Medicine and Health Sciences Commons^™

Pharmacoeconomics Of Metastatic Colorectal Cancer Treatment With Targeted Therapies Guided By Companion Molecular Diagnostics, Luis E. Fernández-Garza, Hector Sánchez-Ibarra, Daniela Treviño-Sáenz, Hugo A. Barrera-Saldaña

Research Symposium

Background: To guide the treatment with monoclonal antibodies (MAbs) against the epidermal growth factor receptor (EGFR) of metastatic colorectal cancer (mCRC), the FDA recommends prior companion molecular diagnosis (CMDx). It initially recommended screening for mutations in exon 2 of the KRAS gene, and most recently to extend to screening to exons 2, 3, and 4 of KRAS and 2, 3, and 4 of NRAS genes; furthermore, to evaluate the BRAF exon 15 mutation status (including V600E). To date, no studies have been done to compare the cost-benefit of these different CMDXs.

Methods: We have compared the cost of treatment without …

Outcomes Of Hypofractionated Radiation Therapy In Locally Advanced Non-Small Cell Carcinoma Lung : A Single Institutional Experience, Meenu Gupta, Shivani Mehra, Vipul Nautiyal, Sunil Saini, Mushtaq Ahmed

Research Symposium

Introduction: Radical treatment in locally advanced non small cell carcinoma lung presents a management dilemma in patients with compromised performance status. Hypofractionated EBRT resolves this by confering high efficacy while avoiding excessive early toxicity.

Objectives: To evaluate the efficacy and tolerance of hypofractionated radiotherapy in locally advanced lung cancer patients with compromised performance status.

Methods: From January 2019 to January 2020,62 patients were enrolled to receive hypofractionated radiotherapy with 40Gy in 16 fractions with 5 fractions per week (2.5Gy per fraction) because of compromised performance status. Follow-up was conducted at 6 weeks and 3 months for symptomatic and radiological response …

Moans, Palpable Groin, And Entrapment Of Bone: A Case Of Malignant Peripheral Nerve Sheath Tumor In An Otherwise Healthy Hispanic Male, Nelson D. Gonzalez, Christine E. Loftis, Rosa Guedez-White

Research Symposium

Background: Malignant peripheral nerve sheath tumors (MPNTs) are rare malignant soft tissue sarcomas that have an incidence of about 0.001 %. MPNTs typically occur in individuals who have neurofibromatosis or secondary to radiation therapy and rarely occur sporadically. We present a case of a previously healthy 56-year-old gentleman who was diagnosed with MPNTs.

Case: A healthy 56-year-old gentleman presented with worsening LLQ abdominal pain for 6 months. Associated symptoms included bloating, LLE swelling, early satiety for the past 2 months, and a 5-10lb unintentional weight loss. Patient denied recent cough, night sweats, dyspnea, fever, chills, melena or hematochezia. Vitals were …

Long Non-Coding Rna (Lncrna) As A New Biomarker For Hepatocellular Carcinoma (Hcc) Drug Resistance, Areeb Masood, Kyle Doxtater, Anupam Dhasmana, Subhash C. Chuahan, Sanjaya Satapathy, Manish Tripathi

Research Symposium

Background: Hepatocellular carcinoma (HCC) is the 4^th leading cause of cancer-related deaths worldwide and the 6^th most common cancer worldwide. When HCC progresses to advanced stages, drug resistance becomes a major hurdle and leaves clinicians with limited therapeutic options. Long non-coding RNAs (lncRNAs) have shown to promote drug resistance in various cancers. The goal of our research is to explain the molecular role of lncRNAs in HCC drug resistance and compile a comprehensive list of studied lncRNAs involved in HCC drug resistance.

Methods: To compile a list of lncRNA involved in HCC drug resistance we performed an advanced …

Association Of Nutritional Status With Failure To Complete Planned Treatment In Patients With Hnscc- A Prospective Cohort Study In A Tertiary Cancer Centre In Northern India., Anshika Arora, Sunil Kumar Saini

Research Symposium

Background: To determine the association between Nutritional status of patient and the ability to complete all planned treatment in Head & Neck Squamous Cell Carcinoma(HNSCC).

Materials & Methods: This prospective cohort study was conducted at CRI India between 2018 and 2020. Patients diagnosed with HNSCC and planned for treatment were enrolled after written informed consent. Nutritional status was determined using- anthropometric measures and Subjective Global Assessment(SGA) scale before starting treatment. Patients were followed up for treatment details, complications and failure to complete planned treatment. Statistical analysis was performed using SPSS version 22. Data was analyzed using parametric and non-parametric …

A Survival Analysis Of High-Grade Gliomas In Sub-Himalayan Population Including The Times Of Lockdown During Covid 19 Pandemic: A Single Institutional Experience, Pooja Kalra, Meenu Gupta, Vipul Nautiyal, Ranjeet Kumar, Sanjeev Pandey, Nazia Shirazi, Brijesh Tiwari, Mushtaq Ahmad

Research Symposium

Background and Objectives: High Grade Gliomas are categorised as Grade III and IV and have high mortality rate with poor prognosis. How we should adopt clinical practice in neuro-oncology during Covid 19 Pandemic is another area of scientific exploration . Hypofractionated radiotherapy protocols can be easily utilised in high grade gliomas during Covid 19 pandemic .

Materials and Methods: Retrospective analysis of 147 patients with diagnosis of high-grade gliomas between January 2009 till December 2020 including Covid-19 pandemic lockdown time was done. Age , gender , KPS , symptoms , extent of surgery and use of concurrent temozolamide , were …

An Ngqd Based Diagnostic Tool For Pancreatic Cancer, Ryan Ketan Ajgaonkar, Bong Lee, Alina Valimukhametova, Anton Naumov, Giridhar Akkaraju

Research Symposium

Background: Pancreatic cancer remains difficult to detect at early stages which contributes to a poor five-yearsurvival rate. Therefore, early detection approaches based on novel technologies should be explored to address this critical health issue. Nanomaterials have recently emerged as frontrunners for diagnostic applications due to their small size in the 1-100 nm range, which facilitates one-on-one interactions with a variety of biomolecules like oligonucleotides and makes them suitable for a plethora of detection and delivery applications. In this work, the presence of specific pancreatic cancer miRNA (pre-miR-132) is detected utilizing the fluorescence properties of highly biocompatible nitrogen-doped graphene quantum dots …

Antigen Staining For Detection Of Muc13 And Mcu16 In Carcinoma Tissue, Jose A. Benitez

Research Symposium

MUC13 and MUC16 are mucosal epithelial expressed proteins associated with various carcinomas. Overexpression of these biomarkers appear to play a role in tumor growth; this discovery has paved a road for multiple studies discussing the potential of targeting mucin proteins and optimize immunotherapy approaches against carcinomas. Our study serves to investigate the level of expression of MUC13 and MUC16 in cancerous and normal tissue and to discuss the implications our findings may have for the utilization of these biomarkers for cancer therapy.

A Two State-Wide Population Based Analysis Of Hepatosplenic T-Cell Lymphoma In Hispanic Vs Non-Hispanic Patients In Texas And Florida, Christine E. Loftis, Rosa White, Joel Michalek, Liu Qianqian, Adolfo Diaz

Research Symposium

Introduction: Peripheral T-cell lymphomas (PTCLs) are a diverse, aggressive form of neoplasms that are rare and constitute % of all non-Hodgkin lymphoma cases (Am J Pathol, PMID:1698028). A sub-set of PTCLs is hepatosplenic T-cell Lymphoma (HSTCL) which is described as an extra-nodal T-cell lymphoma of mature gamma or delta T-cells (Am J Pathol, PMID:1698028). HSTCL is extremely rare accounting for less than 1% of all cases of NHL and because of this, epidemiological research is lacking (Blood PMID: 21300984). Hispanics (H) are one of the fastest growing races in the US but tend to have poorer …

Tale Of Traveling In A Stealth Mode, Blesset Alexander, Priyasha Suri, Don Rajan, Praveen Vijhani

Research Symposium

Background: Melanoma is an aggressive malignancy that tends to form metastases in the brain. The nature of metastatic melanoma with unknown primary is poorly understood and has only theoretical assumptions. Less than 10% of melanoma cases present with an unknown primary tumor location.

Case presentation: A 68-year-old Caucasian male patient, Canadian citizen, presented to the hospital with left-sided weakness and deviation of right side of angle of mouth for three days. Pertinent positive physical signs were motor weakness of left upper and lower extremities. Labs were unremarkable. CT-scan of the brain showed right temporal lobe lobulated masses associated with vasogenic …

Characterization Of An Mtbp Hypomorphic Allele In A Diethylnitrosamine-Induced Liver Carcinogenesis Model, Atul Ranjan, Elizabeth A. Thoenen, Atsushi Kaida, Stephanie Wood, Terry Van Dyke, Tomoo Iwakuma

Manuscripts, Articles, Book Chapters and Other Papers

MTBP is implicated in cell cycle progression, DNA replication, and cancer metastasis. However, the function of MTBP remains enigmatic and is dependent on cellular contexts and its cellular localization. To understand the in vivo physiological role of MTBP, it is important to generate Mtbp knockout mice. However, complete deletion of the Mtbp gene in mice results in early embryonic lethality, while its heterozygous deletion shows modest biological phenotypes, including enhanced cancer metastasis. To overcome this and better characterize the in vivo physiological function of MTBP, we, for the first time, generated mice that carry an Mtbp hypomorphic allele (MtbpH …

Epidemiología Del Cáncer De Colon En Un Plan De Salud De Un Hospital De Comunidad. Estudio De Cohorte Retrospectivo., Nora Fuentes Phd, Mariano Esperatti Phd, Juan Martín Alfonso Md, Marcos Flores Md

AMNET XX Conferencia Internacional

Epidemiología del cáncer de colon en un Plan de Salud de un Hospital de Comunidad. Estudio de cohorte retrospectivo.

Introducción: el CCR ocupa el 4to lugar en ambos sexos y todas las edades (19.5 casos por 100.000 habitantes) y ocupa el 2do lugar en luego del cáncer de pulmón.

Objetivo: Describir la incidencia y sobrevida del cáncer de colon en un hospital de comunidad con Plan de salud (PS)

Métodos: Estudio de cohorte retrospectivo (Aprobado por el comité de ética). Se incluyeron todos los afiliados al Plan de Salud (PS) de 20 años o más entre 2009-2019. Se identificaron los …

Epidemiología Del Cáncer De Pulmón En Un Plan De Salud De Un Hospital De Comunidad. Estudio De Cohorte Retrospectivo., Nora Fuentes Phd, Mariano Esperatti Md, Juan Martin Alfonso Md

AMNET XX Conferencia Internacional

Introducción: El cáncer de pulmón es de los tumores más frecuentes a nivel mundial. En Argentina es 1er causa de muerte por cáncer (15%), sobrevida a 5 años de un 10%.

Objetivo: Describir la incidencia y sobrevida del cáncer pulmón en un hospital de comunidad con Plan de salud (PS)

Métodos:Estudio de cohorte retrospectivo (Aprobado por el comité de ética). Se incluyeron todos los afiliados al Plan de Salud (PS) de 20 años o más entre 2016-2021. Se identificaron los casos por patología. Se calcularon las tasas de incidencia tasa cruda, sexo y estandarizada por población estándar OMS, usando …

The Use Of Prognostic Markers To Predict Disease Progression And Clinical Outcome In Monoclonal Gammopathy Of Undetermined Significance, Smouldering Multiple Myeloma And Multiple Myeloma., Róisín C. Mcmonagle

International Undergraduate Journal of Health Sciences

Multiple Myeloma (MM) is an incurable plasma cell malignancy with a complex and incompletely understood molecular pathogenesis. Monoclonal Gammopathy of Undetermined Significance (MGUS) and Smouldering Multiple Myeloma (SMM) precede MM, with variable risks and rates of disease progression. The continuing high relapse and death rate in MM cases has prompted research into more accurate prognostic markers to predict progression from MGUS and SMM to MM, as well as identify MM cases with aggressive disease, in order to begin early, targeted and effective therapeutic intervention. Many studies have focused on utilising current markers more effectively, including M-protein, serum-free light chain ratio, …

Perceptions Of Facilitators And Barriers To Smoking Cessation Among Patients And Providers In A Cancer Center: A Single Institution Qualitative Exploratory Study, Luke M. Shenton, Udara Perera, Amy Leader, Ann C. Klassen

College of Population Health Faculty Papers

PURPOSE: Cancer patients who remain tobacco users have poorer outcomes, including increased mortality and decreased treatment tolerance; however, cessation post-diagnosis is challenging. Our formative research explored cessation-related perspectives among patients and staff at one National Cancer Institute-designated cancer center, to inform improving cessation services within oncology care.

METHODS: Using a descriptive phenomenological approach, a purposive sample of current cancer patients (n = 13) and cancer center physicians and cessation program staff (n = 9) were recruited to complete one-on-one audio-recorded in-depth qualitative interviews, to explore experiences providing or receiving cessation support, and perspectives on patients' readiness and needs regarding cessation. …

Comparative Retrospective Study Of Proton Arc Planning With Elsa Algorithm And Impt With Monte Carlo Algorithm With Raystation Treatment Planning System, Matthew L. Carpenter Ms, Msha, Bsrt(R)(T)

Culminating Experience Projects

Proton arc therapy (PAT) will become widely available soon. It is crucial to determine if this technique and the associated calculation algorithms provided by treatment planning system vendors compete favorably with established proton therapy techniques like intensity modulated proton therapy (IMPT) and the Monte Carlo dose calculation algorithm used to compute IMPT doses in today’s clinic. RaySearch Laboratories have produced a modified Monte Carlo algorithm called ELSA.

ELSA stands for early layer spot assignment and is RaySearch Laboratories proposed solution to reduce optimization time during treatment planning for PAT. This research study will look at proton plan robustness to determine …

Unveiling The Potential Application Of Intraoperative Brain Smear For Brain Tumor Diagnosis In Low-Middle-Income Countries: A Comprehensive Systematic Review, Muhammad Shakir, Ahmed Altaf, Hawra Hussain, Syed Muhammad Aqeel Abidi, Zoey Petitt, Mahnoor Tariq, Ahmed Gilani, Syed Ather Enam

Section of Neurosurgery

Background: Immediate intraoperative histopathological examination of tumor tissue is indispensable for a neurosurgeon to track surgical resection. A brain smear is a simple, rapid, and cost-effective technique, particularly important in the diagnosis of brain tumors. The study aims to determine the effectiveness of intraoperative brain smear in the diagnosis of brain tumors in low- and middle-income countries (LMICs), while also evaluating its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.
Methods: A comprehensive search of the literature was conducted using PubMed, Scopus, and Google Scholar. The retrieved articles were independently screened by two reviewers. The …

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

Electronic Thesis and Dissertation Repository

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …

Prevalence Of Depression In Patients With Hematologic Diseases In Marrakesh, Morocco: A Single Center Experience, Fatima Zahra Lahlimi, Oumaima Maghnouj, Khawla Khalil, Safaa Chaabane, Illias Tazi

Journal of Community Hospital Internal Medicine Perspectives

Depression in patients with cancer influences negatively their physical symptoms, treatment success, coping, and their quality of life, and it is associated with increased mortality. Reported prevalence of emotional distress in patients followed in hematology varies widely across studies. The present study aimed to investigate the prevalence of depression, and to explore the possible associated factors in patients followed in a hematological department Method: in this descriptive cross-sectional study among patients admitted to the hematology department in the University Hospital Mohammed VI of Marrakech, between August 2020 and December 2020, depression symptoms were assessed using Mini International Neuropsychiatric Interview test …

From The Lung To The Finger: An Unusual Presentation Of Adenosquamous Cell Carcinoma, Preeti Badve, Md, Sussy Obando Lara, Md, Elisenda Valdez Pena, Md, Myriah Magaris, Do, Zunaira Naeem, Md, Charalambos Solomides, Md, Avnish Bhatia

Department of Medical Oncology Posters

Learning Objective

To recognize unusual presentations of metastatic lung disease.

A Genomics Driven Pluripotent Stem Cell Model Of Infant Acute Lymphoblastic Leukemia, Meagan Vacek, Jacqelyn Nemechek, Julia Draper, Irina Pushel, Bradley Thornton, Molly Leyda, Priyanka Prem Kumar, Midhat S. Farooqi, Jay L. Vivian, Erin M. Guest, John M. Perry

Posters

Acute lymphoblastic leukemia in infants (iALL) is a high-risk subtype of childhood leukemia, with poor survival outcomes despite intensive therapies. Rearrangement of KMT2A (KMT2A-r) on chromosome 11q23 is the most frequent cytogenetic abnormality in iALL, occurring in 70% of cases. KMT2A-r is associated with chemotherapy resistance, early relapse, and rapid leukemic progression, all of which contribute to poor survival outcomes. The most common KMT2A-r in iALL is KMT2A::AFF1 (MLL::AF4), derived from t(4;11)(q21;23) and arises in utero as shown in multiple clinical studies. Infant ALL’s cell of origin is thought to be a very early hematopoietic precursor, with transcriptomic studies of …

Inducing Accelerated Lung Toxicity In Mice Using A Partial Arc Sbrt Technique, Andrew Gerry, Charita Kunta, Noelle Francois, Tiziana Deangelis, Anuradha Shastri, Nicole Simone, Reza Taleei

Department of Radiation Oncology Posters

Background

• Radiation-induced pulmonary fibrosis (RIPF) is a frequent outcome of thoracic radiation therapy, constraining safe tumor radiation dosage. Various animal models, such as mice, rats, and pigs, have been devised to study RIPF
• Current methods for inducing lung fibrosis in mice involve whole lung irradiation with doses between 2-20 Gy. These methods used fixed anterior and posterior (AP/PA) x-ray beams at 0º and 180º with analysis typically commencing 24 to 52 weeks post-radiation
• Current methods are unrepresentative of modern radiation therapy techniques and are limited by the associated long latency of RIPF

Mavs Is A Double-Edged Sword, Christina Huang, Jack L. Arbiser

Student Papers, Posters & Projects

No abstract provided.

Racial/Ethnic Disparities In Prostate Cancer 5-Year Survival: The Role Of Health-Care Access And Disease Severity, Christiane J. El Khoury, Sean A.P. Clouston

Department of Medical Oncology Faculty Papers

Introduction: Prostate cancer (PCa) exhibits one of the widest racial and socioeconomic disparities. PCa disparities have also been widely linked to location, as living in more deprived regions was associated with lower healthcare access and worse outcomes. This study aims to examine PCa survival across various USA counties in function of different socioeconomic profiles and discuss the role of potential intermediary factors. Methods: The SEER database linked to county-level SES was utilized. Five-year PCa-specific survival using the Kaplan–Meier method was performed for five racial/ethnic categories in function of SES quintiles. Multilevel Cox proportional hazards regression was performed to assess the …

Intrinsic Disorder In Prame And Its Role In Uveal Melanoma, Michael Antonietti, David J. Taylor, Mak Djulbegovic, Guy W. Dayhoff, Vladimir N. Uversky, Carol L. Shields, Carol L. Karp

Wills Eye Hospital Papers

Introduction

The PReferentially expressed Antigen in MElanoma (PRAME) protein has been shown to be an independent biomarker for increased risk of metastasis in Class 1 uveal melanomas (UM). Intrinsically disordered proteins and regions of proteins (IDPs/IDPRs) are proteins that do not have a well-defined three-dimensional structure and have been linked to neoplastic development. Our study aimed to evaluate the presence of intrinsic disorder in PRAME and the role these structureless regions have in PRAME( +) Class 1 UM.

Methods

A bioinformatics study to characterize PRAME’s propensity for the intrinsic disorder. We first used the AlphaFold tool to qualitatively assess the …

Metastatic Papillary Thyroid Carcinoma Gone Wild, Khulood Talpur, Ambreen Soomro, Afrah Talpur

Abington Jefferson Health Papers

Thyroid cancers account for only 1.5% of all cancers in adults and 3% of all cancers in children. In females, however, thyroid cancers are the fifth most common cancer, comprising 4% of all cases. Of all thyroid cancers, 74-80% of cases are papillary cancer. The prevalence of thyroid cancer is rising worldwide. Although thyroid cancer has a favorable prognosis, up to 20% of patients experienced recurrent disease during the follow-up period. Extra-thyroidal extension occurs in 8% to 32% of cases. Local or regional recurrences occur in 5-15% of patients with papillary thyroid carcinoma (PTC). Distant metastasis occurs in only 1% …

Targeting Breast Cancer: The Familiar, The Emerging, And The Uncharted Territories, Hamidreza Montazeri Aliabadi, Arthur Manda, Riya Sidgal, Co Chung

Pharmacy Faculty Articles and Research

Breast cancer became the most diagnosed cancer in the world in 2020. Chemotherapy is still the leading clinical strategy in breast cancer treatment, followed by hormone therapy (mostly used in hormone receptor-positive types). However, with our ever-expanding knowledge of signaling pathways in cancer biology, new molecular targets are identified for potential novel molecularly targeted drugs in breast cancer treatment. While this has resulted in the approval of a few molecularly targeted drugs by the FDA (including drugs targeting immune checkpoints), a wide array of signaling pathways seem to be still underexplored. Also, while combinatorial treatments have become common practice in …

Psychometric Results Of A New Patient-Reported Outcome Measure For Uveal Melanoma Post-Brachytherapy Treatment: The Prom-Um, Ezekiel Weis, Jing Jiang, Alison H. Skalet, Carol L. Shields, R. Trafford Crump

Wills Eye Hospital Papers

The objective of this study was to evaluate the psychometric properties of a new patient-reported outcome instrument intended for use with patients who have undergone brachytherapy for uveal melanoma (PROM-UM). Classical test theory and item response theory were used to evaluate the performance of individual items and domains. A convenience sample of 439 participants who had undergone brachytherapy for uveal melanoma from one of three North American ocular oncology treatment centers were included in this cross-sectional study. Exploratory factor analysis identified three domains which were labelled “Symptom Impairment”, “Worry”, and “Discomfort”. The acceptability of the instrument was supported by little …

Variant Characterization Of A Representative Large Pedigree Suggests “Variant Risk Clusters” Convey Varying Predisposition Of Risk To Lynch Syndrome, Mouadh Barbirou, Amanda A. Miller, Amel Mezlini, Balkiss Bouhaouala-Zahar, Peter J. Tonellato

Department of Medical Oncology Faculty Papers

Recently, worldwide incidences of young adult aggressive colorectal cancer (CRC) have rapidly increased. Of these incidences diagnosed as familial Lynch syndrome (LS) CRC, outcomes are extremely poor. In this study, we seek novel familial germline variants from a large pedigree Tunisian family with 12 LS-affected individuals to identify putative germline variants associated with varying risk of LS. Whole-genome sequencing analysis was performed to identify known and novel germline variants shared between affected and non-affected pedigree members. SNPs, indels, and structural variants (SVs) were computationally identified, and their oncological influence was predicted using the Genetic Association of Complex Diseases and Disorders, …

A Retrospective Comparison Of Dose Distribution Within Density Override And Avoidance Structures In Volumetric Arc Therapy Prostate Plans With Hip Prosthetics: A Dosimetric Evaluation, Jared Richard Brinkman

Culminating Experience Projects

Introduction

Prostate cancer is one of the most common cancers among men, and its incidence is a significant health concern. The optimal radiation treatment for prostate cancer patients needs to be tailored to reduce toxicities to organs at risk within the treated area. This study aims to retrospectively evaluate the dose distribution to organs at risk (OARs) in patients with hip prosthetics for volumetric modulated arc therapy (VMAT) prostate cancer plans.

Methods

The study included ten prostate cancer patients with at least one prosthetic hip who received VMAT plans at a Midwest Radiation Oncology Center. Various data points, including target …