المؤلفون: Barry Paul, Yue Zhao, Gavin Loitsch, Daniel Feinberg, Parker Mathews, Ian Barak, Megan Dupuis, Zhiguo Li, Lindsay Rein, Endi Wang, Yubin Kang

المصدر: Cancer Medicine, Vol 9, Iss 16, Pp 5869-5880 (2020)

مصطلحات موضوعية: bone marrow fibrosis, immunohistochemical staining, JAK2, multiple myeloma, overall survival, progression free survival, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Abstract We determined the impact of bone marrow fibrosis (BMF) on the clinical outcomes of newly diagnosed multiple myeloma (NDMM) patients in the current era of myeloma therapy. A total of 393 MM patients were included in the final analysis. The median followup was 83 months (range: 3.9 to 212 months). BMF was noted in 122 (48.2%) evaluable patients. Median progression free survival (PFS) in patients without BMF was 30.2 (95% CI: 24.7‐38.0) months, and 21.1 (95% CI: 18.8‐27.5) months in patients with BMF present (P = .024). Median overall survival (OS) was 61.2 (95% CI: 51.5‐81.2) months in patients without BMF, and 45.1 (95% CI: 38.7‐57.0) months in patients with BMF (P = .0048). A subset of 99 patients had their bone marrow biopsies stained for JAK1 and JAK2 by immunohistochemistry. Of these samples 67 (67.7%) patients had detectable JAK2 expression predominantly noted on bone marrow megakaryocytes. JAK2 expression correlated with myeloma disease stage (P = .0071). Our study represents the largest dataset to date examining the association of BMF with prognosis in the era of novel therapies and widespread use of hematopoietic stem cell transplant (HSCT). Our data suggest that MM patients with BMF (particularly those with extensive BMF) have a poorer prognosis even when treated with immunomodulatory agents and proteasome inhibitors.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2045-7634Test

الوصول الحر: https://doaj.org/article/61f7841b051f4ba48d649ace03521803Test

المؤلفون: Debu Tripathy, Sukh Makhnoon, Banu Arun, Aysegul Sahin, Nicole M. Kettner, Senthil Damodaran, Khandan Keyomarsi, Wei Yang, Kelly K. Hunt, Mark Clemens, Wendy A. Woodward, Melissa P. Mitchell, Rachel Layman, Evthokia A. Hobbs, Bora Lim, Megan Dupuis, Rashmi Murthy, Omar Alhalabi, Nuhad Ibrahim, Ishwaria M. Subbiah, Carlos Barcenas

المصدر: Holland‐Frei Cancer Medicine. :1-62

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::afc75ea4bc5b9c0be84ae7c895f26495Test
https://doi.org/10.1002/9781119000822.hfcm109.pub2Test

المؤلفون: Jeremy A. Ross, Alyssa G. Rieber, Megan Dupuis, Eric K. Singhi, Nishin A. Bhadkamkar

المصدر: Journal of Cancer Education

مصطلحات موضوعية: Medical education, Male, Attitude of Health Personnel, Pneumonia, Viral, education, Medical Oncology, Article, Education, Distance, Betacoronavirus, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, SAFER, Humans, Learning, Medicine, 030212 general & internal medicine, Session (computer science), Fellowships and Scholarships, Pandemics, Response rate (survey), SARS-CoV-2, business.industry, Social distance, Public Health, Environmental and Occupational Health, Attendance, COVID-19, Flexibility (personality), Hematology, Texas, Knowledge acquisition, Social relation, Oncology, Online learning, Education, Medical, Graduate, 030220 oncology & carcinogenesis, Medical trainees, Female, Coronavirus Infections, business

الوصف: In response to the COVID-19 social distancing guidelines, residency and fellowship programs transitioned to virtual instruction to deliver didactics and continue with medical education. The efficacy of such a fully online learning environment, however, remains unknown. To investigate its impact on medical education, this study surveyed hematology/oncology fellows at The University of Texas MD Anderson Cancer Center on their attitudes regarding the online-based lecture program. Fellows were emailed a 19-question survey with questions on demographics, ease of technical access to the online platform, level of comfort with participation, knowledge acquisition, wellness, and COVID-19-specific coverage. A free-text question soliciting ways to improve upon online learning was also included. The response rate was 71% (30/42). Most respondents reported easy/very easy accessibility to the online environment. Seventy-seven percent of the participants did not experience a technical issue. Seventy percent felt comfortable/very comfortable with participating in the conference. Thirty-seven percent felt comfortable/very comfortable with actively offering an answer to questions during the interactive board review session. Eighty-seven percent would have been more willing to offer an answer during the board review session if an anonymous poll format was utilized. Sixty-three percent felt they learned the same amount as they typically do during an in-person session. Thirty-three percent reported they were less focused as compared with an in-person session. One hundred percent of the participants had their questions answered, either at all times (87%) or sometimes (13%). Sixty percent experienced a change in social interactions as compared with an in-person session. Fifty-four percent reported that it was easy/very to balance online attendance despite personal/family commitments. One hundred percent appreciated the flexibility of the online learning environment. Ninety percent felt safer at home attending these lectures compared with receiving these lectures in-person during the COVID-19 pandemic. Overall, most fellows felt comfortable with the transition to a fully online learning environment. Strategies to encourage active participation, enhance social interaction, and provide additional flexibility are still needed. Electronic supplementary material The online version of this article (10.1007/s13187-020-01863-6) contains supplementary material, which is available to authorized users.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ff526c729f02a25ffa044f658b32a816Test
https://doi.org/10.1007/s13187-020-01863-6Test

المؤلفون: Ian Barak, Gavin Loitsch, Sascha A. Tuchman, Megan Dupuis, Zhiguo Li, Parker Mathews, Barry Paul, Yubin Kang, Daniel Feinberg

المصدر: JCO Oncol Pract

مصطلحات موضوعية: Treatment response, Pediatrics, medicine.medical_specialty, Oncology (nursing), business.industry, Health Policy, Point-of-care testing, MEDLINE, Retrospective cohort study, medicine.disease, ORIGINAL CONTRIBUTIONS, Cost of Illness, Oncology, Point-of-Care Testing, Chart review, Cost of illness, Humans, Medicine, Multiple Myeloma, business, Disease burden, Multiple myeloma, Retrospective Studies

الوصف: PURPOSE: We performed a retrospective chart review on 393 patients with multiple myeloma (MM) to determine the utility of the gamma gap (GG). METHODS: We calculated the difference between a patient’s total serum protein and albumin as a point-of-care test for assessing disease status in MM. RESULTS: GG is highly correlated with the level of M-spike, and the change in GG correlates with myeloma treatment response. In addition, fitted linear models were established that allow for the calculation of M-protein level from the GG within hours from blood draw. CONCLUSION: Our study has important implications in the care of MM, particularly in countries/areas with limited resources.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f8d7965cef7769ad6891dba9aeeb687dTest
https://doi.org/10.1200/jop.19.00517Test

المؤلفون: Gavin Loitsch, Megan Dupuis, Yue Zhao, Ian Barak, Endi Wang, Daniel Feinberg, Zhiguo Li, Barry Paul, Lindsay A.M. Rein, Parker Mathews, Yubin Kang

المصدر: Cancer Medicine, Vol 9, Iss 16, Pp 5869-5880 (2020)
Cancer Medicine

مصطلحات موضوعية: Male, 0301 basic medicine, Cancer Research, Biopsy, Disease, Gastroenterology, 0302 clinical medicine, Bone Marrow, Stage (cooking), Multiple myeloma, Original Research, Aged, 80 and over, progression free survival, Hematopoietic stem cell, Middle Aged, Prognosis, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Immunohistochemistry, Progression-Free Survival, multiple myeloma, Treatment Outcome, medicine.anatomical_structure, bone marrow fibrosis, Oncology, JAK2, 030220 oncology & carcinogenesis, Female, Megakaryocytes, Proteasome Inhibitors, Adult, medicine.medical_specialty, overall survival, lcsh:RC254-282, 03 medical and health sciences, Internal medicine, Confidence Intervals, medicine, Humans, Immunologic Factors, Radiology, Nuclear Medicine and imaging, Progression-free survival, Aged, Retrospective Studies, business.industry, Clinical Cancer Research, Janus Kinase 1, Janus Kinase 2, medicine.disease, 030104 developmental biology, Proteasome, Primary Myelofibrosis, immunohistochemical staining, Syndecan-1, Bone marrow, business, Follow-Up Studies

الوصف: We determined the impact of bone marrow fibrosis (BMF) on the clinical outcomes of newly diagnosed multiple myeloma (NDMM) patients in the current era of myeloma therapy. A total of 393 MM patients were included in the final analysis. The median followup was 83 months (range: 3.9 to 212 months). BMF was noted in 122 (48.2%) evaluable patients. Median progression free survival (PFS) in patients without BMF was 30.2 (95% CI: 24.7‐38.0) months, and 21.1 (95% CI: 18.8‐27.5) months in patients with BMF present (P = .024). Median overall survival (OS) was 61.2 (95% CI: 51.5‐81.2) months in patients without BMF, and 45.1 (95% CI: 38.7‐57.0) months in patients with BMF (P = .0048). A subset of 99 patients had their bone marrow biopsies stained for JAK1 and JAK2 by immunohistochemistry. Of these samples 67 (67.7%) patients had detectable JAK2 expression predominantly noted on bone marrow megakaryocytes. JAK2 expression correlated with myeloma disease stage (P = .0071). Our study represents the largest dataset to date examining the association of BMF with prognosis in the era of novel therapies and widespread use of hematopoietic stem cell transplant (HSCT). Our data suggest that MM patients with BMF (particularly those with extensive BMF) have a poorer prognosis even when treated with immunomodulatory agents and proteasome inhibitors.
We determined the impact of bone marrow fibrosis (BMF) on the clinical outcomes of newly diagnosed multiple myeloma patients in the current era of myeloma therapy. We found that BMF is common in myeloma and MM patients with BMF (particularly those with extensive BMF) have a poorer prognosis even when treated with immunomodulatory agents and proteasome inhibitors.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2d2fe2d0e7d442a72e1cc1a9afb2d360Test
https://doaj.org/article/61f7841b051f4ba48d649ace03521803Test

المؤلفون: Vivek Patel, Shakthi Bhaskar, Christopher G Cann, Jennifer Green, Sanjay Mohan, Katherine Jean Walsh, Megan Dupuis

المصدر: Journal of Clinical Oncology. 40:11027-11027

مصطلحات موضوعية: Cancer Research, Oncology

الوصف: 11027 Background: Journal club (JC) is an essential tool in hematology/oncology fellowship to develop critical appraisal skills. The traditional JC format of reviewing an article followed by group discussion may not provide optimal education in appraising literature. We applied a novel JC curriculum and measured impact on fellow comfort with trial design, statistics, and endpoint interpretation. Methods: A novel JC curriculum was implemented for hematology/oncology fellows at Vanderbilt in the 2021-2022 academic year. JC for the prior year utilized the traditional format. We developed five focused learning objectives (LO’s) for each JC and emphasized the goal was to not place the paper in clinical context but to focus on developing the foundational tools for critical appraisal skills. The sessions involved (1) 15 minute introductory lecture from a biostatistician to cover foundations of the LO’s; (2) group discussion led by an upper year fellow to describe the paper in the context of the LO’s; (3) question and answer session from the fellows to both the statistician and a clinical trial expert. We developed anonymous pre and post surveys to understand the impact of the novel JC curriculum on a 5-point Likert scale. Two sample unpaired t-test was used to compare mean differences. Results: A total of 15/22 fellows (68%) completed the pre-survey and 12/22 fellows (55%) completed the post survey. There was an even distribution of fellows by year in the pre survey and 33% first years, 41% second years, and 25% third years in the post survey. There was a statistically significant improvement in pre and post mean fellow comfort in understanding differences in trial types (2.9 vs. 4, p < 0.001), randomization strategy (2.6 vs. 4.25, p < 0.001), endpoints (3 vs. 4.1, p < 0.001), and interpretation of the statistical methodology of represented data (3 vs. 4.3, p < 0.001) on a 1-5 Likert scale (5 being entirely comfortable). In a subset analysis, we did a direct comparison of fellows who had previously participated in both JC formats (n = 9); the new format was rated as a more useful tool for learning data interpretation than prior with a mean of 4.8/5. When comparing fellow perception in the utility of traditional compared to the novel JC, there was a statistically significant mean improvement in utility of JC to prepare fellows to understand differences in trial types (1.9 vs. 4.1, p < 0.001), randomization strategy (1.4 vs. 4.5, p < 0.001), endpoints (2.7 vs. 4.5, p < 0.001), and interpretation of the statistical methodology of represented data (2.33 vs. 4.6, p < 0.001) favoring the novel JC. Conclusions: Fellows’ comfort with trial design and content significantly improved with our novel JC. To our knowledge, this is the first time such a curriculum has been used in hematology/oncology training. Our successfully piloted novel JC model can be adapted to other fellowships to improve foundational skills in the critical appraisal of clinical trials.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::e6d204c172dbda20db3c8994a789186cTest
https://doi.org/10.1200/jco.2022.40.16_suppl.11027Test

المؤلفون: Angshumoy Roy, Anthony P. Conley, Jacquelyn Reuther, Behrang Amini, J. Andrew Livingston, Wei-Lien Wang, Jeanne M. Meis, Yulei Shen, Christian Curcio, Laurence D. Rhines, Megan Dupuis, Kevin E. Fisher

المصدر: Clinical Sarcoma Research, Vol 10, Iss 1, Pp 1-7 (2020)
Clinical Sarcoma Research

مصطلحات موضوعية: 0301 basic medicine, Oncology, medicine.medical_specialty, medicine.medical_treatment, Case Report, Entrectinib, Malignancy, lcsh:RC254-282, Targeted therapy, 03 medical and health sciences, 0302 clinical medicine, Surgical oncology, Internal medicine, Biopsy, Medicine, medicine.diagnostic_test, business.industry, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Clinical trial, 030104 developmental biology, LPF-NT, 030220 oncology & carcinogenesis, Trk receptor, business, Lipofibromatosis, Lipofibromatosis-like neural tumors, NTRK

الوصف: Background Lipofibromatosis-like neural tumors (LPF-NT) are a newly identified class of rare mesenchymal neoplasms. Current standard of care therapy is surgical resection alone; there are no chemotherapies or molecular targeted therapies that have been shown to be effective in patients who are not surgical candidates due to either tumor bulk or location. Most LPF-NT harbor NTRK fusions, although the therapeutic significance of these fusions has not been previously demonstrated in this malignancy. Here, we present the first case of a patient with surgically-unresectable LPF-NT successfully treated with medical therapy, specifically the TRK fusion-protein inhibitor entrectinib. Case presentation The patient is a 21 year old man with no co-morbidities who presented for evaluation due to intermittent abdominal pain and was found to have a mass spanning from T12-L2. Biopsy revealed a mesenchymal spindle cell neoplasm and S100 positivity pointed to possible nerve sheath origin. The sample was ultimately found to have an LMNA-NTRK1 fusion, confirming the diagnosis of LP-NFT. Unfortunately, due to the bulk and location of the tumor, surgery was felt to be exceptionally morbid and the patient was treated in a clinical trial with the NTRK inhibitor entrectinib. Surprisingly, he had such a robust clinical response that he was ultimately deemed a surgical candidate and he was successfully taken to surgery. Post-operative pathology revealed > 95% necrosis, demonstrating exceptional sensitivity to the targeted therapy. The patient remains NED and on entrectinib 12 months post-operatively. Conclusions The exceptional treatment response of this patient suggests that NTRK fusions are true drivers of the disease. Thus, all patients should be evaluated for NTRK fusions using sensitive methodologies and treatment with TRK fusion-protein inhibitors should be considered in patients who are not candidates for oncologic resection.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fb61c5f5365ed50061b5580e10d958a7Test
https://doi.org/10.1186/s13569-020-00136-6Test