Medical Specialties Commons^™

Sarcoma European And Latin American Network (Selnet) Recommendations On Prioritization In Sarcoma Care During The Covid-19 Pandemic, J. Martin-Broto, N. Hindi, S. Aguiar, R. Badilla-Gonzalez, V. Castro-Oliden, M. Chacon, R. Correa-Generoso, E. De Alava, R. Maki, J. Blay, +25 Additional Authors

Journal Articles

No abstract provided.

Management Of Pancreatic Cancer During Covid-19 Pandemic: To Treat Or Not To Treat?, R. Patel, M. W. Saif

Journal Articles

Pancreatic cancer is a very aggressive disease and survival remains dismal even with treatment. Currently, management of patients with pancreatic cancer has been complicated by the ongoing COVID-19 pandemic. Medical oncologists face the dilemma of whether to treat or to not treat these patients who are at high-risk of complications and even death from COVID-19. No current guidelines are available and our limited experience at this time makes it more difficult to manage these patients. Although we have general strategies available from experience in Italy, we need more treatment specific strategies to help mitigate risks of complications and toxicities from …

Evaluating Of Hpv-Dna Ish As An Adjunct To P16 Testing In Oropharyngeal Cancer, J. Chi, I. R. Preeshagul, S. Sheikh-Fayyaz, S. Teckie, N. Kohn, Y. Ziemba, A. Laser, D. Frank, M. Ghaly, D. Kamdar, D. Kraus, D. Paul, N. Seetharamu

Journal Articles

© 2020 Jeffrey Chi. Aim: Current guidelines recommend p16 immunohistochemistry (IHC) for testing human papillomavirus (HPV) in oropharyngeal carcinoma (OPSCC). We evaluated the value of adding DNA in situ hybridization (ISH) to p16 IHC. Methods: Fifty patients with OPSCC were analyzed. Concordance between HPV-DNA ISH and p16 IHC was measured by Gwet's agreement coefficient. Results: p16 IHC was positive in 35/48 (72.9%), negative in 8/48 (16.7%) patients. Wide spectrum DNA-ISH was positive in 9/23 (39%) and negative in 14/23 (60.9%) patients. High-risk 16/18 (HR) HPV DNA-ISH was positive in 11/23 (47.8%) and negative in 12 (52.2%) patients. The agreement between …

Optimizing Tissue Use: A Step-Wise Approach To Diagnosing Squamous Cell Lung Carcinoma On Small Biopsies, C. Olazagasti, I. Preeshagul, M. Aziz, N. Seetharamu

Journal Articles

© The Author(s) 2020. Background: Histologic subtyping of lung cancer has significant implications for treatment planning. Accurate diagnosis based on cytology/small biopsy specimens is challenging and frequently determined by morphology, as material is often not sufficient for immunohistochemical studies (IHC). We investigated the concordance between the rates of diagnosis from cytology/small biopsies compared with surgical specimens in patients with squamous cell lung cancer (SCC) and the utility of IHC for diagnostic precision in lung cancer subtyping. Methods: We conducted a 5-year retrospective analysis identifying cases of SCC diagnosed on cytology/small biopsies ± IHC and compared them with subsequent surgical specimens …

Associations Between Oncogenic Risk Markers And Clinical Outcomes Among Black And White Colorectal Cancer Patients, Victoria B. Starks, Edith P. Mitchell, Md, Facp

Phase 1

Introduction: Blacks have a 25% higher incidence of colorectal cancer compared to their white societal counterparts. Additionally, the overall mortality rate among black colorectal cancer patients is 50% higher than that of whites. However, little is known about the biomarkers prevalent among blacks and their possible correlation to treatment response and patient outcomes.

Objective: The objective of this study is to explore disease trends that may unveil a correlation between molecular markers and poor clinical outcomes among black colorectal cancer patients.

Methods: De-identified patient data was obtained from The Oncology Data Services Department (Cancer Registry) of TJUH. The population cohort …

A Look At Gene Control: Tracking The Ccnd1 Gene, Bryan Anders

Mahurin Honors College Capstone Experience/Thesis Projects

Cancer occurs when the cell does not properly control its own cell cycle. It then replicates in an out of control fashion leading to the death of various organs and then the demise of the organism as a whole. As it seems to have always been a problem for cell-based life, certain safeguards against cancer have been evolved over time. One such method comes in the form of prevention via cyclin proteins, which are encoded from cyclin genes. The gene that is the focus of this research is the CCND1, or cyclin D1, gene that controls the progression through various …

A Modular Framework For Early-Phase Seamless Oncology Trials, Philip S. Boonstra, Thomas M. Braun, Elizabeth C. Chase

The University of Michigan Department of Biostatistics Working Paper Series

Background: As our understanding of the etiology and mechanisms of cancer becomes more sophisticated and the number of therapeutic options increases, phase I oncology trials today have multiple primary objectives. Many such designs are now 'seamless', meaning that the trial estimates both the maximum tolerated dose and the efficacy at this dose level. Sponsors often proceed with further study only with this additional efficacy evidence. However, with this increasing complexity in trial design, it becomes challenging to articulate fundamental operating characteristics of these trials, such as (i) what is the probability that the design will identify an acceptable, i.e. safe …

Reduced Length Of Stay In Major Hepatectomy Surgery After Implementation Of An Enhanced Recovery Pathway In The United States Veteran Population, Yvonne Nguyen Md, Marilyn Mcnulty Np, Leopoldo Fernandez Md, Michael R. Kazior Md

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction

Enhanced recovery after surgery (ERAS) pathways are associated with better postoperative recovery, however, evidence is lacking in major liver surgery, .This study aimed to evaluate the impact of an ERAS pathway in U.S. veterans undergoing major hepatectomy surgery. We hypothesized that the adoption of an ERAS pathway reduces decreased length of stay (LOS).

Methods

After approval from the Hunter Holmes McGuire VA Medical Center IRB, we compared data from consecutive patients undergoing elective open hepatectomy within an ERAS pathway (January 2019-December 2019) to a previous cohort of patients before introduction of ERAS (July 2016-December 2017). One surgeon performed all …

The Role Of Rassf5 On Cell Growth And Hippo Signaling In Rhabdomyosarcoma, Megan Garver, Lee Helman, Md, Katrina Slemmons, Phd

Phase 1

Introduction: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma of childhood. Dysregulation of the Hippo pathway, a signaling cascade that regulates many biological processes, is associated with many human cancers. The goal of my project was to delete RASSF5, a regulator of the Hippo pathway, in RMS cells utilizing CRISPR/Cas9 and then to evaluate how the absence of RASSF5 affects RMS cell growth and Hippo signaling, with and without DNMTi Tx.

Methods: A lipofectamine transfection was performed in two different RMS cell lines, Rh30 & RD, in which two different CRIPSR/Cas9 vectors with RASSF5 guide RNA were introduced. …

Role Of Helicobacter Pylori Infection In Development Of Gastrointestinal Malignancy, Zilola Khashimova

Physician Assistant Studies | Faculty Scholarship

Introduction. Helicobacter Pylori (HP) infection has been associated with chronic inflammation of the stomach and may also be associated with the development of gastrointestinal malignancy.

Purpose of Study: This study will examine the literature related to HP infection associated with the cancers of the stomach.

Materials and Methods: A literature review was conducted on the reported research of HP infection associated with gastric cancer cases.

Results and Discussions: Helicobacter pylori is a gastric pathogen that colonizes approximately 50% of the world’s population. Infection with H. pylori causes chronic inflammation and significantly increases the risk of developing …

Protocol For Ground Glass Opacity, Elissa Goldman

Phase 1

Rationale: Pure ground glass opacities (GGO), identified incidentally or on lung cancer screening, may indicate pre-invasive subtypes of lung adenocarcinoma. These neoplasms typically demonstrate indolent patterns of growth, and Fleischner Society guidelines recommend up to five years of serial imaging. Our aim was to determine the frequency of diagnosed lung adenocarcinoma arising from GGO detected beyond 5 years of CT surveillance.

Methods: We reviewed all pathologic diagnoses of lung adenocarcinoma (n=442) between 2016 and 2018 of a tertiary academic hospital and National Cancer Institute-designated cancer center to identify all cancers that arose from ground glass opacities detected on CT scan. …

Machine Learning Prediction Of Glioblastoma Patient One-Year Survival, Andrew Du '20, Warren Mcgee, Jane Y. Wu

Student Publications & Research

Glioblastoma (GBM) is a grade IV astrocytoma formed primarily from cancerous astrocytes and sustained by intense angiogenesis. GBM often causes non-specific symptoms, creating difficulty for diagnosis. This study aimed to utilize machine learning techniques to provide an accurate one-year survival prognosis for GBM patients using clinical and genomic data from the Chinese Glioma Genome Atlas. Logistic regression (LR), support vector machines (SVM), random forest (RF), and ensemble models were used to identify and select predictors for GBM survival and to classify patients into those with an overall survival (OS) of less than one year and one year or greater. With …

Helicobacter Pylori Infection And Its Importance In The Development Of Idiopathic Thrombocytopenic Purpura, Zilola Khashimova

Physician Assistant Studies | Faculty Scholarship

Helicobacter Pylori (HP) infection has been associated with chronic inflammation of the stomach and may also be associated with Idiopathic thrombocytopenic purpura (ITP). A literature review was conducted on the reported research of HP infection associated with ITP.

Advances In Targeted Therapy For Acute Myeloid Leukemia., Jifeng Yu, Peter Y Z Jiang, Hao Sun, Xia Zhang, Zhongxing Jiang, Yingmei Li, Yongping Song

Articles, Abstracts, and Reports

Acute myeloid leukemia (AML) is a clonal malignancy characterized by genetic heterogeneity due to recurrent gene mutations. Treatment with cytotoxic chemotherapy has been the standard of care for more than half of a century. Although much progress has been made toward improving treatment related mortality rate in the past few decades, long term overall survival has stagnated. Exciting developments of gene mutation-targeted therapeutic agents are now changing the landscape in AML treatment. New agents offer more clinical options for patients and also confer a more promising outcome. Since Midostaurin, a FLT3 inhibitor, was first approved by US FDA in 2017 …

The Association Between Testicular Cancer And Female Reproductive Cancers: A Systematic Review, Alyssa Church

Honors Undergraduate Theses

The most common neoplasm found in young to middle-aged men is testicular cancer (TCa). This disease not only poses a risk of early death, but can also affect a male's fertility and testosterone levels and can diminish one's mental health and/or quality of life. One particular line of research that is emerging in the field is a possible genetic association of TCa with female reproductive cancers. We employed a systematic review to assess the methodological quality of articles that met the inclusionary criteria. To be selected for this review, articles had to go through a primary, secondary, and tertiary screening …

Determination Of N-Linked Glycosylation Changes In Hepatocellular Carcinoma And The Associated Glycoproteins For Enhanced Biomarker Discovery And Therapeutic Targets, Connor Allen West

MUSC Theses and Dissertations

With hepatocellular carcinoma (HCC) remaining as the fifth most common cancer in the world, causing more than 700,000 deaths annually, the need for reliable, early stage diagnoses and preventive treatments is crucial. While serum glycoproteins are hepatic in origin, making them excellent targets for HCC biomarkers, they can originate from both cancerous and non-cancerous regions and direct analysis of cancerous tissue itself is lacking. To counteract this, I hypothesized that direct tissue analysis combined with proteomic analysis could be utilized to identify more potential targets specific to HCC for early detection. This was done with a primary focus on glycosylation—as …

Conjunctival Melanoma: Features Based On The Fitzpatrick Skin Type (Fst) In 540 Patients At A Single Ocular Oncology Center, Sunihidi Ramesh, Antonio Yaghy, Lauren A. Dalvin, Sara E. Lally, Jerry A. Shields, Carol L. Shields

Phase 1

Background: The Fitzpatrick skin type (FST) is a classification system for skin pigmentation that has been used to stratify risk for cutaneous melanoma; however, it has not yet been explored in the context of conjunctival melanoma. Herein, we examine FST and its association with the clinical features of conjunctival melanoma.

Methods: A retrospective review was conducted on 540 medical records of patients with pathologic diagnosis of conjunctival melanoma. The patients were categorized according to the FST classification based on their external facial photographs at presentation. This includes: Type I (white skin color), Type II (fair skin color), Type III (average …

Early Perioperative Fluid Benchmarking To Predict Pancreaticoduodenectomy (Pd) Outcomes, David Moskal, Carrie D. Walsh, Sofia Duque, Charles Yeo, Md, Facs, Harish Lavu, Md, Facs

Phase 1

Introduction: PD is a complex operation associated with a marked systemic inflammatory response and significant fluid shifts. Establishing a benchmark for ideal perioperative fluid management is critical to optimising PD patient recovery.

Methods: In this retrospective study, we evaluated perioperative fluid data for patients undergoing PD. We compared an optimal benchmark group who were discharged home by postoperative day five (≤5day) to a group of patients with an in hospital recovery greater than ten days (≥10day).

Results: Seventy-six patients who underwent PD between June 2015 and November 2016 were evaluated. The ≤5day group had a significantly lower intraoperative fluid administration …

Manipulation Of Genome Integrity Signaling Axes Contributing To Prostate Cancer Aggressiveness, Frank Duan, Veronica Rodriguez-Bravo, Phd

Phase 1

Introduction: Prostate cancer (PC) is one of the leading causes of death in men, and despite current treatment options patients can develop aggressive disease that spreads to other parts of the body. Little research has focused to date on the effect of centrosome biology in the pathogenesis of PC.

Methods: Two metastatic PC cell lines, DU145 and 22Rv1, as well as highly aggressive derivatives generated in Dr. Rodriguez-Bravo lab (docetaxel-resistant; (DR) variants) were compared through various experiments to determine differences in centrosome proteins expression and functionality. All cells (DU145 /DR and 22Rv1 /DR) underwent electroporations with siRNAs to knockout …

Ethnic Differences In Germline Genetic Testing For Breast Cancer, Kathryn Dent, Rebecca J. Jaslow, Md

Phase 1

Introduction: Ethnic variations in uptake of genetic testing and differences in findings of germline mutations within ethnic groups, are not well understood. The goal of this research is to assess for any such differences or similarities within a genetic counseling and testing program at an urban Cancer Center.

Methods: This is a non-comparative, descriptive epidemiology study assessing individuals with a diagnosis of breast cancer undergoing genetic counseling at the TJUH Sidney Kimmel Cancer Center in Philadelphia between 2014 and 2019. Data were compiled onto Research Electronic Data Capture (REDCAP) and analyzed statistically.

Results: Patients with Breast Cancer (n=1075) were included …

The Financial And Psychosocial Impact Of Medicinal Cannabis, Chris Ahmed, Andrew Lee, Amanda Campbell, Gregory Garber, Msw, Lcsw, Neil D. Palmisiano, Md, Brooke Worster, Md

Phase 1

Introduction: Therapeutic utilization of medicinal cannabis for symptom management in oncology patients is a burgeoning area of research focus. We hypothesize that medicinal cannabis use can result in subjective improvements in quality of life (QOL) metrics for cancer patients.

Methods: Adult palliative care patients at a medical oncology clinic are consented to the study after being certified to access medicinal cannabis. After three months, subjective changes in QOL, including well-being, financial burden, pain, chemotherapy induced nausea and vomiting (CINV), and other categories are recorded via telephone interview. Responses are documented with a numerical Likert scale (from 1-5, with a score …

Case Report: Co-Existence Of Brca2 And Palb2 Germline Mutations In Familial Prostate Cancer With Solitary Lung Metastasis., Tang Tang, Lin-Ang Wang, Peng Wang, Dali Tong, Gaolei Liu, Jun Zhang, Nan Dai, Yao Zhang, Gang Yuan, Kyla Geary, Dianzheng Zhang, Qiuli Liu, Jun Jiang

PCOM Scholarly Works

Background: Mutation-caused loss-of-function of factors involved in DNA damage response (DDR) is responsible for the development and progression of ~20% of prostate cancer (PCa). Some mutations can be used in cancer risk assessment and informed treatment decisions.

Methods: Target capture-based deep sequencing of 11 genes was conducted with total DNA purified from the proband's peripheral blood. Sanger sequencing was conducted to screen potential germline mutations in the proband's family members. Targeted sequencing of a panel of 1,021 genes was done with DNA purified from the tumor tissue.

Results: Two previously unreported germline mutations in the DDR pathway,

Conclusions: The newly …

Aml Risk Stratification Models Utilizing Eln-2017 Guidelines And Additional Prognostic Factors: A Swog Report., Era L Pogosova-Agadjanyan, Anna Moseley, Megan Othus, Frederick R Appelbaum, Thomas R Chauncey, I-Ming L Chen, Harry P Erba, John E Godwin, Isaac C Jenkins, Min Fang, Mike Huynh, Kenneth J Kopecky, Alan F List, Jasmine Naru, Jerald P Radich, Emily Stevens, Brooke E Willborg, Cheryl L Willman, Brent L Wood, Qing Zhang, Soheil Meshinchi, Derek L Stirewalt

Articles, Abstracts, and Reports

Background: The recently updated European LeukemiaNet risk stratification guidelines combine cytogenetic abnormalities and genetic mutations to provide the means to triage patients with acute myeloid leukemia for optimal therapies. Despite the identification of many prognostic factors, relatively few have made their way into clinical practice.

Methods: In order to assess and improve the performance of the European LeukemiaNet guidelines, we developed novel prognostic models using the biomarkers from the guidelines, age, performance status and select transcript biomarkers. The models were developed separately for mononuclear cells and viable leukemic blasts from previously untreated acute myeloid leukemia patients (discovery cohort,

Results: Models …

Transcriptional And Immunohistological Assessment Of Immune Infiltration In Pancreatic Cancer., Brady Bernard, Venkatesh Rajamanickam, Christopher Dubay, Brian D. Piening, Emilio Alonso, Zeljka Jutric, Ephraim Tang, Pippa Newell, Paul D Hansen, Terry R Medler, Andrew J Gunderson, Kristina H Young, Carlo Bifulco, Joanna Pucilowska, Marka R Crittenden, Michael J. Gough

Articles, Abstracts, and Reports

Pancreatic adenocarcinoma is characterized by a complex tumor environment with a wide diversity of infiltrating stromal and immune cell types that impact the tumor response to conventional treatments. However, even in this poorly responsive tumor the extent of T cell infiltration as determined by quantitative immunohistology is a candidate prognostic factor for patient outcome. As such, even more comprehensive immunophenotyping of the tumor environment, such as immune cell type deconvolution via inference models based on gene expression profiling, holds significant promise. We hypothesized that RNA-Seq can provide a comprehensive alternative to quantitative immunohistology for immunophenotyping pancreatic cancer. We performed RNA-Seq …

The Impact Of Age On Survival In Cll Patients Receiving Ibrutinib As Initial Therapy., Chaitra Ujjani, Anthony Mato, Brian T Hill, John N Allan, Frederick Lansigan, Ryan Jacobs, Alan Skarbnik, Hande Tuncer, John M Pagel, Danielle Brander, Bruce Cheson, Paul Barr, Lindsey E Roeker, Jeffrey Pu, Nirav N Shah, Andre Goy, Stephen J Schuster, Nicole Lamanna, Alison Sehgal, Constantine S Tam, Mazyar Shadman

Articles, Abstracts, and Reports

Introduction: Recent randomized trials have demonstrated the efficacy of ibrutinib-based therapy in the treatment of patients with CLL. In Alliance A041202, a higher than expected number of unexplained deaths were reported with front-line ibrutinib in a patient population aged at least 65 years compared to ECOG 1912, which included patients up to 70 years of age.

Methods: Therefore, we conducted a retrospective analysis to investigate whether ibrutinib was associated with a greater mortality in older patients outside of a clinical trial setting. This multicenter analysis was performed by investigators at 20 academic and community practices.

Results: Amongst the 391 patients …

Primary Cns Lymphoma Commonly Expresses Immune Response Biomarkers., Alexander Ou, Ashley Sumrall, Surasak Phuphanich, David Spetzler, Zoran Gatalica, Joanne Xiu, Sharon Michelhaugh, Andrew Brenner, Manjari Pandey, Santosh Kesari, W Michael Korn, Sandeep Mittal, Jason Westin, Amy B Heimberger

Articles, Abstracts, and Reports

Background: Primary central nervous system lymphoma (PCNSL) is rare and there is limited genomic and immunological information available. Incidental clinical and radiographic responses have been reported in PCNSL patients treated with immune checkpoint inhibitors.

Materials and Methods: To genetically characterize and ascertain if the majority of PCNSL patients may potentially benefit from immune checkpoint inhibitors, we profiled 48 subjects with PCNSL from 2013 to 2018 with (1) next-generation sequencing to detect mutations, gene amplifications, and microsatellite instability (MSI); (2) RNA sequencing to detect gene fusions; and (3) immunohistochemistry to ascertain PD-1 and PD-L1 expression. Tumor mutational burden (TMB) was calculated …

Prior Tonsillectomy Is Associated With An Increased Risk Of Esophageal Adenocarcinoma., Katherine S Garman, Teminioluwa A Ajayi, Harold J Boutte, Shih-Ting Chiu, Richard J Von Furstenberg, Benjamin R Lloyd, Cecelia Zhang, Mark W Onaitis, Shein-Chung Chow, Shannon J Mccall

Articles, Abstracts, and Reports

BACKGROUND: Esophageal cancer is a deadly cancer with 5-year survival

METHODS: Cases included 452 esophagectomy cases, including 396 with EAC and 56 who underwent esophagectomy for Barrett's esophagus (BE) with high grade dysplasia (HGD). 1,102 thoracic surgery patients with surgical indications other than dysplastic BE or esophageal cancer represented the controls for our analysis. The association of tonsillectomy and HGD/EAC were primarily evaluated by using univariate tests and then verified by logistic regression analysis. Baseline demographics, medical history, and thoracic surgery controls were compared by using χ2 tests or 95% CIs. Significant risk factors were considered as covariates in the …

Simultaneous Isolation Of Circulating Nucleic Acids And Ev-Associated Protein Biomarkers From Unprocessed Plasma Using An Ac Electrokinetics-Based Platform., Juan Pablo Hinestrosa, David J Searson, Jean M Lewis, Alfred Kinana, Orlando Perrera, Irina Dobrovolskaia, Kevin Tran, Robert Turner, Heath I Balcer, Iryna Clark, David Bodkin, Dave Hoon, Rajaram Krishnan

Articles, Abstracts, and Reports

The power of personalized medicine is based on a deep understanding of cellular and molecular processes underlying disease pathogenesis. Accurately characterizing and analyzing connections between these processes is dependent on our ability to access multiple classes of biomarkers (DNA, RNA, and proteins)-ideally, in a minimally processed state. Here, we characterize a biomarker isolation platform that enables simultaneous isolation and on-chip detection of cell-free DNA (cfDNA), extracellular vesicle RNA (EV-RNA), and EV-associated proteins in unprocessed biological fluids using AC Electrokinetics (ACE). Human biofluid samples were flowed over the ACE microelectrode array (ACE chip) on the Verita platform while an electrical signal …

Cdca2 Inhibits Apoptosis And Promotes Cell Proliferation In Prostate Cancer And Is Directly Regulated By Hif-1Α Pathway., Yixiang Zhang, Yingduan Cheng, Zhaoxia Zhang, Zhongyuan Bai, Hongtao Jin, Xiaojing Guo, Xiaoyan Huang, Meiqi Li, Maolin Wang, Xing-Sheng Shu, Yeqing Yuan, Ying Ying

Articles, Abstracts, and Reports

Prostate cancer (PCa) is a major serious malignant tumor and is commonly diagnosed in older men. Identification of novel cancer-related genes in PCa is important for understanding its tumorigenesis mechanism and developing new therapies against PCa. Here, we used RNA sequencing to identify the specific genes, which are upregulated in PCa cell lines and tissues. The cell division cycle associated protein (CDCA) family, which plays a critical role in cell division and proliferation, is upregulated in the PCa cell lines of our RNA-Sequencing data. Moreover, we found that CDCA2 is overexpressed, and its protein level positively correlates with its histological …

Cri Iatlas: An Interactive Portal For Immuno-Oncology Research., James A Eddy, Vésteinn Thorsson, Andrew E Lamb, David L Gibbs, Carolina Heimann, Jia Xin Yu, Verena Chung, Yooree Chae, Kristen Dang, Benjamin G Vincent, Ilya Shmulevich, Justin Guinney

Articles, Abstracts, and Reports

The Cancer Research Institute (CRI) iAtlas is an interactive web platform for data exploration and discovery in the context of tumors and their interactions with the immune microenvironment. iAtlas allows researchers to study immune response characterizations and patterns for individual tumor types, tumor subtypes, and immune subtypes. iAtlas supports computation and visualization of correlations and statistics among features related to the tumor microenvironment, cell composition, immune expression signatures, tumor mutation burden, cancer driver mutations, adaptive cell clonality, patient survival, expression of key immunomodulators, and tumor infiltrating lymphocyte (TIL) spatial maps. iAtlas was launched to accompany the release of the TCGA …