Specific Cancer Diagnosis Research Articles

Effects of chemotherapy-induced peripheral neuropathy on daily living: a cross-sectional survey

BackgroundChemotherapy has several side-effects, including chemotherapy-induced peripheral neuropathy (CIPN), that can substantially reduce patients’ activities of and participation in daily living. Few studies have addressed this issue. We investigated the effects that CIPN has on daily living of patients in occupied Palestinian territory. MethodsWe did a quantitative observational cross-sectional survey of patients at the Augusta Victoria Hospital, East Jerusalem, which provides chemotherapy, and the Dunya Women's Cancer Centre, Ramallah, which provides services for women during and after chemotherapy. Eligible patients were aged 18–65 years, had received six or more cycles of chemotherapy, did not have end-stage cancer, could read and understand Arabic, and had no other illnesses that affected the nervous system or mobility. The CIPN Rasch-built overall disability scale was translated into Arabic and two questions were added. The first was to determine CIPN-associated symptoms and the second was to add the activity of cleaning with water. The questionnaire was distributed to patients via the study sites. SPSS version 22.0 was used to analyse the data with multiple tests, such as one-way ANOVA, t test, χ2, and the Tukey test. The threshold for significance was α=0·05. FindingsOf 37 eligible patients, 32 were included (10 men and 22 women) with any type of cancer. CIPN had significantly negative effects on activities and participation in daily living (α=0·008). Women were affected more than men (α=0·001) but there was no correlation between effects on daily living and age (α=0·773), place of living (α=0·092), or chemotherapy (α=0·894). The most reported symptom of CIPN was pain (n=23 [72%]) and the least reported symptom was loss of hearing (n=10 [31%]). The most affected activity was walking uphill (mean score 1·3438 [SD 0·82733]) and the least affected activity was moving a chair (2·8438 [0·3689]). InterpretationWe found that chemotherapy has notable consequences for activities of daily living. This study had several limitations: small sample size, limited number of centres that provide cancer treatments. These were due to the geographical locations of such centres and checkpoints sometimes preventing access. Additionally, the statistical data about cancer patients were limited because not all centres record chemotherapy cycle numbers, and specific cancer diagnoses and, therefore, we could not include more study sites. CIPN is, therefore, probably under-reported. FundingNone.

Utilization of telemedicine among patients newly diagnosed with cancer.

1595 Background: The use of telemedicine among cancer patients remains limited. Because of the COVID-19 pandemic, CMS expansion of telehealth with 1135 waiver was enacted in March 2020, broadening the opportunities to provide patient care using telemedicine. This study examined the impact of the CMS expansion on the use of telemedicine among cancer patients. Methods: We identified newly diagnosed patients with 5 common cancers (breast, prostate, lung, colorectal, and lymphoma) between 3/2019 and 12/2020 from Optum’s de-identified Clinformatics Data Mart Database. Patients who had 6 months of full enrollment (3 months before and 3 months after the first [index] cancer diagnosis date), had cancer claims on 3 separate dates within 3 months of the index date for the specific cancer diagnosis, and no prior history of cancer were included. We defined telemedicine use as patients who had a telemedicine procedure code within 1 month of their index diagnosis and had the cancer diagnosis on the telemedicine claim. We conducted an interrupted time series analysis to examine the impact of CMS expansion on telemedicine use. A multivariable logistic regression model was used to identify factors associated with telemedicine use during the post-expansion period. Results: Of 96,632 patients included, the average crude rate of telemedicine use was 0.12% before and 14.2% after the expansion in March 2020 (see Table). There was a significant impact of expansion on telemedicine use (21% increase; p<0.001). The peak rate (adjusted) was 28% in April 2020, decreasing and plateauing in July/August 2020, with rates staying in the range of 10-12% between August and December 2020. During the post-expansion period, lymphoma, prostate, and lung cancer patients (adjusted rates: 14.6%, 15.7%, and 15.9%, respectively) were more likely to use telemedicine compared to patients who had breast (12.7%) or colorectal (12.3%) cancer. Patients who were older (adjusted rates: ≥65 years, 13.8%; 50-64, 14.2%; 20-49, 18.6%), Black (12.4% vs 14.4% for White, 15.5% for Hispanic and 16.6% for Asian), resided in East South Central census division (8.4% vs 23.5% in New England) and had Medicare (12.2% vs 20.3% for commercial insurance) were less likely to use telemedicine (all p<.001). Conclusions: After the CMS telehealth expansion, the use of telemedicine among newly diagnosed cancer patients increased significantly. Telemedicine use varied by patient age, geographic location, race/ethnicity, and payer. Further research is needed to understand the pattern of telemedicine use.[Table: see text]

Late effects of high-dose methotrexate treatment in childhood cancer survivors\u2014a systematic review

BackgroundHigh-dose methotrexate (HD-MTX) is used in the treatment of different childhood cancers, including leukemia, the most common cancer type and is commonly defined as an intravenous dose of at least 1 g/m2 body surface area per application. A systematic review on late effects on different organs due to HD-MTX is lacking.MethodWe conducted a systematic literature search in PubMed, including studies published in English or German between 1985 and 2020. The population of each study had to consist of at least 75% childhood cancer survivors (CCSs) who had completed the cancer treatment at least twelve months before late effects were assessed and who had received HD-MTX. The literature search was not restricted to specific cancer diagnosis or organ systems at risk for late effects. We excluded case reports, case series, commentaries, editorial letters, poster abstracts, narrative reviews and studies only reporting prevalence of late effects. We followed PRISMA guidelines, assessed the quality of the eligible studies according to GRADE criteria and registered the protocol on PROSPERO (ID: CRD42020212262).ResultsWe included 15 out of 1731 identified studies. Most studies included CCSs diagnosed with acute lymphoblastic leukemia (n = 12). The included studies investigated late effects of HD-MTX on central nervous system (n = 10), renal (n = 2) and bone health (n = 3). Nine studies showed adverse outcomes in neuropsychological testing in exposed compared to non-exposed CCSs, healthy controls or reference values. No study revealed lower bone density or worse renal function in exposed CCSs. As a limitation, the overall quality of the studies per organ system was low to very low, mainly due to selection bias, missing adjustment for important confounders and low precision.ConclusionsCCSs treated with HD-MTX might benefit from neuropsychological testing, to intervene early in case of abnormal results. Methodological shortcomings and heterogeneity of the tests used made it impossible to determine the most appropriate test. Based on the few studies on renal function and bone health, regular screening for dysfunction seems not to be justified. Only screening for neurocognitive late effects is warranted in CCSs treated with HD-MTX.

Improving the generalization of unsupervised feature learning by using data from different sources on gene expression data for cancer diagnosis.

Machine learning techniques have been utilized on gene expression profiling for cancer diagnosis. However, the gene expression data suffer from the curse of high dimensionality. Different kinds of feature reduction methods have been proposed to decrease the features for specific cancer diagnosis. However, with the difficulty of obtaining the samples of a particular tumor, the lack of training samples may lead to the overfitting problem. In addition, the feature reduction model on a specific tumor may lead to the problem that the model is not scalable and cannot be generalized to new cancer types. To handle these problems, this paper proposes an unsupervised feature learning method to reduce the data dimensionality of gene expression data. This method amplifies the training samples of feature learning by utilizing the unlabeled samples from different sources. Two heuristic rules are devised to check if the unlabeled samples could be used for amplifying the training set. The amplified training set is used to train the feature learning model based on sparse autoencoder. Since the method leverages the knowledge among the expression data from different sources, it improves the generalization of unsupervised feature learning and further boosts the cancer diagnosis performance. A series of experiments are carried out on the gene expression datasets from TCGA and other sources. Experimental results prove that our method improves the generalization of cancer diagnosis when unlabeled data are used for latent feature learning. The flowchart of our proposed feature learning method.

Residual work capacity and (in)ability to work fulltime among a year cohort of cancer survivors who claim a disability benefit.

Residual work capacity (RWC) and inability to work fulltime (IWF) are important outcomes in disability benefit assessments for workers diagnosed with cancer. The aim of this study is to gain insight into the prevalence of both outcomes, the associations of disease-related and socio-demographic factors and if these differ across cancer diagnosis groups. A year cohort of anonymized register data of cancer survivors who claim a disability benefit after 2years of sick leave (n = 3690, age 53.3 ± 8.8, 60.4% female) was used. Having no RWC was defined as having no possibilities to perform any work at all, whereas IWF was defined as being able to work less than 8h per day. The prevalence of being assessed with no RWC was 42.6%. Of the applicants with RWC (57.4%), 69.8% were assessed with IWF. Cancers of the respiratory organs showed the highest odds for having no RWC, whereas lymphoid and haematopoietic cancers showed the highest odds for IWF. Within specific cancer diagnosis groups, different associations were identified for both outcomes. The prevalence of no RWC and IWF in applicants of work disability benefits diagnosed with cancer is high compared to the prevalence in other diagnoses. The odds for no RWC, IWF, and associated factors differ per cancer diagnosis group. Being diagnosed with cancer has an enormous impact on work (dis)ability. Our results show that 2years after being diagnosed with cancer, the majority of the disability benefit applicants are assessed with RWC; however, only 15% of all applicants with cancer had a normal ability to work fulltime, and therefore, it is of great importance to accompany them in their return to work.

Research progress in bladder cancer

Bladder cancer refers to malignant tumors that originate in the bladder mucosa. Globally, bladder cancer is the ninth most common malignant tumor and the second most common urinary tumor. Recently, the search for highly sensitive, specific, non-invasive, convenient, quick, and economical bladder cancer diagnosis and follow-up methods becomes a research challenge in the fields of basic medicine, oncology, and urology. This article covers the current status of national and international research on the diagnosis and treatment of bladder cancer, as well as the forefront achievement from our team and international peers in basic and translational medicine research on bladder cancer. As translational medicine is the only way to achieve precision medicine, there are unprecedented opportunities in the fields of bladder cancer research and translational medical research.

1010-P: Prevalence of Acute Diabetes Complications following Cancer Diagnosis and Treatment

Introduction: Multiple case studies have reported diabetic ketoacidosis (DKA) in recently-diagnosed cancer patients, especially those taking immune checkpoint inhibitors. The prevalence of DKA and other acute diabetes complications (ADC), including hypoglycemia and hyperosmolarity, and their relationship with the onset of systemic cancer therapy is unclear. Methods: This study utilized data from n=9,588 cancer patients from the Huntsman Cancer Institute, UT. Data on clinicodemographic characteristics, biomarkers, and cancer diagnoses were extracted from electronic medical records (EMR) and tumor registry. Patients included in this analysis received an ICD diagnosis of hypoglycemia, hyperosmolarity with or without coma, and/or DKA with or without coma. Systemic therapy was defined as any chemotherapy, immunotherapy or hormone therapy resulting from a specific first primary cancer diagnosis. Results: There were 243 instances of ADC within this cohort, occurring in 211 (2.2%) unique patients. Of these 211 unique patients with an ADC, 106 (50.0%) experienced their first ADC within one year after cancer diagnosis, with a median time to ADC diagnosis of 88 days. Forty-seven (44%) of these patients experienced the ADC following the onset of systemic therapy, with a median time from systemic therapy onset to ADC diagnosis of 120 days. In these 47 patients who received an ADC diagnosis following the onset of systemic therapy, 40 (85.1%) received chemotherapy (n=20 as monotherapy), 20 (42.6%) received immunotherapy (n=4 as monotherapy) and 12 (25.5%) received hormone therapy (n=2 as monotherapy). Only 54% of patients experiencing an ADC after cancer diagnosis had a history of diabetes prior to cancer, and on average their first diabetes diagnosis was 5.4 ± 4.4 years prior to their cancer diagnosis. Discussion: ADCs may be common following a cancer diagnosis, however a substantial number occurred prior to the onset of systemic cancer therapy and in patients with no prior history of diabetes. Disclosure R. Viskochil: None. S. Hardikar: None. S. Pauleck: None. M. Winn: None. K. Funai: None. M. L. Litchman: Research Support; Self; Abbott Diabetes. W. Akerley: None. H. Colman: Advisory Panel; Self; Adastra Pharmaceuticals, Orbus Therapeutics, Consultant; Self; Best Doctors/Teladoc. C. M. Ulrich: None. M. C. Playdon: None. Funding University of Utah Health/Larry H. Miller Family Wellness Initiative

A Tumor Microenvironment Responsive Nanotheranostics Agent for Magnetic Resonance Imaging and Synergistic Photodynamic Therapy/Photothermal Therapy of Liver Cancer.

Surgery is the main treatment for liver cancer in clinic owing to its low sensitivity to chemotherapy and radiotherapy, but this results in high mortality, recurrence, and metastasis rates. It is a feasible strategy to construct tumor microenvironments activated by nanotheranostics agents for the diagnosis and therapy of liver cancer. This study reports on a nanotheranostic agent (MONs@PDA-ICG) with manganese oxide nanoflowers (MONs) as core and polydopamine (PDA) as shell loading, with ICG as a photosensitizer and photothermal agent. MONs@PDA-ICG can not only produce ROS to kill cancer cells but also exhibit good photothermal performance for photothermal therapy (PTT). Importantly, O2 generated by MONs decomposition can relieve the tumor hypoxia and further enhance the treatment effects of photodynamic therapy (PDT). In addition, the released Mn2+ ions make MONs@PDA-ICG serve as tumor microenvironments responsive to MRI contrast for highly sensitive and specific liver cancer diagnosis.

Outcomes of kidney injury including dialysis and kidney transplantation in pediatric oncology and hematopoietic cell transplant patients.

Pediatric oncology and hematopoietic cell transplant (HCT) patients are susceptible to both acute kidney injury (AKI) and chronic kidney disease (CKD). The etiologies of AKI vary but include tumor infiltration, radiation, drug-induced toxicity, and fluid and electrolyte abnormalities including tumor lysis syndrome. HCT patients can also have additional complications such as sinusoidal obstructive syndrome, graft-versus-host disease, or thrombotic microangiopathy. For patients with severe AKI requiring dialysis, multiple modalities can be used successfully, although continuous kidney replacement therapy (CKRT) is often the principal modality for critically ill patients. While increasing numbers of pediatric cancer and HCT patients are now surviving long term, they remain at risk for a number of chronic medical conditions, including CKD. Certain high-risk patients, due to underlying risk factors or treatment-related complications, eventually develop kidney failure and may require kidney replacement therapies. Management of co-morbidities and complications associated with kidney failure, including use of erythropoietin for anemia and potential need for ongoing cancer-related treatment while on dialysis, is an additional consideration in this patient population. Kidney transplantation can be successfully performed in pediatric cancer survivors, although additional features such as specific cancer diagnosis and duration of remission should be considered.

Exosome-mediated diagnosis of pancreatic cancer using lectin-conjugated nanoparticles bound to selective glycans

The unique profile of upregulated glycosylation in metastatic cancer cells may form the basis for the development of new biomarkers for the targeting and diagnosis of specific cancers. This study introduces a pancreatic cancer cell-derived exosome detection technology, which is based on the specific binding of lectins to distinctive glycan profiles on the surface of exosomes. Lectins with a high and specific affinity for sialic acid or fucose were attached to bifunctional Janus nanoparticles (JNPs), which facilitated interactions with pancreatic cancer cell-derived exosomes in a microfluidic device. Here, we show that pancreatic cancer cell-derived exosomes from two cell lines and plasma samples collected from patients diagnosed with pancreatic cancer were successfully captured on the lectin-conjugated JNPs with affinities that were comparable to those of CA19-9, a conventional antibody. In addition, exosome detection using our platform could differentiate between metastatic and nonmetastatic pancreatic cancer cells. This study opens the possibility to achieve a new early diagnosis marker based on the glycan properties of pancreatic cancer cell-derived exosomes.

Nanogel Multienzyme Mimics Synthesized by Biocatalytic ATRP and Metal Coordination for Bioresponsive Fluorescence Imaging

AbstractThe design of enzyme mimics from stable and nonprotein systems is especially attractive for applications in highly specific cancer diagnosis and treatment, and it has become an emerging field in recent years. Herein, metal crosslinked polymeric nanogels (MPGs) were prepared using FeII ion coordinated biocompatible acryloyl‐lysine polymer brushes obtained from an enzyme‐catalyzed atomic transfer radical polymerization (ATRPase) method. The monoatomic and highly dispersed Fe ions in the MPGs serve as efficient crosslinkers of the gel network, and also as active centers of multienzyme mimics of superoxide dismutase (SOD) and peroxidase (POD). The catalytic activities were compared to those of conventional Fe‐based nanozymes. Studies on both cells and animals verify that efficient reactive oxygen species (ROS) responsive biofluorescence imaging can be successfully realized using the MPGs.

Nanogel Multienzyme Mimics Synthesized by Biocatalytic ATRP and Metal Coordination for Bioresponsive Fluorescence Imaging.

The design of enzyme mimics from stable and nonprotein systems is especially attractive for applications in highly specific cancer diagnosis and treatment, and it has become an emerging field in recent years. Herein, metal crosslinked polymeric nanogels (MPGs) were prepared using FeII ion coordinated biocompatible acryloyl-lysine polymer brushes obtained from an enzyme-catalyzed atomic transfer radical polymerization (ATRPase) method. The monoatomic and highly dispersed Fe ions in the MPGs serve as efficient crosslinkers of the gel network, and also as active centers of multienzyme mimics of superoxide dismutase (SOD) and peroxidase (POD). The catalytic activities were compared to those of conventional Fe-based nanozymes. Studies on both cells and animals verify that efficient reactive oxygen species (ROS) responsive biofluorescence imaging can be successfully realized using the MPGs.

Cause-specific mortality after diagnosis of cancer among HIV-positive patients: A collaborative analysis of cohort studies.

People living with HIV (PLHIV) are more likely than the general population to develop AIDS‐defining malignancies (ADMs) and several non‐ADMs (NADMs). Information is lacking on survival outcomes and cause‐specific mortality after cancer diagnosis among PLHIV. We investigated causes of death within 5 years of cancer diagnosis in PLHIV enrolled in European and North American HIV cohorts starting antiretroviral therapy (ART) 1996–2015, aged ≥16 years, and subsequently diagnosed with cancer. Cancers were grouped: ADMs, viral NADMs and nonviral NADMs. We calculated cause‐specific mortality rates (MR) after diagnosis of specific cancers and compared 5‐year survival with the UK and France general populations. Among 83,856 PLHIV there were 4,436 cancer diagnoses. Of 603 deaths after ADM diagnosis, 292 (48%) were due to an ADM. There were 467/847 (55%) and 74/189 (39%) deaths that were due to an NADM after nonviral and viral NADM diagnoses, respectively. MR were higher for diagnoses between 1996 and 2005 versus 2006–2015: ADMs 102 (95% CI 92–113) per 1,000 years versus 88 (78–100), viral NADMs 134 (106–169) versus 111 (93–133) and nonviral NADMs 264 (232–300) versus 226 (206–248). Estimated 5‐year survival for PLHIV diagnosed with liver (29% [19–39%]), lung (18% [13–23%]) and cervical (75% [63–84%]) cancer was similar to general populations. Survival after Hodgkin's lymphoma diagnosis was lower in PLHIV (75% [67–81%]). Among ART‐treated PLHIV diagnosed with cancer, MR and causes of death varied by cancer type, with mortality highest for liver and lung cancers. Deaths within 5 years of NADM diagnoses were more likely to be from cancer than AIDS.

Burden of Cancer Mortality in the Canadian Armed Forces, 1976-2012: A Retrospective Cohort Study.

Military personnel may have potential exposures to carcinogens during their military careers. However, the generalizability of causal evidence between occupational exposures and cancer outcomes in military personnel is limited. This study aims to describe the epidemiology cause-specific cancer mortality in still serving and released Canadian Armed Forces (CAF) personnel recruited between 1976 and 2012. Data came from the Canadian Forces Cancer and Mortality Study II (CF CAMS II), a record-linkage study of approximately 228,685 CAF Regular Force personnel and Reservists. Sex-stratified standardized mortality ratios (SMR) were calculated for each neoplasm subcategory, with the Canadian general population (CGP) as the reference. Approximately 1,450 deaths were attributable to neoplasms. Cancer mortality was lower in both men and women with military service (SMR = 0.77 and 0.78, respectively) versus CGP. Females had a significantly lower risk of breast cancer. Males in the cohort had a significantly lower risk of lip, oral cavity and pharynx, digestive organs, respiratory and intrathoracic organs, bone and articular cartilage, and mesothelial and soft-tissue cancers. However, males also had a significantly increased risk for neoplasms of the central nervous system and lymphoid cells, as well as for certain specific cancer diagnoses. Current and former CAF personnel were at comparable, or lower risk than, the CGP for cancer-related deaths. However, there was an increased risk for certain neoplasm subcategories and specific cancers. These findings contribute to the limited body of evidence investigating the link between military service and cancer mortality.

Rapid One-Step Plasma Test for the Electrochemical and Colorimetric Detection of a Universal Cancer Biomarker.

Despite the remarkable diagnostic and therapeutic advances in recent years, cancer continues to rank as the second leading cause of global deaths, accounting for 9.6 million deaths in 2018 (1). One of the reasons cancer is fatal is that it is a disease of the genome. Abnormal changes to certain genes of cells cause cell replication malfunction and death, thus leading to the proliferation of deadly cancer cells and their distribution throughout the body in an uncontrolled manner. The nature of cancer as a genetic disease has challenged many researchers to investigate the association of mutated cancer DNA with the stage, type, and patient's family history of cancers. In particular, tumor-derived fragmented cancer DNA in the bloodstream, which is known as circulating tumor DNA (ctDNA), has recently garnered attention because of its considerable potential as a cancer biomarker for the diagnosis of specific cancers. Currently, the detection of ctDNA from blood samples is performed via liquid biopsy, in contrast to the conventional tissue biopsy, and is one of the hottest topics in cancer diagnostics. Considering the drawbacks of tissue biopsy, which is currently the only definitive clinical way to diagnose most cancers, much simpler blood tests would be highly attractive to both patients and medical doctors. However, owing to technical challenges, the investigation of ctDNA has been limited to research laboratories, and ctDNA has not yet been used for the clinical diagnosis of cancer in patients (2). In addition to the genetic changes associated with cancers revealed by biomarkers such as ctDNA, abnormal epigenetic alterations have been investigated intensively as an important aspect of cancer cells. In particular, DNA methylation is of utmost interest because it is frequently observed at a high occurrence rate in most types of cancer cells, demonstrating its strong potential as a universal cancer biomarker. …

Impact of Open Access to Physician Notes on Radiation Oncology Patients: Results from an Exploratory Survey

PurposeThere is an increasing effort to allow patients open access to their physician notes through electronic medical record portals. However, limited data exist on the impact of such access on oncology patients, and concerns remain regarding potential harms. Therefore, we determined the baseline perceptions and impact of open access to oncology notes on radiation oncology patients. Methods and materialsPatients receiving radiation therapy were provided instructional materials on accessing oncology notes at the time of their initial evaluation. Patients were prospectively surveyed to evaluate baseline interest and expectations before access and to determine the actual usage and impact at the end of their radiation treatment course. ResultsA total of 220 patients were surveyed; 136 (62%) completed the baseline survey, of which 88 (40%) completed the final survey. The majority of participants were age >60 years (n = 83; 61%), and 70 were male (51%). Before accessing the notes, the majority of patients agreed that open access to oncology notes would improve understanding of diagnosis (99%), understanding of treatment side effects (98%), reassurance about treatment goals (96%), and communication with family (99%). All patients who accessed the notes found them to be useful. After accessing the notes, approximately 96%, 94%, and 96% of patients reported an improved understanding of their diagnosis, an improved understanding of treatment side effects, and feeling more reassured about their treatment, respectively. Approximately 11%, 6%, and 4% of patients noted increased worry, increased confusion, and finding information they now regret reading, respectively. Patient age, sex, and specific cancer diagnoses were not predictive of experiencing negative effects from accessing the notes. ConclusionsRadiation oncology patients have a strong interest in open access to their physician notes, and the majority of patients expect and actually report meaningful benefits. These data support strategies to allow more patients with cancer access to their physicians’ notes.

Abstract IA25: Disparities in survivors of pediatric, adolescent, and young adult cancers

Abstract Outcome disparities in pediatric, adolescent, and young adult cancer are multifaceted. While disparities are commonly described along racial/ethnic lines, the underlying causes of these differences in outcome are often rooted in socioeconomic status, host genetics, disease biology, health literacy lifestyle factors, health behaviors, and comorbidities. Nonetheless, by the middle of this century, racial/ethnic minority populations will collectively constitute 50% of the U.S. population. This temporal shift in the racial/ethnic composition of the U.S. population demands a close examination of the observed disparities in both the quality and quantity of survival in pediatric, adolescent, and young adult cancer. In this talk we describe the differences in overall and event-free survival by race/ethnicity as well as by age (children vs. adolescent and young adult) across a variety of cancer types. We examine the causes of the difference in these outcomes. We describe the burden of morbidity carried by cancer survivors across racial/ethnic and socioeconomic lines and present the current evidence for the causes of observed differences in morbidity. We speculate that any racial/ethnic differences in outcome are likely to be multifactorial, and draw on extant literature to illustrate the various contributors (socioeconomic characteristics, health behaviors, disease biology, and comorbidities) that could explain any observed differences in key treatment-related complications. Finally, we outline challenges in conducting race/ethnicity-specific survivorship research, demonstrating that there are limited absolute numbers who are diagnosed and survive histologically distinct cancers in any one racial/ethnic minority population, thereby precluding a rigorous evaluation of adverse events among specific primary cancer diagnoses and treatment exposure groups. Citation Format: Smita Bhatia. Disparities in survivors of pediatric, adolescent, and young adult cancers [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr IA25.

Treatment-related mortality in newly diagnosed pediatric cancer: a population-based analysis.

Using a previously developed reliable and valid treatment‐related mortality (TRM) definition, our objective was to describe the proportion of children newly diagnosed with cancer experiencing TRM and to identify risk factors for TRM in a population‐based cohort. We included children with cancer <19 years diagnosed and treated in Ontario who were diagnosed between 2003 and 2012. Children with cancer were identified using data in a provincial registry. Cumulative incidence of TRM was calculated where progressive disease death was considered a competing event. Among the 5179 children included, 179 had TRM, 478 died of progressive disease, and 4522 were still alive. At 5 years, the cumulative incidence of TRM among the entire cohort was 3.9% (95% confidence interval (CI) 3.3–4.5%). When compared to brain tumor patients, leukemia and lymphoma patients had a significantly higher risk of TRM (hazard ratio (HR) 2.5, 95% CI: 1.6–4.0; P < 0.0001). Infants were at significantly higher risk of TRM across diagnostic groups. Other factors associated with higher risks of TRM were metastatic disease (P < 0.0001), diagnosis prior to 1 January 2008 (P = 0.001), hematopoietic stem cell transplantation (HSCT) (P < 0.0001), and relapse (P < 0.0001). The 5‐year cumulative incidence of TRM was 3.9% among newly diagnosed children with cancer. Infants were at higher risk of TRM across diagnostic groups. Other risk factors for TRM were leukemia or lymphoma, metastatic disease, earlier diagnosis year, HSCT, and relapse. Future work should further refine prognostic factors by specific cancer diagnosis to best understand when and how to intervene to improve outcomes.

Aptamer-Conjugated Nanomaterials for Specific Cancer Diagnosis and Targeted Therapy

Aptamer-Conjugated Nanomaterials for Specific Cancer Diagnosis and Targeted Therapy

Safety and feasibility of exercise interventions in patients with advanced cancer: a systematic review.

The beneficial effects of exercise in cancer patients are reasonably well-established, although research in this field has predominantly investigated cancer patients in the earlier stages of disease. However, the most recent evidence surrounding exercise interventions in advanced cancer populations has yet to be systematically evaluated. This review critically analyses the safety and feasibility of exercise interventions in patients with advanced cancer. All randomised, non-randomised and prospective observational trials of exercise training interventions in patients with advanced cancer were included. 'Safety' was defined as the number and severity of reported adverse events during exercise training. 'Feasibility' was determined by participant adherence, attendance and/or study completion rates. A total of 25 studies involving 1088 patients were included: 16 randomised controlled and nine prospective observational cohort trials. Seven studies included advanced lung cancer patients exclusively, while eight involved patients with various cancer diagnoses. Aerobic exercise was investigated in five studies, resistance training in two studies and combination training (aerobic and resistance) in 14 studies. Six minor adverse events were reported due to exercise. All of these were musculoskeletal in nature, resulting in two participants' withdrawal from the study. Exercise adherence ranged from 65 to 89% but was only described in nine studies. Attendance at each exercise session was described in a further nine studies, ranging from 59 to 100%. Implementation of exercise interventions appears to be safe and feasible in advanced cancer clinical practice, although targeted studies are required to determine the optimal exercise dose for specific cancer diagnoses.