0%), and high‐risk cytogenetic abnormalities (HRCA, 26.8%) were detected by novel detection techniques. The best confirmed ORR was 86.5%, including 39.4% with CR. Short‐ and long‐term PFS and OS rates persistently increased each year along with increasing novel drug applications. Median PFS and OS were 30.9 and 64.7 months. Advanced ISS stage, HRCA, light‐chain amyloidosis and EMD independently predicted an inferior PFS. First‐line ASCT indicated a superior PFS. Advanced ISS stage, elevated serum LDH, HRCA, light‐chain amyloidosis, and receiving PI/IMiD‐based regimen versus PI+IMiD‐based regimen independently indicated a poorer OS. Conclusions In brief, we illustrated a dynamic landscape of MM patients in a national medical center. Chinese MM patients evidently benefited from newly introduced techniques and drugs in this field.

Abstract Background Survivorship care plans (SCPs) communicate cancer‐related information from oncology providers to patients and primary care providers. SCPs may limit overuse testing by specifying necessary follow‐up care. From a randomized, controlled trial of SCP delivery, we examined whether cancer‐related tests not specified in SCPs, but conducted after SCP receipt, were appropriate or consistent with overuse. Methods Survivors of breast, colorectal, or prostate cancer treated at urban‐academic or rural‐community health systems were randomized to one of three SCP delivery arms. Tests during 18 months after SCP receipt were classified as consistent with overuse if they were (1) not included in SCPs and (2) on a guideline‐based predetermined list of “not recommended surveillance.” After chart abstraction, physicians performed review and adjudication of potential overuse. Descriptive analyses were conducted of tests consistent with overuse. Negative binomial regression models determined if testing consistent with overuse differed across study arms. Results Among 316 patients (137 breast, 67 colorectal, 112 prostate), 140 individual tests were identified as potential overuse. Upon review, 98 were deemed to be consistent with overuse: 78 tumor markers and 20 imaging tests. The majority of overuse testing was breast cancer‐related (95%). Across sites, 27 patients (9%) received ≥1 test consistent with overuse; most were breast cancer patients (22/27). Exploratory analyses of overuse test frequency by study arm showed no significant difference. Conclusions This analysis identified practice patterns consistent with overuse of surveillance testing and can inform efforts to improve guideline‐concordant care. Future interventions may include individual practice patterns and provider education.

Background: CPX‐351 is approved for the treatment of therapy related acute myeloid leukemia (t‐AML) and AML with myelodysplastic related changes (MRC‐AML). The benefits of this treatment over standard chemotherapy has not been addressed in well matched cohorts of real‐life patients. Methods: Retrospective analysis of AML patients treated with CPX‐351 as per routine practice. A propensity score matching (PSM) was used to compare their main outcomes with those observed in a matched cohort among 765 historical patients receiving intensive chemotherapy (IC), all of them reported to the PETHEMA epidemiologic registry. Results: Median age of 79 patients treated with CPX‐351 was 67 years old (interquartile range 62–71), 53 were MRC‐AML. The complete remission (CR) rate or CR without recovery (CRi) after 1 or 2 cycles of CPX‐351 was 52%, 60‐days mortality 18%, measurable residual disease <0.1% in 54% (12 out of 22) of them. Stem cell transplant (SCT) was performed in 27 patients (34%), median OS was 10.3 months, and 3‐year relapse incidence was 50%. Using PSM, we obtained two comparable cohorts treated with CPX‐351 (n = 52) or IC (n = 99), without significant differences in CR/CRi (60% vs. 54%) and median OS (10.3 months vs. 9.1 months), although more patients were bridged to SCT in the CPX‐351 group (35% vs. 12%). The results were confirmed when only 3 + 7 patients were included in the historical cohort. In multivariable analyses, SCT was associated with better OS (HR 0.33 95% CI: 0.18–0.59), p < 0.001. Conclusion: Larger post‐authorization studies may provide evidence of the clinical benefits of CPX‐351 for AML in the real‐life setting. [ABSTRACT FROM AUTHOR]

Background: High‐grade serous ovarian carcinoma (HGSOC) is the deadliest ovarian cancer subtype, and survival relates to initial cytoreductive surgical treatment. The existing tools for surgical outcome prediction remain inadequate for anticipating the outcomes of the complex relationship between tumour biology, clinical phenotypes, co‐morbidity and surgical skills. In this genotype–phenotype association study, we combine phenotypic markers with targeted DNA sequencing to discover novel biomarkers to guide the surgical management of primary HGSOC. Methods: Primary tumour tissue samples (n = 97) and matched blood from a phenotypically well‐characterised treatment‐naïve HGSOC patient cohort were analysed by targeted massive parallel DNA sequencing (next generation sequencing [NGS]) of a panel of 360 cancer‐related genes. Association analyses were performed on phenotypic traits related to complete cytoreductive surgery, while logistic regression analysis was applied for the predictive model. Results: The positive influence of complete cytoreductive surgery (R0) on overall survival was confirmed (p = 0.003). Before surgery, low volumes of ascitic fluid, lower CA125 levels, higher platelet counts and relatively lower clinical stage at diagnosis were all indicators, alone and combined, for complete cytoreduction (R0). Mutations in either the chromatin remodelling SWI_SNF (p = 0.036) pathway or the histone H3K4 methylation pathway (p = 0.034) correlated with R0. The R0 group also demonstrated higher tumour mutational burden levels (p = 0.028). A predictive model was developed by combining two phenotypes and the mutational status of five genes and one genetic pathway, enabling the prediction of surgical outcomes in 87.6% of the cases in this cohort. Conclusion: Inclusion of molecular biomarkers adds value to the pre‐operative stratification of HGSOC patients. A potential preoperative risk stratification model combining phenotypic traits and single‐gene mutational status is suggested, but the set‐up needs to be validated in larger cohorts. [ABSTRACT FROM AUTHOR]

Phosphorylated inositol hexaphosphate (IP6) is a naturally occurring carbohydrate, and its parent compound, myoinositol (Ins), is abundantly present in plants, particularly in certain high-fiber diets, but also in mammalian cells, where they regulate essential cellular functions. IP6 has profound modulation effects on macrophages, which warrants further research on the therapeutic benefits of IP6 for inflammatory diseases. Here, we review IP6 as a promising compound that has the potential to be used in various areas of dentistry, including endodontics, restorative dentistry, implantology, and oral hygiene products, due to its unique structure and characteristic properties. Available as a dietary supplement, IP6 + Ins has been shown to enhance the anti-inflammatory effect associated with preventing and suppressing the progression of chronic dental inflammatory diseases. IP6 in dentistry is now substantial, and this narrative review presents and discusses the different applications proposed in the literature and gives insights into future use of IP6 in the fields of orthodontics, periodontics, implants, and pediatric dentistry. [ABSTRACT FROM AUTHOR]

Abstract There is a lack of data focused on the specific coagulopathic derangements in COVID‐19 versus non‐COVID‐19 acutely ill cancer patients. Our objective was to characterize features of coagulopathy in cancer patients with active COVID‐19 illness who required hospitalization at MD Anderson in the Texas Medical Center and to correlate those features with thrombotic complications, critical illness, and mortality within the first 30 days after hospital admission for COVID‐19 illness. COVID‐19 and non‐COVID‐19 hospitalized cancer patients, with at least five consecutive measures of PT, PTT, d‐dimer, and CBC during the same period, were matched 1:1 to perform a retrospective analysis. We reviewed complete blood cell counts with differential, PT, PTT, fibrinogen, D‐Dimer, serum ferritin, IL‐6, CRP, and peripheral blood smears. Clinical outcomes were thrombosis, mechanical ventilation, critical illness, and death. Compared with matched hospitalized cancer patients without COVID‐19, we found elevated neutrophil and lower lymphocyte counts in those with critical illness ( p = 0.00) or death ( p = 0.00); only neutrophils correlated with thrombosis. COVID‐19 cancer patients with a platelet count decline during the hospital stay had more frequent critical illness ( p = 0.00) and fatal outcomes ( p = 0.00). Of the inflammatory markers, interleukin‐6 showed consistently higher levels in the COVID‐19 patients with poor outcomes. The findings of unique platelet changes and coagulopathy during severe COVID‐19 illness in the cancer population are of interest to explore disease mechanisms and future risk stratification strategies to help with the management of cancer patients with COVID‐19.

Background: Patients with alveolar rhabdomyosarcoma (ARMS) have inferior outcomes compared to patients with embryonal rhabdomyosarcoma (ERMS) and more effective chemotherapy options are needed for these patients. Vinorelbine is a semisynthetic vinca alkaloid that has clinical activity in relapsed rhabdomyosarcoma (RMS) when used alone or in combination with cyclophosphamide. Aims: The goal of our study was to evaluate whether RMS histology subtype influences response rate to vinorelbine alone or in combination. Materials & Methods: Five Phase 2 trials that enrolled RMS patients were included in the meta‐analysis. Two studies evaluated vinorelbine alone, two studies evaluated vinorelbine in combination with low dose oral cyclophosphamide, and one study evaluated vinorelbine and intravenous cyclophosphamide in combination with temsirolimus or bevacizumab. All RMS patients had relapsed or refractory disease and had received at least one prior therapy. Response was reported according to RECIST1.1 and was defined as a complete or partial response. Response data was obtained from published results or from trial principal investigator. RMS NOS patients were grouped with ERMS patients for this analysis. Summary estimates comparing differences between ARMS and ERMS response rates were generated using a random‐effects model to account for heterogeneity among the studies. Results: One hundred fifty‐six enrolled patients evaluable for response were included in the meta‐analysis, 85 ARMS, 64 ERMS and 7 RMS‐NOS. The combined effect generated from the random‐effects model demonstrated a 41% increase (p = 0.001, 95% CI; 0.21–0.60) in response to vinorelbine as a single agent or in combination in patients with ARMS compared to patients with ERMS. There was no significant difference in the rate of progressive disease between patients with ARMS compared to ERMS (p = 0.1, 95%CI; −0.26–0.02). Discussion: Vinorelbine is an active agent for the treatment of relapsed or refractory RMS and a meta‐analysis of Phase 2 studies shows that radiographic responses in patients with ARMS were significantly higher than ERMS or RMS‐NOS. Conclusion: These data support further investigation of vinorelbine in newly diagnosed patients with RMS particularly those with alveolar histology. [ABSTRACT FROM AUTHOR]

Background: Survivorship care plans (SCPs) communicate cancer‐related information from oncology providers to patients and primary care providers. SCPs may limit overuse testing by specifying necessary follow‐up care. From a randomized, controlled trial of SCP delivery, we examined whether cancer‐related tests not specified in SCPs, but conducted after SCP receipt, were appropriate or consistent with overuse. Methods: Survivors of breast, colorectal, or prostate cancer treated at urban‐academic or rural‐community health systems were randomized to one of three SCP delivery arms. Tests during 18 months after SCP receipt were classified as consistent with overuse if they were (1) not included in SCPs and (2) on a guideline‐based predetermined list of "not recommended surveillance." After chart abstraction, physicians performed review and adjudication of potential overuse. Descriptive analyses were conducted of tests consistent with overuse. Negative binomial regression models determined if testing consistent with overuse differed across study arms. Results: Among 316 patients (137 breast, 67 colorectal, 112 prostate), 140 individual tests were identified as potential overuse. Upon review, 98 were deemed to be consistent with overuse: 78 tumor markers and 20 imaging tests. The majority of overuse testing was breast cancer‐related (95%). Across sites, 27 patients (9%) received ≥1 test consistent with overuse; most were breast cancer patients (22/27). Exploratory analyses of overuse test frequency by study arm showed no significant difference. Conclusions: This analysis identified practice patterns consistent with overuse of surveillance testing and can inform efforts to improve guideline‐concordant care. Future interventions may include individual practice patterns and provider education. [ABSTRACT FROM AUTHOR]

BackgroundPrior to August 7, 2022, there had been no positive cases of novel coronavirus in Tibet for 920 consecutive days. However, with the first case of Omicron variant infection, the disease rapidly spread and was prevalent in Tibet for nearly 3 months, from August 7th to November 1st. With the spread of the epidemic, the local government responded quickly and established several mobile cabin hospitals to treat patients with mild and asymptomatic Omicron infection. However, the epidemiological and clinical characteristics of these patients are unknown.MethodsThis is a retrospective study including a total of 14,264 mild and asymptomatic cases with Omicron infection in Tibet between August to October, 2022. The clinical data and epidemiological characteristics of COVID-19 cases admitted to Tibet mobile cabin hospitals were collected by using standardized forms from mobile cabin hospital database system, including demographic characteristics, onset symptoms, medication use, past medical history, hospitalization time, and discharge time. In terms of statistical analysis, multivariate Cox regression model was used to analyze the relationship between case characteristics and the length of stay in hospital.ResultsAmong 14,264 patients infected with Omicron, the average length of hospital stay was six (4–8, Interquartile range) days. Fifty percent of the patients were discharged by the 6th day, and 90% were discharged by the 10th day. Patients of all ages are generally susceptible to COVID-19, and there was no difference in discharge time, but the average length of hospital stay of Tibetan patients with COVID-19 was longer than that of Han patients. According to the statistics of clinical symptoms, sore throat (38.7%) and fever (19.4%) were the most common symptoms, while muscle pain (17.4%), cough (16.6%), and expectoration (13.2%) were also common. In addition, patients with chronic gastritis had significantly longer hospital stays.ConclusionBased on the experience of Tibet mobile cabin hospitals and data analysis, we believe that patients of all ages are generally susceptible to Omicron. Compared with other novel coronavirus strains, Omicron infected patients had a shorter hospital stay, and treatment of symptoms is expected to shorten the time of nucleic acid negative conversion.

Abstract Background Inflammatory responses from benign conditions can cause non‐cancer‐related elevations in tumor markers. The severe acute respiratory coronavirus 2 (SARS‐CoV‐2) induces a distinct viral inflammatory response, resulting in coronavirus disease 2019 (COVID‐19). Clinical data suggest carcinoembryonic antigen (CEA), carbohydrate antigen 19–9 (CA 19–9), and cancer antigen 125 (CA 125) levels might rise in patients with COVID‐19. However, available data excludes cancer patients, so little is known about the effect of COVID‐19 on tumor markers among cancer patients. Methods We conducted a case series and identified patients with a positive SARS‐CoV‐2 PCR test, diagnosis of a solid tumor malignancy, and a CEA, CA 19–9, CA 125, or CA 27–29 laboratory test. Cancer patients with documented COVID‐19 infection and at least one pre‐ and two post‐infection tumor marker measurements were included. We abstracted the electronic health record for demographics, cancer diagnosis, treatment, evidence of cancer progression, date and severity of COVID‐19 infection, and tumor marker values. Results Seven patients were identified with a temporary elevation of tumor marker values during the post‐COVID‐19 period. Elevation in tumor marker occurred within 56 days of COVID‐19 infection for all patients. Tumor markers subsequently decreased at the second time point in the post‐infectious period among all patients. Conclusion We report temporary elevations of cancer tumor markers in the period surrounding COVID‐19 infection. To our knowledge this is the first report of this phenomenon in cancer patients and has implications for clinical management and future research.

Abstract Background Primary human herpesvirus 8 (HHV8)‐unrelated effusion large B‐cell lymphoma is a clinical disease entity distinct from HHV8‐positive primary effusion lymphoma (PEL). However, the lack of experimental HHV8‐unrelated effusion large B‐cell lymphoma models continues to hinder the pathophysiologic and therapeutic investigations of this disorder. Methods The lymphoma cells were obtained from the pleural effusion of a patient with primary HHV8‐unrelated effusion large B‐cell lymphoma and cultured in vitro. Results We established a novel HHV8‐unrelated effusion large B‐cell lymphoma cell line, designated Pell‐1, carrying a c‐MYC rearrangement with features distinct from those of HHV8‐positive PEL. Moreover, we developed an HHV8‐unrelated effusion large B‐cell lymphoma cell line‐derived xenograft model. Pell‐1 cells induced profuse lymphomatous ascites and subsequently formed intra‐abdominal tumors after intraperitoneal implantation into irradiated nonobese diabetic/severe combined immunodeficient mice. Thus, this xenograft mouse model mimicked the clinical phenomena observed in patients and recapitulated the sequential stages of aggressive HHV8‐unrelated effusion large B‐cell lymphoma. The bromodomain and extraterminal domain (BET) inhibitors JQ1 and birabresib (MK‐8628/OTX015) reduced the proliferation of Pell‐1 cells in vitro through the induction of cell cycle arrest and apoptosis. The antitumor effect of BET inhibition was also demonstrated in vivo, as birabresib significantly reduced ascites and suppressed tumor progression without apparent adverse effects in the xenografted mice. Conclusion These preclinical findings suggest the therapeutic potential of targeting c‐MYC through BET inhibition in HHV8‐unrelated effusion large B‐cell lymphoma.

There is a lack of data focused on the specific coagulopathic derangements in COVID‐19 versus non‐COVID‐19 acutely ill cancer patients. Our objective was to characterize features of coagulopathy in cancer patients with active COVID‐19 illness who required hospitalization at MD Anderson in the Texas Medical Center and to correlate those features with thrombotic complications, critical illness, and mortality within the first 30 days after hospital admission for COVID‐19 illness. COVID‐19 and non‐COVID‐19 hospitalized cancer patients, with at least five consecutive measures of PT, PTT, d‐dimer, and CBC during the same period, were matched 1:1 to perform a retrospective analysis. We reviewed complete blood cell counts with differential, PT, PTT, fibrinogen, D‐Dimer, serum ferritin, IL‐6, CRP, and peripheral blood smears. Clinical outcomes were thrombosis, mechanical ventilation, critical illness, and death. Compared with matched hospitalized cancer patients without COVID‐19, we found elevated neutrophil and lower lymphocyte counts in those with critical illness (p = 0.00) or death (p = 0.00); only neutrophils correlated with thrombosis. COVID‐19 cancer patients with a platelet count decline during the hospital stay had more frequent critical illness (p = 0.00) and fatal outcomes (p = 0.00). Of the inflammatory markers, interleukin‐6 showed consistently higher levels in the COVID‐19 patients with poor outcomes. The findings of unique platelet changes and coagulopathy during severe COVID‐19 illness in the cancer population are of interest to explore disease mechanisms and future risk stratification strategies to help with the management of cancer patients with COVID‐19. [ABSTRACT FROM AUTHOR]

Questionnaires and clinical observations are significant components of human and veterinary epidemiology surveys, providing a comprehensive prognosis of the occurrence and prevalence of diseases. The information compiled by these two survey methods is equally important for establishing an epidemiological surveillance system for disease outbreak management. This review summarizes 57 previous surveys, including questionnaires and clinical observations on sheep myiasis globally from 1976 to 2023, with an emphasis on their methodologies and areas of findings. Overall, this review establishes a baseline understanding of the essential entomological and veterinary aspects required for designing questionnaires and clinical observation surveys on sheep myiasis. Additionally, it provides guidance for implementing future study protocols and proposes a farmer-based approach that integrates these techniques to achieve improved outcomes in mitigating sheep myiasis., (© The Author(s) 2024. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Abstract Background There are no series evaluating penile squamous cell carcinoma (pSCC) based on human papillomavirus (HPV) infection. Herein, we present national registry data on clinical and survival outcomes for pSCC based on HPV status. Methods We performed a retrospective review of 1224 pSCC patients with known HPV staining from the National Cancer Database. Patients with cM1 disease, those who did not receive treatment, or had missing follow‐up data were excluded. Logistic regression identified factors associated with locally aggressive disease. Univariable, multivariable, and inverse probability of treatment weighting (IPTW)‐Cox proportional hazard modeling were used to assess hazard ratios (HR) associated with overall survival (OS). Results After exclusion criteria, we identified 825 cases of which 321 (38.9%) were HPV positive. The HPV‐positivity rate did not significantly change by year. HPV‐positive patients were younger, had lower Charlson‐Deyo performance score, and resided in areas with both lower median household income and lower school education completion. HPV‐positive tumors presented with lower American Joint Committee on Cancer clinical T‐stage (cT), poorer differentiation, lower rates of lymphovascular invasion (LVI), but more node‐positive disease (cN+). For those who underwent lymph node surgery, there were no differences in final pathologic stage, upstaging, or presence of extranodal extension. Only tumor differentiation, LVI, and performance score were independent predictors for locally aggressive disease. HPV status was not a predictor of OS (IPTW‐HR:0.89, p = 0.13). Conclusions In the largest series evaluating pSCC based on HPV status, HPV‐positive tumors were associated with lower cT stages, less LVI, but more cN + disease. More studies on prognostic factors are needed, and time may still be immature to use HPV information for risk stratification.

Background: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To increase the success in treating patients with COVID-19, many drug suggestions and some clinical studies are shared in the literature. However, the combination of several drugs with other clinical care has improved patients' conditions. And this review discusses some side effects of Covid-19 drugs' adverse effects. Objectives: Here, we have shortly reported the recent updates on the most common and plausible drugs for treating COVID-19 patients. We also compare these treatment options based on their impact on symptom management, inpatient length of stay, and overall morbidity and mortality. Methods: An extensive literature search was performed through PubMed, Scopus, Web of Science, and Google Scholar. Most of the keywords used were: "COVID-19", "Side effects of used drugs," "Treatment of COVID-19", "Risk factors," "Organ damage," and "Methods of diagnosis and treatment." Results: Anti-inflammatory, antimicrobial, and vitamin supplements do not have obvious benefits, but there is limited information to consider. Other factors and drugs such as improved plasma, eculizumab, immunoglobulins, IgG1-neutralizing monoclonal antibodies, remidseiver, steroids, and tosilizumab have shown potential effects on patient's length of hospital stay and mortality. Currently, there is no evidence that any other vaccines, apart from those specifically designed for the SARS-Cov-2 virus, will protect against COVID-19. Conclusion: Since the prevention of the COVID-19 virus is a new issue in the medical world, there is no known effective treatment option in this area, and the prevention of its adverse side effects has not been conclusively proven. Of course, the occurrence of side effects in patients undergoing treatment such as hepatotoxicity, retinal damage, nephrotoxicity, and cardiotoxicity proves that the necessary caution should be used in drug combination methods.

Abstract Background Patients with unresectable or metastatic differentiated thyroid carcinoma (DTC) are rare and require individualized therapy. This may require approaches not typically used in resectable disease. We report a patient treated with lenvatinib and external beam radiation therapy. Case An 87‐year‐old woman presented with cT4N1aM1 papillary thyroid carcinoma with tracheal invasion. She was not a candidate for surgery, radioactive‐iodine, or radiation, so a trial of lenvatinib was offered. Her tumor showed clinical, biochemical, and radiological response after 5 months of lenvatinib, and she subsequently received external beam radiation. She enjoys good quality of life without evidence of cancer progression off therapy 21 months post‐initiation of treatment. Conclusion Lenvatinib may be effective in RAI‐naïve advanced DTC patients as a component of individualized multimodal therapy when conventional options are not feasible.

Background: Inflammatory responses from benign conditions can cause non‐cancer‐related elevations in tumor markers. The severe acute respiratory coronavirus 2 (SARS‐CoV‐2) induces a distinct viral inflammatory response, resulting in coronavirus disease 2019 (COVID‐19). Clinical data suggest carcinoembryonic antigen (CEA), carbohydrate antigen 19–9 (CA 19–9), and cancer antigen 125 (CA 125) levels might rise in patients with COVID‐19. However, available data excludes cancer patients, so little is known about the effect of COVID‐19 on tumor markers among cancer patients. Methods: We conducted a case series and identified patients with a positive SARS‐CoV‐2 PCR test, diagnosis of a solid tumor malignancy, and a CEA, CA 19–9, CA 125, or CA 27–29 laboratory test. Cancer patients with documented COVID‐19 infection and at least one pre‐ and two post‐infection tumor marker measurements were included. We abstracted the electronic health record for demographics, cancer diagnosis, treatment, evidence of cancer progression, date and severity of COVID‐19 infection, and tumor marker values. Results: Seven patients were identified with a temporary elevation of tumor marker values during the post‐COVID‐19 period. Elevation in tumor marker occurred within 56 days of COVID‐19 infection for all patients. Tumor markers subsequently decreased at the second time point in the post‐infectious period among all patients. Conclusion: We report temporary elevations of cancer tumor markers in the period surrounding COVID‐19 infection. To our knowledge this is the first report of this phenomenon in cancer patients and has implications for clinical management and future research. [ABSTRACT FROM AUTHOR]

Cynomolgus macaques, the most commonly utilized nonhuman primate in nonclinical toxicology studies, are acquired from purpose-bred colonies across various geographic locations, including China, Cambodia, and Vietnam. Importation challenges and limited availability have restricted animals suitable for inclusion in nonclinical studies. The coronavirus disease 2019 (COVID-19) outbreak further stressed supply chains, reducing the ability to source animals from a singular location to complete a drug development program. These challenges raised concerns of increased variability in study endpoints due to heterogeneity of animals and that this could subsequently impact historical control data and toxicology study interpretation. To investigate the impact of Chinese, Vietnamese, or Cambodian geographic origin on standard nonclinical toxicology study endpoints, historical control data from studies conducted at a single facility from 2005 to 2020 were compiled and evaluated for the following: clinical observations, body weight, ophthalmoscopic examinations, and clinical and anatomic pathology data. Study populations consisted of 2- to 5-year-old cynomolgus macaques sourced from China (n = 750 males/741 females), Cambodia (n = 282 males/271 females), and Vietnam (n = 122 males/120 females). Interpretation of the various data demonstrated no notable differences in standard toxicology study endpoints or background findings among cynomolgus macaques originating from China, Cambodia, or Vietnam. [ABSTRACT FROM AUTHOR]

Given the increased incidence of colorectal cancer worldwide, especially in developed and developing countries, is comes as no surprise that researchers are concentrating on methods to combat this public health issue, through investigating both lifestyle interventions and treatment options. Although treatment options are being constantly discovered and developed, researchers have also begun investigating the influence that nutrition and lifestyle have on CRC. Among the food categories, nuts and seeds boast numerous beneficial effects for cardiovascular health and metabolic balance and they contain a plethora of phytochemicals and antioxidants. The present narrative review aims to offer a broad perspective to date on the known effects of this consumption on colorectal cancer. For this purpose, articles were identified by conducting a search in the PubMed and Google Scholar databases, using search phrases such as ″nut intake and colorectal cancer″ and ″seed consumption and colorectal cancer", narrowing the search pool to those articles published between 2019 and 2022. The search returned eight relevant papers, all of which were validated by a second author. While the existing research is divided between those studies which have found no significant link between nut consumption and colorectal cancer protection and those which have, there is a consensus regarding the necessity for further research on this subject, as well as the possible mechanisms which might be involved in the protective effect observed by some researchers. [ABSTRACT FROM AUTHOR]

Susarah Maria Richter,1,2 Tobias George Barnard2 1Department of Optometry, University of Johannesburg, Johannesburg, South Africa; 2Water and Health Research Centre, University of Johannesburg, Johannesburg, South AfricaCorrespondence: Susarah Maria RichterUniversity of Johannesburg, PO Box 17077, Doornfontein, Johannesburg, 2028, South AfricaTel +27115596716Email mrichter@uj.ac.zaBackground: The link between hand and surface hygiene and the spread of disease has been reported by various studies and understanding the appropriate use of hand hygiene is important in healthcare. The World Health Organization (WHO) introduced the “My Five Moments for Hand Hygiene” model to educate healthcare workers about the importance of hand hygiene to stop the spread of disease.Objective: The objectives of this paper were to determine if the WHO Hand Hygiene Observation Form could be used to monitor for hand and personal hygiene practices of Optometry students, and what their actual hygiene practices are in an Optometry training facility in South Africa.Methods: This cross-sectional study was performed at an Optometry training facility in South Africa using third (n=32) and fourth year (n=39) students. The Hand Hygiene Knowledge Questionnaire for Health Care Workers by the WHO was used to determine their knowledge regarding hand hygiene. After completing the questionnaire, participants were observed in the clinic while consulting patients to determine the hand and surface hygiene practices they apply.Results: The WHO hand hygiene observation rubric was not appropriate to evaluate hand and surface hygiene in Optometry facilities. The adapted observation rubric created was a better tool to evaluate student hygiene practices and was able to record which hand or surface hygiene were missed when presented with such opportunities. Although 90.1% of the students knew that germs could be transferred to the patients via hands, only 46.5% routinely used an alcohol-based hand sanitizer.Conclusion: This observation rubric developed during this study can assist in creating awareness with students about their own hand and surface hygiene deficiencies when interacting with patients.Keywords: hand hygiene, Optometry in South Africa, surface hygiene, clinical observations

Abstract Tisagenlecleucel (tisa‐cel) is a second‐generation autologous CD19‐targeted chimeric antigen receptor (CAR) T‐cell therapy approved for relapsed/refractory (R/R) large B‐cell lymphoma (LBCL). The approval was based on the results of phase II JULIET trial, with a best overall response rate (ORR) and complete response (CR) rate in infused patients of 52% and 40%, respectively. We report outcomes with tisa‐cel in the standard‐of‐care (SOC) setting for R/R LBCL. Data from all patients with R/R LBCL who underwent leukapheresis from December 2018 until June 2020 with the intent to receive SOC tisa‐cel were retrospectively collected at 10 Spanish institutions. Toxicities were graded according to ASTCT criteria and responses were assessed as per Lugano 2014 classification. Of 91 patients who underwent leukapheresis, 75 (82%) received tisa‐cel therapy. Grade 3 or higher cytokine release syndrome and neurotoxicity occurred in 5% and 1%, respectively; non‐relapse mortality was 4%. Among the infused patients, best ORR and CR were 60% and 32%, respectively, with a median duration of response of 8.9 months. With a median follow‐up of 14.1 months from CAR T‐cell infusion, median progression‐free survival and overall survival were 3 months and 10.7 months, respectively. At 12 months, patients in CR at first disease evaluation had a PFS of 87% and OS of 93%. Patients with an elevated lactate dehydrogenase showed a shorter PFS and OS on multivariate analysis. Treatment with tisa‐cel for patients with relapsed/refractory LBCL in a European SOC setting showed a manageable safety profile and durable complete responses.

Phosphorylated inositol hexaphosphate (IP6) is a naturally occurring carbohydrate, and its parent compound, myoinositol (Ins), is abundantly present in plants, particularly in certain high-fiber diets, but also in mammalian cells, where they regulate essential cellular functions. IP6 has profound modulation effects on macrophages, which warrants further research on the therapeutic benefits of IP6 for inflammatory diseases. Here, we review IP6 as a promising compound that has the potential to be used in various areas of dentistry, including endodontics, restorative dentistry, implantology, and oral hygiene products, due to its unique structure and characteristic properties. Available as a dietary supplement, IP6 + Ins has been shown to enhance the anti-inflammatory effect associated with preventing and suppressing the progression of chronic dental inflammatory diseases. IP6 in dentistry is now substantial, and this narrative review presents and discusses the different applications proposed in the literature and gives insights into future use of IP6 in the fields of orthodontics, periodontics, implants, and pediatric dentistry.