Clinical Cancer Research Research Articles

Empirical evaluation of language modeling to ascertain cancer outcomes from clinical text reports

BackgroundLongitudinal data on key cancer outcomes for clinical research, such as response to treatment and disease progression, are not captured in standard cancer registry reporting. Manual extraction of such outcomes from unstructured electronic health records is a slow, resource-intensive process. Natural language processing (NLP) methods can accelerate outcome annotation, but they require substantial labeled data. Transfer learning based on language modeling, particularly using the Transformer architecture, has achieved improvements in NLP performance. However, there has been no systematic evaluation of NLP model training strategies on the extraction of cancer outcomes from unstructured text.ResultsWe evaluated the performance of nine NLP models at the two tasks of identifying cancer response and cancer progression within imaging reports at a single academic center among patients with non-small cell lung cancer. We trained the classification models under different conditions, including training sample size, classification architecture, and language model pre-training. The training involved a labeled dataset of 14,218 imaging reports for 1112 patients with lung cancer. A subset of models was based on a pre-trained language model, DFCI-ImagingBERT, created by further pre-training a BERT-based model using an unlabeled dataset of 662,579 reports from 27,483 patients with cancer from our center. A classifier based on our DFCI-ImagingBERT, trained on more than 200 patients, achieved the best results in most experiments; however, these results were marginally better than simpler “bag of words” or convolutional neural network models.ConclusionWhen developing AI models to extract outcomes from imaging reports for clinical cancer research, if computational resources are plentiful but labeled training data are limited, large language models can be used for zero- or few-shot learning to achieve reasonable performance. When computational resources are more limited but labeled training data are readily available, even simple machine learning architectures can achieve good performance for such tasks.

Machine Learning-Based Prediction of Distant Recurrence in Invasive Breast Carcinoma Using Clinicopathological Data: A Cross-Institutional Study.

Breast cancer is the most common type of cancer worldwide. Alarmingly, approximately 30% of breast cancer cases result in disease recurrence at distant organs after treatment. Distant recurrence is more common in some subtypes such as invasive breast carcinoma (IBC). While clinicians have utilized several clinicopathological measurements to predict distant recurrences in IBC, no studies have predicted distant recurrences by combining clinicopathological evaluations of IBC tumors pre- and post-therapy with machine learning (ML) models. The goal of our study was to determine whether classification-based ML techniques could predict distant recurrences in IBC patients using key clinicopathological measurements, including pathological staging of the tumor and surrounding lymph nodes assessed both pre- and post-neoadjuvant therapy, response to therapy via standard-of-care imaging, and binary status of adjuvant therapy administered to patients. We trained and tested four clinicopathological ML models using a dataset (144 and 17 patients for training and testing, respectively) from Duke University and validated the best-performing model using an external dataset (8 patients) from Dartmouth Hitchcock Medical Center. The random forest model performed better than the C-support vector classifier, multilayer perceptron, and logistic regression models, yielding AUC values of 1.0 in the testing set and 0.75 in the validation set (p < 0.002) across both institutions, thereby demonstrating the cross-institutional portability and validity of ML models in the field of clinical research in cancer. The top-ranking clinicopathological measurement impacting the prediction of distant recurrences in IBC were identified to be tumor response to neoadjuvant therapy as evaluated via SOC imaging and pathology, which included tumor as well as node staging.

Global research trends on B7-H3 for cancer immunotherapy: A bibliometric analysis (2012-2022)

ABSTRACT Immunotherapy has revolutionized cancer treatment. B7-H3 is a promising target for cancer immunotherapy (CI). The present study aimed to utilize bibliometric methods to assess the current research status and explore future trends in the use of B7-H3 for CI. We collected publications related to B7-H3/CI from the Clarivate Web of Science Core Collection database. VOSviewer, Microsoft Excel, the bibliometrix R package, and an online platform were used to conduct qualitative and visualized analyses of the literature. A total of 555 papers were analyzed, revealing a significant increase in annual publications since 2018. The most productive countries were China and the USA, and the leading institutions were Soochow University and Sichuan University. Zang and Ferrone were the most popular authors. Among the journals, Frontiers in Immunology had the highest number of papers, whereas Clinical Cancer Research was the most influential. Historical citation analysis reveals the development of B7-H3/CI. Top-cited papers and keyword analyses were performed to highlight current hotspots in the domain. Using cluster analysis, we classified all keywords into four clusters: “immunotherapy,” “co-stimulatory molecule,” “B7 family,” and “PD-L1.” Finally, Trends analysis suggested that future research might focus on “chimeric antigen receptor,” “pathways,” and “targeting B7-H3.” This is the first bibliometric crosstalk analysis between B7-H3 and CI. Our study illustrates that the topic of B7-H3/CI is very popular and has great clinical implications and that the number of correlative publications will continue to increase. B7-H3-based CI may lead to new research trends.

An ASCO leadership development project to understand barriers to clinical cancer research in the Asia-Pacific.

96 Background: There are huge challenges in conducting clinical research, with gross disparities in trial access for patients in the Asia-Pacific (APAC). ASCO initiated a leadership development program in 2021, and one of the projects involved understanding the barriers to conducting clinical research and trials regionally. Methods: We conducted a cross-sectional survey on barriers to clinical research using a 29-item questionnaire which covered potential barriers to establishing clinical groups to support trials, and respondents’ demographic and other information. We targeted oncology healthcare professionals (HCPs) from APAC via national societies, locoregional hospitals, and via social media channels. Data were collected through the SurveyMonkey platform. Countries were classified into high-income (HICs), upper-middle (UMICs), and lower-middle income countries (LMICs) according to the World Bank criterion. We hypothesized substantial differences in the responses of HCPs by income (HICs vs UMICs vs LMICs) due to political, cultural, ethical, and socioeconomic factors and evaluated the univariate association of each potential barrier using Chi-square test. Multivariable logistic regression models evaluated the association between the top five significant potential barriers and country grouping, adjusting for age, gender, specialty and affiliation. Results: Three-hundred responses were received from May to July 2022, representing 21 APAC countries and regions in total. Among these, 102 (34%), 57 (19%), and 137 (46%) HCPs practiced in HICs, UMICs, and LMICs, respectively, with 51% of respondents being female. Most HCPs practiced in medical oncology (35%), radiation oncology (29%), and surgical oncology (13%). Just under 70% of respondents had &lt;= 10 years of training. Overall, the top five reported barriers included competing demands (reported by 88% of respondents), lack of financial support (86%), healthcare access issues for patients (75%), lack of research environment and infrastructure (72%), and lack of expertise of staff (68%). Adjusting for other factors, among these barriers lack of financial support, research environment and infrastructure, expertise, and healthcare access differed significantly between HICs and LMICs with respondents from LMICs more often reporting these barriers than those from HICs (p&lt;=0.02 for all). Conclusions: This is the largest survey exploring the research and trial landscape in APAC that revealed common and specific challenges affecting different countries, thus emphasizing the importance of targeted measures when addressing these barriers. These findings will inform future potential action plans by ASCO and the APAC Regional Council such as skills training, embedding clinical research within practice and facilitating cross border interaction; to empower research in the region.

Opportunities and Challenges of Synthetic Data Generation in Oncology.

Widespread interest in artificial intelligence (AI) in health care has focused mainly on deductive systems that analyze available real-world data to discover patterns not otherwise visible. Generative adversarial network, a new type of inductive AI, has recently evolved to generate high-fidelity virtual synthetic data (SD) trained on relatively limited real-world information. The AI system is fed with a collection of real data, and it learns to generate new augmented data while maintaining the general characteristics of the original data set. The use of SD to enhance clinical research and protect patient privacy has drawn a lot of interest in medicine and in the complex field of oncology. This article summarizes the main characteristics of this innovative technology and critically discusses how it can be used to accelerate data access for secondary purposes, providing an overview of the opportunities and challenges of SD generation for clinical cancer research and health care.

Thymus-derived hormonal and cellular control of cancer.

The thymus gland is a central lymphoid organ in which developing T cell precursors, known as thymocytes, undergo differentiation into distinct type of mature T cells, ultimately migrating to the periphery where they exert specialized effector functions and orchestrate the immune responses against tumor cells, pathogens and self-antigens. The mechanisms supporting intrathymic T cell differentiation are pleiotropically regulated by thymic peptide hormones and cytokines produced by stromal cells in the thymic microenvironment and developing thymocytes. Interestingly, in the same way as T cells, thymic hormones (herein exemplified by thymosin, thymulin and thymopoietin), can circulate to impact immune cells and other cellular components in the periphery. Evidence on how thymic function influences tumor cell biology and response of patients with cancer to therapies remains unsatisfactory, although there has been some improvement in the knowledge provided by recent studies. Herein, we summarize research progression in the field of thymus-mediated immunoendocrine control of cancer, providing insights into how manipulation of the thymic microenvironment can influence treatment outcomes, including clinical responses and adverse effects of therapies. We review data obtained from clinical and preclinical cancer research to evidence the complexity of immunoendocrine interactions underpinning anti-tumor immunity.

Recent Progress in Nanotechnology Improving the Therapeutic Potential of Polyphenols for Cancer.

Polyphenols derived from fruits, vegetables, and plants are bioactive compounds potentially beneficial to human health. Notably, compounds such as quercetin, curcumin, epigallocatechin-3-gallate (EGCG), and resveratrol have been highlighted as antiproliferative agents for cancer. Due to their low solubility and limited bioavailability, some alternative nanotechnologies have been applied to encapsulate these compounds, aiming to improve their efficacy against cancer. In this comprehensive review, we evaluate the main nanotechnology approaches to improve the therapeutic potential of polyphenols against cancer using in vitro studies and in vivo preclinical models, highlighting recent advancements in the field. It was found that polymeric nanomaterials, lipid-based nanomaterials, inorganic nanomaterials, and carbon-based nanomaterials are the most used classes of nanocarriers for encapsulating polyphenols. These delivery systems exhibit enhanced antitumor activity and pro-apoptotic effects, particularly against breast, lung, prostate, cervical, and colorectal cancer cells, surpassing the performance of free bioactive compounds. Preclinical trials in xenograft animal models have revealed decreased tumor growth after treatment with polyphenol-loaded delivery systems. Moreover, the interaction of polyphenol co-delivery systems and polyphenol-drug delivery systems is a promising approach to increase anticancer activity and decrease chemotherapy side effects. These innovative approaches hold significant implications for the advancement of clinical cancer research.

Neoadjuvant treatment does not influence PD-L1 expression in stage III non-small-cell lung cancer: a retrospective analysis of tumor samples from the trials SAKK 16/96, 16/00, 16/01, and 16/14

The inclusion of immune checkpoint inhibitors (ICIs) in the treatment of operable stage III non-small-cell lung cancer is becoming a new standard. Programmed death-ligand 1 (PD-L1) protein expression on tumor cells has emerged as the most important biomarker for sensitivity to ICIs targeting the programmed cell death protein 1 (PD-1)-PD-L1 axis. Little is known about the impact of neoadjuvant treatment on PD-L1 expression. We assessed PD-L1 expression by immunohistochemistry (Ventana SP263 assay) on tumor cells in treatment-naive diagnostic tumor samples and matched lung resections from patients with stage III non-small-cell lung cancer included in the Swiss Group for Clinical Cancer Research (SAKK) trials 16/96, 16/00, 16/01, and 16/14. All patients received neoadjuvant chemotherapy (CT) with cisplatin/docetaxel, either as single modality (CT), with sequential radiotherapy [chemoradiation therapy (CRT)] or with the PD-L1 inhibitor durvalumab (CT+ ICI). Overall, 132 paired tumor samples were analyzed from patients with neoadjuvant CT (n= 69), CRT (n= 33) and CT+ ICI (n= 30). For CT and CRT, PD-L1 expression before and after neoadjuvant treatment did not differ significantly (Wilcoxon test, P= 0.94). Likewise, no statistically significant difference was observed between CT and CRT for PD-L1 expression after neoadjuvant treatment (P= 0.97). For CT+ ICI, PD-L1 expression before and after neoadjuvant treatment also did not differ significantly (Wilcoxon test, P > 0.99). Event-free survival and overall survival for patients with downregulation or upregulation of PD-L1 expression after neoadjuvant treatment were similar. In our cohort of patients neoadjuvant treatment did not influence PD-L1 expression, irrespective of the specific neoadjuvant treatment protocol. Dynamic change of PD-L1 expression did not correlate with event-free survival or overall survival.

DNAzyme-Amplified Cascade Catalytic Hairpin Assembly Nanosystem for Sensitive MicroRNA Imaging in Living Cells.

Sensitive imaging of microRNAs (miRNAs) in living cells is significant for accurate cancer clinical diagnosis and prognosis research studies, but it is challenged by inefficient intracellular delivery, instability of nucleic acid probes, and limited amplification efficiency. Herein, we engineered a DNAzyme-amplified cascade catalytic hairpin assembly (CHA)-based nanosystem (DCC) that overcomes these challenges and improves the imaging sensitivity. This enzyme-free amplification nanosystem is based on the sequential activation of DNAzyme amplification and CHA. MnO2 nanosheets were used as nanocarriers for the delivery of nucleic acid probes, which can resist the degradation by nucleases and supply Mn2+ for the DNAzyme reaction. After entering into living cells, the MnO2 nanosheets can be decomposed by intracellular glutathione (GSH) and release the loaded nucleic acid probes. In the presence of target miRNA, the locking strand (L) was hybridized with target miRNA, and the DNAzyme was released, which then cleaved the substrate hairpin (H1). This cleavage reaction resulted in the formation of a trigger sequence (TS) that can activate CHA and recover the fluorescence readout. Meanwhile, the DNAzyme was released from the cleaved H1 and bound to other H1 for new rounds of DNAzyme-based amplification. The TS was also released from CHA and involved in the new cycle of CHA. By this DCC nanosystem, low-abundance target miRNA can activate many DNAzyme and generate numerous TS for CHA, resulting in sensitive and selective analysis of miRNAs with a limit of detection of 5.4 pM, which is 18-fold lower than that of the traditional CHA system. This stable, sensitive, and selective nanosystem holds great potential for miRNA analysis, clinical diagnosis, and other related biomedical applications.

Prevalence, trends, and characteristics of trials investigating local therapy in contemporary phase 3 clinical cancer research.

Although most patients with cancer are treated with local therapy (LT), the proportion of late-phase clinical trials investigating local therapeutic interventions is unknown. The purpose of this study was to determine the proportion, characteristics, and trends of phase 3 cancer clinical trials assessing the therapeutic value of LT over time. This was a cross-sectional analysis of interventional randomized controlled trials in oncology published from 2002 through 2020 and registered on ClinicalTrials.gov. Trends and characteristics of LT trials were compared to all other trials. Of 1877 trials screened, 794 trials enrolling 584,347 patients met inclusion criteria. A total of 27 trials (3%) included a primary randomization assessing LT compared with 767 trials (97%) investigating systemic therapy or supportive care. Annual increase in the number of LT trials (slope [m]=0.28; 95% confidence interval [CI], 0.15-0.39; p<.001) was outpaced by the increase of trials testing systemic therapy or supportive care (m=7.57; 95% CI, 6.03-9.11; p<.001). LT trials were more often sponsored by cooperative groups (22 of 27 [81%] vs. 211 of 767 [28%]; p<.001) and less often sponsored by industry (5 of 27 [19%] vs. 609 of 767 [79%]; p<.001). LT trials were more likely to use overall survival as primary end point compared to other trials (13 of 27 [48%] vs. 199 of 767 [26%]; p=.01). In contemporary late-phase oncology research, LT trials are increasingly under-represented, under-funded, and evaluate more challenging end points compared to other modalities. These findings strongly argue for greater resource allocation and funding mechanisms for LT clinical trials. Most people who have cancer receive treatments directed at the site of their cancer, such as surgery or radiation. We do not know, however, how many trials test surgery or radiation compared to drug treatments (that go all over the body). We reviewed trials testing the most researched strategies (phase 3) completed between 2002 and 2020. Only 27 trials tested local treatments like surgery or radiation compared to 767 trials testing other treatments. Our study has important implications for funding research and understanding cancer research priorities.

Mapping knowledge landscapes and emerging trends of the biomarkers in melanoma: a bibliometric analysis from 2004 to 2022.

Melanoma is a skin tumor with a high mortality rate, and early diagnosis and effective treatment are the key to reduce its mortality rate. Therefore, more and more attention has been paid for biomarker identification for early diagnosis, prognosis prediction and prognosis evaluation of melanoma. However, there is still a lack of a report that comprehensively and objectively evaluates the research status of melanoma biomarkers. Therefore, this study aims to intuitively analyze the research status and trend of melanoma biomarkers through the methods of bibliometrics and knowledge graph. This study uses bibliometrics to analyze research in biomarkers in melanoma, summarize the field's history and current status of research, and predict future research directions. Articles and Reviews related to melanoma biomarkers were retrieved by using Web of Science core collection subject search. Bibliometric analysis was performed in Excel 365, CiteSpace, VOSviewer and Bibliometrix (R-Tool of R-Studio). A total of 5584 documents from 2004 to 2022 were included in the bibliometric analysis. The results show that the number of publications and the frequency of citations in this field are increasing year by year, and the frequency of citations has increased rapidly after 2018. The United States is the most productive and influential country in this field, with the largest number of publications and institutions with high citation frequency. Caroline Robert, F. Stephen Hodi, Suzanne L. Topalian and others are authoritative authors in this field, and The New England Journal of Medicine, Journal of Clinical Oncology and Clinical Cancer Research are the most authoritative journals in this field. Biomarkers related to the diagnosis, treatment and prognosis of melanoma are hot topics and cutting-edge hotspots in this field. For the first time, this study used the bibliometric method to visualize the research in the field of melanoma biomarkers, revealing the trends and frontiers of melanoma biomarkers research, which provides a useful reference for scholars to find key research issues and partners.

President Biden Chooses Monica M. Bertagnolli, MD, to Lead the NIH

President Biden Chooses Monica M. Bertagnolli, MD, to Lead the NIH

Clinical Cancer Research in South America and Potential Health Economic Impacts.

Increased global cancer incidence rates have led to a growing demand for cancer diagnosis and treatment, as well as basic and clinical research on the subject. The expansion of clinical cancer trials beyond the borders of highly developed countries has aided the arrival of these assessments in South American countries. In this context, this study's objective is to highlight clinical cancer trial profiles developed and sponsored by pharmaceutical companies and conducted in South American countries from 2010 to 2020. This study comprises descriptive and retrospective research conducted following a search for clinical trials (phases I, II and III), registered at clinicaltrials.gov, carried out in Latin American countries and sponsored by pharmaceutical companies ("Argentina", "Brazil", "Chile", "Peru", "Colombia", "Ecuador", "Uruguay", "Venezuela", "Paraguay", "Bolivia"), registered between 1 January 2010 and 31 December 2020. A total of 1451 clinical trials were retrieved, of which 200 trials unrelated to cancer were excluded and 646 duplicates were removed, leading to a final total of 605 clinical trials employing qualitative and quantitative analyses. A 122% increase in the number of clinical trial registrations from 2010 to 2020 was noted, with a prevalence of phase III studies (431 trials of a total of 605). Lung (119), breast (100), leukemia (42), prostate (39) and melanoma (32) were the main cancers tested for new drugs. The data reported herein indicate the need for strategic basic and clinical research planning that considers South American epidemic cancer profiles.

OTHR-11. THE IMPORTANCE AND INFLUENCE OF PATIENT FAMILY INVOLVEMENT IN PEDIATRIC NEURO-ONCOLOGY RESEARCH

Abstract The involvement of patient families in clinical research in pediatric brain cancer is an underutilized tool that benefits all those involved. These families are ultimately responsible for making decisions on treatment, as well as end-of-life decisions such as post-mortem tissue donation. As demonstrated by organizations such as Gift from a Child, listening to family input on how to best have the conversation surrounding post-mortem tissue donation has led to an increase in total donations, as well as parents stating they are overwhelmingly happy with their decision to donate. Tissue donation is just one example of a large, complex hindrance in the field that had not previously been addressed successfully. Due to the rarity and devastating impact of pediatric brain tumors, the family community is tight-knit and passionate. There is incredibly impactful communication that happens between families influencing decision-making for treatment, funding, and advocacy. Partnering with families allows care teams and researchers both the ability to understand the decision-making process as well as educate and discuss with the families. Surveys of families overwhelmingly show satisfaction with the decision to donate post-mortem and dissatisfaction when they are deprived of the option. Frustration with the lack of treatment has led families to become more proactive in both their child’s treatment and future research. Increasingly, family advocates are becoming more sophisticated in their support of research opportunities. An example of this spearheading the creation of an open access, safe, anonymized data bank with clinical data paired to the patient’s tumor tissue. Family foundations are actively partnering with researchers and industry to make it happen. It is clear that this type of partnership is a strong force for change that benefits researchers, clinicians, and most importantly, patients and their families.

The overall survival analysis of FUTURE-C-PLUS: Combination of famitinib with camrelizumab plus nab-paclitaxel as first-line treatment for advanced, immunomodulatory triple-negative breast cancer—An open-label, single-arm, phase 2 trial.

1086 Background: Camrelizumab and nab-paclitaxel demonstrated promising anti-tumour activity in refractory metastatic immunomodulatory triple-negative breast cancer (TNBC) in FUTURE trial. Anti-angiogenic agents have been reported to facilitate immune infiltration. Famitinib is a tyrosine kinase inhibitor targeting VEGFR-2, PDGFR and c-kit. The FUTURE-C-PLUS trial (NCT04129996) which added famitinib to camrelizumab and nab-paclitaxel is a single-arm, phase 2 trial evaluating this novel triplet combinatorial strategy in patients with advanced immunomodulatory TNBC. Study design and the primary endpoint ORR has been reported previously (Zhi-ming Shao, et al. ASCO 2021, Abstract 1007). The final PFS data had been published in Clinical Cancer Research (Clin Cancer Res 2022;28:2807–17). Here, we reported the final overall survival of this trial. Methods: Briefly, this study enrolled women aged 18-70 years, with previously untreated, histologically confirmed, unresectable, locally advanced, recurrent or metastatic immunomodulatory TNBC. Immunomodulatory TNBC was defined as CD8 expression on at least 10% of cells using immunohistochemistry analysis. Eligible patients received the triple therapy. Results: Forty-eight patients were enrolled and treated between Oct 2019 and Oct 2020. The median follow-up was 33.1 months (range, 31.8–34.4). 39 (81.3%, 95% CI 70.2-92.3) patients had a confirmed objective response which has been reported in ASCO 2021. At this updating data cutoff (Feb 1, 2023), the median progression-free survival was 13.6 months (95% CI, 8.4-18.8). While overall survival was 29.4 months (95% CI, 23.3-35.5). The disease control rate was 95.8% (46/48). The most common treatment-related grade 3 or 4 adverse events were neutropenia (16 [33.3%]), anemia (5 [10.4%]), febrile neutropenia (5 [10.4%]), and thrombocytopenia (4 [8.3%]). No new safety concerns were detected. No treatment-related deaths were reported. Conclusions: These data, combined with those from our previous reports, provide further evidence for the triplet combination of famitinib, camrelizumab and nab-paclitaxel as an active therapy in advanced Immunomodulatory TNBC. To our knowledge, this is the best overall survival reached in first-line treatment of advanced TNBC. A randomized controlled FUTURE-Super trial is ongoing to further validate these findings. Clinical trial information: NCT04129996 .

A national survey of current scenario and future perspectives of cancer research in Brazil.

e18721 Background: Epidemiological and clinical cancer research are the backbone to understand tumor behavior and to develop new therapies in oncology. However, several countries including Brazil and many regions in the world have a very small participation in cancer research. Despite 625.000 new cancer cases recorded in Brazil in 2022, only 2,2% of ongoing cancer clinical trials are available in the country We conducted an online survey to describe physician engagement with research and to identify the main barriers precluding participation and conduct of clinical cancer research in the country. Methods: An anonymous online survey of 23 objective questions was sent by e-mail to members of the Latin American Cooperative Oncology Group (LACOG) and the Brazilian Society of Clinical Oncology (SBOC). The first 13 questions addressed demographic information, medical training, and previous research participation. In the second part, the main barriers to engagement and participation in clinical trials in Brazil were addressed. Continuous variables were measured by median and range. Analyses were performed using SAS statistical software (version 9.4; SAS Institute, Inc. Cary, NC). Results: 109 physicians answered the survey. Most participants were oncologists (N = 98, 89.9%), living in capital cities (N = 84, 77.1%), were from the Southeast region of Brazil (N = 63, 57.8%), worked at institutions providing exclusively private healthcare (N = 59, 54.1%). Of the 109 respondents, 83 (76.1%) reported working in research centers (as investigators or sub-investigators). Surprisingly, 31.2% of physicians recognized they invite less than 1% of their patients to participate in clinical trials, even though 98 (89.9%) considered the participation of patients in clinical trials extremely relevant. The main barriers compromising conduct of research in the country were low number of available trials proposed by pharma/Clinical Research Organizations (48.2%) and the lack of qualified human resources to staff research sites (22.9%). Other reported barriers were the lengthy regulatory approval process (42.2%), followed by lack of awareness of clinical research by patients resulting in low recruitment rates (24.1%). Of the 26 (23.8%) respondents not working with research, 25 (96.1%) reported interest in being involved, 31.8% have tried participating in research, and 62.4% reported limited knowledge of trial procedures. Conclusions: These results suggest a clear need to further engage physicians in clinical research activities in Brazil. Patient education strategies should improve the low recruitment rates and secondarily increase the number of proposed trials to the country.

Effects of a focused one-day interactive session on oncology research on medical students’ interest in and understanding of oncology research.

11037 Background: Literacy and proficiency in medical research are crucial for the development of modern-day physicians. The need to equip future doctors with sufficient research skills is particularly important in oncology research, as cancer is the second leading cause of death in Jordan and the first worldwide. With the support of the University of Jordan ASCO-OSIG, we explored the efficacy of an interactive research intervention in highlighting the foundations of cancer clinical, basic, and translational research among undergraduate medical students. Methods: We designed and implemented a one-day educational program about all types of cancer research: clinical, basic, and translational. To evaluate the impact of this ASCO-OSIG initiative, students were asked to voluntarily fill surveys before and after the event. Medical students in both their pre-clinical and clinical training were invited to attend the event. Prominent researchers and experts from multiple tertiary cancer centers in Jordan presented 50min lectures on the foundations of clinical, basic, and translational oncology research. Results: A total of 111 participants filled the pre and post surveys, of which ASCO-OSIG members comprised 28.8% of the sample. Approximately 51.4% of participants were pre-clinical students and 48.2% were in their clinical years. About half of our cohort (50.2%) have previously engaged in research projects with only 10.2% of participants have been involved in oncology research. The event was effective in promoting participants’ understanding and familiarity of the fundamentals of clinical (p-value &lt; 0.001), translational (p-value &lt; 0.001), and basic oncology research (p-value &lt; 0.001). Most students were satisfied with the event; with 55% and 32.4% of students reporting being very satisfied and extremely satisfied with the event, respectively. Moreover, 83.8% of participants felt that oncology research was easier to get into after the event. About 96% of students reported that they would recommend this event to a colleague. Conclusions: We demonstrated that a focused one-day cancer research conference had improved medical students’ understanding towards oncology research. Due to its design simplicity, other global ASCO-OSIG coordinators could implement the model within their respective institutions. Future efforts should expand on the available research initiatives and include other medical schools worldwide.

The Platon Network: One step closer to improved personalized medicine.

e15097 Background: Personalized medicine is a life saving approach in oncology, but it still needs improvement in profiling, applicability and accessibility. The PLATON Network (PLATON, NCT05489250) is an interactive precision oncology network that aims to improve personalized medicine by interlinking scientists, allowing them to view/follow their patients’ clinical and molecular profiles and to recruit new patients for ongoing clinical trials and to implement substudies or to benefit from the BioDataBank within the Network. PLATON covers various tumor entities and can also be considered as an umbrella structure for subprojects, substudies and a screening tool for molecular driven trials. Methods: PLATON enrolls patients during or prior to first line treatment and collects information on routine clinical data (baseline data, histopathology reports, treatment decisions, etc.). During follow up, all anti tumor therapy lines, tumor response, survival and quality of life data are recorded. Importantly, PLATON is able to offer molecular testing e.g. Foundation CDx and CDx Liquid and provide reports and molecular pathologoy case discussions by its own board of pathology experts. PLATON also enrolls cases with compatible external NGS reports through an evaluation by the central review board of medical advisors. PLATON is conducted by the Institute of Clinical Cancer Research (IKF) in Frankfurt. Results: Up to date 188 patients (122 male (m) and 66 female (f)) with complete standardized data capture of NGS report results and clinical data are enroled in the PLATON Network, from 31 sites. The mean age is 65(m)/67(f) (min: 21(m)/24(f) and max: 88(m)/87(f)). Within the diagnostic cohorts 43 patients with esophagogastric cancer, 50 with intra-/extrahepatic cholangiocellular carcinoma together with 13 patients with gallbladder carcinoma, 35 patients with hepatocellular cancer and 47 patients with pancreatic cancer are included. The individual observational status is ongoing in 88 out of 188 enrolled patients, while 87 died within 10 to 726 days after recruitment. Out of all cases, 134 were discussed in the educational series of the PLATON project ”Molecular Pathology Case Discussion. In 87 of these patients, targeted therapies were recommended based on the respective molecular profile of the tumors. In total 2707 genetic alterations were detected 1640 of them are variants of unknown significance (VUS). A tumor mutational burden (TMB) over 10 up to 67 mutations/mb could be detected in 21 cases. Conclusions: This first analysis of PLATON data shows the feasibility of the network. The obtained molecular results not only provide patient specific therapy follow up but also can provide a baseline data for further projects and substudies. PLATON’s interactive, multicenter, prospective cohort provides a well annotated and managed BioDataBank for translational research. PLATON aims to grow through prospective studies and is open to participation.

Cancer research in vulnerable populations: A call for collaboration and sustainability from MENATC countries.

e13649 Background: Cancer is a major burden across the Middle East and North Africa including Turkey and Cyprus (MENATC). Many MENATC countries experience acute and chronic emergencies, including COVID-19 pandemic, disasters, political instability, fragility, as well as chronic conflict that result in cumulative vulnerability to the region. This study examines the current level and the potential for cancer research among vulnerable populations in the MENATC, including its challenges, and gaps. Furthermore, it tries to ascertain cancer practitioners’ views on what defines vulnerability in the MENATC. Methods: Recurrent expert-driven meetings were held to conceptualize the study approach and highlight the barriers to conducting clinical cancer research among vulnerable populations in the MENATC. A self-administered online survey questionnaire was circulated to over 500 cancer practitioners in twenty-three MENATC countries. The survey covered: Demographic and general information, Clinical practice, Research capacity, Vulnerable populations, and logistics. Results: Half of the respondents considered clinical research in vulnerable cancer patients a key concern, while 24.5% did not. Out of the total respondents, 21.8% had worked on research that explicitly included vulnerable populations. About 60% of respondents reported seeing vulnerable populations during their daily practice. Lack of funding (60%), lack of protected time (42%), and lack of research training (35%) were the top three main reasons for research scarcity and major research challenges. Over half of the respondents agreed that recent wars/conflicts worsened the conditions for vulnerable populations. The top five ranked vulnerability groups were geriatric, terminally ill, mental health-related, chronically ill, and socioeconomically deprived patients, while the lower five ranked groups were LGBTQ+ community, veterans, divorced individuals or widowed women, prisoners, and ethnic minorities patients. Conclusions: This is the first study in the MENATC region to look at the status of and potential for research among vulnerable populations. The study highlights the challenges faced by cancer practitioners in the MENATC in research, especially among vulnerable populations. We believe that these limitations in research will negatively impact the outcomes for vulnerable communities in the region. Lack of research funding and training of cancer practitioners in the MENATC are major factors negatively affecting cancer outcomes which could lead to health improvement failure. Geopolitical, economic, and cultural differences clearly define the most vulnerable populations in cancer research. Addressing cancer disparities in the MENATC is a complex and pressing issue. By working together and providing the necessary resources, we can improve cancer research outcomes for the most vulnerable populations in the region.

The PLATON Network: An interactive platform for precision oncology.

TPS1613 Background: To increase the access of patients to precision oncology and personalized medicine, we need not only to undertake molecular profiling but rather we need to interlink patients, physicians and researchers using modern technological opportunities, increasing the likelihood of providing new therapies to patients with suitable targets. The PLATON Network (NCT05489250, IKF-T008) addresses these important issues. Methods: The PLATON Network (PLATON) is an interactive structure aiming at improving personalized medicine for all tumor entities (starting with upper GI tumors). The goal of the PLATON Network is to provide a platform for connecting medical practitioners, researchers and patients to personalized cancer treatments. The platform combines comprehensive molecular profiling, data on active clinical trials, remote data access with networking solutions, implemented substudies and associated educational and discussion forums. The main elements of PLATON are: a Platform-study design, an interactive Cloud-based WebApp, Networking, a Molecular Pathology Case Discussion Board, an educational forum, and a BioDataBank. The network will be composed of a global network of cancer centers and cancer specialists who can submit genomic data of their patients to PLATON. The WebApp allows members and associated scientists to view each other's current patients' clinical and molecular data and get into contact with the treating physicians or identify patients for ongoing biomarker-driven clinical trials using advanced algorithms. The PLATON Network also offers molecular testing via Foundation CDx and CDx Liquid for standardized NGS testing and functions as an umbrella for substudies within the platform design. PLATON enrolls patients during first line treatment and collects information on routine clinical data (baseline data, medical history, histopathology reports, treatment decisions, etc.). During follow up, all anti tumor therapy lines, tumor response and survival data are recorded. Importantly, quality of life data is captured monthly under therapy (with EORTC QLQ-30,-BIL21, -HCC18, -PAN26, -STO22 and EQ-5D-5L) and at further follow up (with EQ-5D-5L). So far, 110 cancer centers have joined the PLATON network. Over 200 patients with upper GI tumors received comprehensive molecular profiling and 162 cases were reviewed and discussed in the Molecular Pathology Case Discussion Board. Five sub-projects/-studies have been initiated under the umbrella of PLATON. The educational forum is in the planning stage. PLATON is conducted by the Institute of Clinical Cancer Research (IKF) in Frankfurt with the supervision of an independent scientific steering committee.