Tito R. Mendoza, Ph.D., MS, MEd from The University of Texas MD Anderson Cancer Center speaks about Associations between the gut microbiome and fatigue in cancer patients.

Links Mentioned in Question 1:
https://www.sciencedirect.com/science/article/pii/S0923753419357151

And
https://www.nejm.org/doi/full/10.1056/NEJMoa1003466

Link to Article:
https://www.nature.com/articles/s41598-021-84783-9/metrics

Access and Citations: Web of Science and CrossRef have citation counts. The counts may differ by service and are dependent on the data's availability. Counts will be updated on a regular basis once they become accessible.

Online Attention: Altmetric assigns a score to an article based on the amount of online attention it gets. Each particular type of online attention is represented by a different colored thread in the circle. The Altmetric score is the number in the middle. The primary sources for calculating the score are social media and conventional news media. Mendeley and other reference managers are tracked, but they do not factor into the ranking. Since older papers have had more opportunities to gain publicity, they also earn higher ratings. Altmetric has taken this into account by using background data from other publications of a similar era.

Lisa McKenzie, Founder, and Executive Producer, You Night Empowering Events speaks about being This Years Astellas Oncology C3 Prize - Innovation Prize Winner.

The Astellas Oncology C³ Prize, launched in 2016, is a global challenge that aims to address the complexities of the cancer journey by funding the best ideas in cancer care beyond medicine. The C³ Prize sparks innovative developments in cancer care, tackling cancer challenges by awarding the winners with grants and connecting them with resources and support.

Link to Astellas C3 Prize:
http://www.c3prize.com/

Link to You Night:
https://www.younightevents.com/

Idea: A narrative therapy storytelling course that helps cancer patients express their life journeys, find inner strength, and inspire those who are coping with the disease.

You Night Inspiring Activities encourages women to accept life after cancer, understanding that mental and emotional wellbeing is an often-overlooked yet critical aspect of cancer care. The Story Crafting E-Course is designed to put cancer survivors together virtually to share their experiences, find inner strength, and inspire others. They feel that simply by articulating their experience so that everyone can appreciate it, people living with cancer can have their lives changed for the better.

You Night Empowering Events' Founder and Executive Producer is Lisa McKenzie. She believes in the power of stories and encourages people to remember that they are more than their cancer diagnosis.

Allison W. Kurian, MD, MSc from Stanford University California speaks about Genetic Testing for Breast and Ovarian Cancer: What Has Changed and What Still Needs To Change?

Link to Article:
https://www.medscape.com/viewarticle/947040

A major retrospective review illustrates how germline genetic testing in women with breast or ovarian cancer has progressed over time, as well as a way forward for testing these patients.

Researchers discovered racial and ethnic differences in genetic testing, as well as "persistent underuse" of testing in ovarian cancer patients.

The researchers also discovered that the majority of pathogenic variant (PV) findings came from 20 genes linked to breast and/or ovarian cancer, while testing other genes mostly showed variants of unknown significance (VUS).

The results were published in the Journal of Clinical Oncology by Allison W. Kurian, MD, of Stanford (Calif.) University and colleagues.

Genetic testing has become more accessible to clinicians for patient management and cancer prevention as sequencing technology has improved, competition among commercial purveyors has increased, and costs have decreased (JAMA. 2015 Sep 8;314[10]:997-8). While germline testing can help direct treatment for a variety of solid tumors, little research has been done about how often and how well it is used in practice.

Kurian and colleagues conducted a population-based evaluation of cancer risk testing using a SEER Genetic Testing Linkage Demonstration Project. From 2013 to 2017, the researchers looked at 7-year trends in testing for all women diagnosed with breast or ovarian cancer in Georgia or California, looking at testing patterns and outcome perception from 2012 to 2019.

The investigators made the following hypotheses before analyzing the data:

Multigene panels (MGP) will fully replace BRCA1/2 testing.

Over time, testing underutilization of ovarian cancer patients will increase.

More patients will be screened for PVs at lower pre-test risk levels.

* There will be no sociodemographic variations in research patterns.

* PV and VUS detection will improve.

* Racial and ethnic inequalities in VUS rates will be reduced.

Conduct of the Research

The researchers looked at genetic tests conducted at major commercial laboratories from 2012 to the beginning of 2019 and compared them to data from the SEER registries in Georgia and California on all breast and ovarian cancer patients diagnosed between 2013 and 2017. There were just a few exclusionary conditions.

The American College of Medical Genetics classified the findings of genetic testing as defining a PV or probable PV, VUS, or benign or likely benign mutation. The most recent procedure was used when a patient had genetic testing on more than one occasion.

If a PV was found, the types of PVs were classified into the following groups based on the degree of evidence supporting pathogenicity:

* Mutations in BRCA1 or BRCA2.

* PVs in other genes linked to breast or ovarian cancer, according to the National Comprehensive Cancer Network (e.g., ATM, BARD1, BRIP1, CDH1, CHEK2, EPCAM, MLH1, MSH2, MSH6, NBN, NF1, PALB2, MS2, PTEN, RAD51C, RAD51D, STK11, and TP53).

* PVs of other genes that can be acted upon (e.g., APC, BMPR1A, MEN1, MUTYH, NF2, RB1, RET, SDHAF2, SDHB, SDHC, SDHD, SMAD4, TSC1, TSC2, and VHL).

* Some other genes that have been studied.

Douglas Johnson, MD, MSCI, associate professor of Medicine at Vanderbilt University Medical Center and clinical director of Melanoma at Vanderbilt-Ingram Cancer Center speaks about Forty-three Percent Of Melanoma Patients Have Chronic Complications From Immunotherapies.

Link to Article:
https://news.vumc.org/2021/03/25/forty-three-percent-of-melanoma-patients-have-chronic-complications-from-immunotherapies/

According to a report published March 25 in JAMA Oncology, chronic side effects among melanoma survivors treated with anti-PD-1 immunotherapies are more frequent than previously thought.

Chronic complications, which affected 43% of patients, mainly affected the joints and endocrine system, with salivary glands, lungs, peripheral nerves, and other organs coming in second and third. Just 14% of cases were resolved at the last follow-up, indicating that these problems could last a long time. This result contrasted with prior records of immunotherapy-related acute complications affecting visceral organs such as the liver, colon, lungs, and kidneys, all of which were successfully treated with steroids. The vast majority of chronic complications, on the other hand, were not serious or life-threatening.

“Chronic and long-lasting side effects were more common than we expected and involved a variety of often overlooked organs like the thyroid, salivary glands, and joints,” said the study’s senior author, Douglas Johnson, MD, MSCI, associate professor of Medicine at Vanderbilt University Medical Center and clinical director of Melanoma at Vanderbilt-Ingram Cancer Center.

Between 2015 and 2020, researchers looked at the frequency and range of chronic immune-related adverse effects in melanoma patients treated with adjuvant anti-PD-1 immunotherapies (pembrolizumab or nivolumab) at eight academic medical centers. Chronic side effects were described as those that lasted for at least 12 weeks after the immunotherapy treatment had finished. The research is the first to look at anti-PD-1-related chronic complications in patients with resected high-risk melanoma.

The majority (96 percent) of chronic complications were grade 1 or 2 cases with no or minor symptoms. Adrenal insufficiency, arthritis, dermatitis, and thyroiditis were among the most common side effects.

Rare and acute immune-related adverse effects, such as cardiovascular complications, that arise early in the course of immunotherapy care may be more severe. Johnson and his Vanderbilt-Ingram colleagues were the first to record unusual but fatal cardiac side effects from immunotherapies in 2016.

“While these side effects are important to monitor and treat, anti-PD-1 therapies remain life-saving for many patients with melanoma,” Johnson said.

The study’s lead author is J. Randall Patrinely, Jr., BA. Other contributing authors from Vanderbilt included Fei Ye, Ph.D.; Ran Fan, Ph.D., and Elizabeth Davis, MD.

Santhosh Upadhyaya, MD, Pediatric Hematologist from St. Jude Children's Research Hospital speaks about ATRT molecular groups: looking at the biology from the clinic.

Link to Article:
https://www.stjude.org/media-resources/news-releases/2021-medicine-science-news/atrt-molecular-groups-looking-at-the-biology-from-the-clinic.html

Atypical teratoid rhabdoid tumor (ATRT) is a rare form of brain tumor that often affects children. Scientists at St. Jude Children's Research Hospital studied the molecular groups of ATRT and correlated them with clinical results using evidence from two clinical trials. Clinical Cancer Research, a publication of the American Association for Cancer Research, published a paper outlining the findings today.

“If you look at the biology of ATRT, we have learned in the last few years that this is not a single disease but instead there are at least three biologically different groups of the same disease,” said first and corresponding author Santhosh Upadhyaya, M.D., St. Jude Department of Oncology. “But what are the outcomes for these different groups? That is where the current St. Jude study offers insight into how these different groups of ATRT can present, and what their outcomes may be with different treatment regimens.”

ATRT has been categorized into three molecular groups: ATRT-MYC, ATRT-SHH, and ATRT-TYR. Researchers examined the treatment results of 74 children with ATRT using data from the SJYC07 and SJMB03 clinical trials. Since ATRT is a rare pediatric cancer, this is one of the largest populations of children with the disease.

ATRT-TYR is more common in children under the age of three and is less likely to spread, according to the results. They also discovered that ATRT-SHH is more prevalent in very young children and has a higher risk of metastasis at the time of diagnosis. Furthermore, while ATRT-TYR children had the best overall response, ATRT-SHH and ATRT-MYC children had similar treatment responses in the absence of metastases.

The researchers also looked at the SMARCB1 gene in the blood, which is a common ATRT genetic mutation. The researchers found that about a third of the children examined had a SMARCB1 gene mutation. These children are more likely to have the ATRT-SHH community and grow ATRT at a younger age. The researchers discovered that having this abnormality had little effect on the results of treatment.

“While we have clearly made giant strides in understanding the molecular basis of ATRT, substantial progress is still required before treatment decisions can be made on the basis of different molecular groups,” Upadhyaya said.

Russell Langan, M.D., Chief of Surgical Oncology and Hepatopancreatobiliary Surgery at Saint Barnabas Medical Center, an RWJBarnabas Health facility, and Surgical Oncologist at Rutgers Cancer Institute of New Jersey speaks about RWJBarnabas Health Pioneers Innovative Pancreatic Cyst Surveillance Program.

Link to Article:
https://www.prnewswire.com/news-releases/rwjbarnabas-health-pioneers-innovative-pancreatic-cyst-surveillance-program-301245061.html

In order to classify, track, follow, and monitor patients with pancreatic cysts, Saint Barnabas Medical Center (SBMC), an RWJBarnabas Health facility, developed one of the first cloud-based data management systems in the world. SBMC's Pancreatic Cyst Surveillance Program, which has a specific collaboration with Eon, a healthcare technology company, detects patients when incidental scans, such as an MRI, CT scan, or ultrasound, identify pancreatic cysts, and at-risk individuals are then notified via a nurse navigator for possible follow-up. The software has reported 136 patients so far.

Traditional surveillance systems rely on an antiquated system of manual data entry and monitoring that isn't designed to respond to patient needs in a timely and consistent manner. This new cloud-based software alerts high-risk individuals instantly, ensuring timely and informed treatment. Furthermore, the platform feeds a cyst's unique characteristics, such as its size, pancreatic duct dilation, and nodularity, into an algorithm that tells doctors objectively whether the cyst is at risk of malignancy over time. When a patient chooses to participate in the program, a nurse navigator may help them schedule the appropriate screenings, treatments, or surgery.

"I believe this technology-based approach will forever change the way we monitor and treat patients with pancreatic cysts and tumors, and SBMC is excited to be at the forefront of the next breakthrough in the management of pancreatic care," said Russell Langan, M.D., Chief of Surgical Oncology and Hepatopancreatobiliary Surgery at SBMC and Surgical Oncologist at Rutgers Cancer Institute of New Jersey, the state's only National Cancer Institute-designated Comprehensive Cancer Center. "Because pancreatic surgery carries morbidity and a potential mortality rate, we want to ensure patients aren't undergoing unnecessary surgery, however, when a pancreatic cyst does require surgery, we want to operate at the most opportune time."

Following the discovery of a pancreatic cyst, a multidisciplinary team of physicians, medical oncologists, radiation oncologists, gastroenterologists, radiologists, pathologists, and geneticists reviews each patient's case on a weekly basis to assess the best course of care. Since the majority of pancreatic cysts are precancerous, it's important that the whole team considers the risks of surgical intervention versus ongoing surveillance or another course of action. Approximately 90% of cysts may not need surgery, with certain patients needing only extra screening and/or endoscopy with a fluid biopsy. However, about 10% of pancreatic cysts necessitate more drastic treatment.

"This is preventative medicine at its best for pancreatic care in general. By capturing patients who have a risk of developing pancreatic cancer in their lifetime, we can monitor these patients and determine whether medical intervention is necessary," said Dr. Langan. "Through our unique multidisciplinary approach and partnership with Rutgers Cancer Institute of New Jersey, we are able to assess patients on a case-by-case basis to ensure we're delivering the highest quality of care."

Jennifer C. King, Ph.D. CFO of the GO2 Foundation speaks about GO2 Foundation Leads Study to Improve Participation of Black Communities in Lung Cancer Clinical Trials.

Link to Article:
https://www.interventionaloncology360.com/content/go2-foundation-leads-study-improve-participation-black-communities-lung-cancer-clinical


The GO2 Foundation for Lung Cancer (GO2 Foundation) has announced its participation in the launch of a major multi-institutional study to see how to increase Black community participation in lung cancer clinical trials.

Although total cancer patient participation in clinical trials in the United States is extremely low, at around 8%1, it is even lower among racial and ethnic minority groups. Just about 6% of patients who participate in clinical trials are Black, 3% are Asian American, and 2% are Hispanic2.

Studying Trial Determinants of Success (STRIDES) is a collaboration between Vanderbilt University Medical Center, the University of Alabama at Birmingham, and Georgia Cancer Center at Augusta University, and is sponsored by Genentech and Bristol Myers Squibb grants to the GO2 Foundation.

"Because of the lack of diversity in lung cancer clinical trials, it can be difficult to fully understand new ways of treating cancer across all patients," Laurie Fenton Ambrose, co-founder, president, and CEO of GO2 Foundation said. "STRIDES will help us address the ongoing healthcare disparities that have kept patients in racial and ethnic groups out of the process of developing new treatments and allow us to work toward better outcomes."

STRIDES will concentrate on gaining a greater understanding of the obstacles to Black patients in Alabama, Tennessee, and Georgia participating in clinical trials. To begin, the project will survey and interview a variety of people involved in the clinical trial process, including patients, research personnel, and physicians, to determine what factors lead to Black patients' lower involvement in clinical trials in these areas. The project's second phase will use the lessons learned to select and pilot various evidence-based programs to improve Black patients' participation in clinical trials.

Lung cancer is 30 percent more prevalent in Black men than in white men, and Black men and women are more likely than any other ethnic group to develop and die from lung cancer. Although Black women's lung cancer rates are approximately equal to white women's, they smoke less cigarettes.

"Because the Black community is disproportionately impacted by lung cancer, it is ever more imperative that we understand how best to effectively treat their cancer, and increasing their participation in clinical trials will be critical to that effort," Ambrose said.

The STRIDES study was designed and implemented in collaboration with a number of researchers and institutions. The research team is made up of investigators from all four universities, and the institutional partners are providing essential services and facilities at their respective institutions.

STRIDES is important in recognizing obstacles to clinical trial participation and how increasing participation can lead to improved results for lung cancer patients, according to the research partners:

"The power of this four-way partnership among GO2 Foundation, Vanderbilt University Medical Center, the University of Alabama at Birmingham, and Georgia Cancer Center at Augusta University is unique. It brings the patient-facing expertise of GO2 Foundation together with a multi-disciplinary team of leading researchers in medical oncology, community engagement, and health disparities," said Christine M. Lovly, MD, Ph.D., associate professor of Medicine, Ingram Associate Professor of Cancer Research, co-leader of the Translational Research and Interventional Oncology Research Program at Vanderbilt University Medical Center and chair of GO2 Foundation's Scientific Leadership Board. "The STRIDES partnership also enables access to three distinct catchment areas in the South with diverse populations, which will allow us to identify strategies both common between and unique to the individual communities."

"Diverse representation in clinical trials is essential to find treatments that are effective for all populations – including people from various racial, ethnic, and geographic backgrounds," said Monica L. Baskin, Ph.D., associate director for outreach and engagement, O'Neal Comprehensive Cancer Center, the University of Alabama at Birmingham. "Good representation in trials also allows researchers to better understand patterns of difference in health and sickness based on backgrounds and behaviors that may provide more effective treatment and/or prevention. "

"Inclusion of a diverse population of patients in clinical trials will ensure access to novel therapies that may likely be among the newly approved therapies," said Nagla Abdel Karim, MD, professor, medical director, Georgia Cancer Center Clinical Trials Program, Augusta University. "In addition, when treating the diverse patient population with the standard of care options, the knowledge of efficacy and toxicity will not be complete, unless there was the adequate contribution of everyone within those studies."

To learn more about STRIDES visit https://go2foundation.org/research/our-research-studies/strides/.