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De Souza-Lima, Josivaldo, Frano Giakoni-Ramírez, Catalina Muñoz-Strale, et al. "Analysis of speeds in the 400-meter hurdles and gender differences." Journal of Human Sport and Exercise 20, no. 2 (2025): 435–45. https://doi.org/10.55860/fptent35.
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Background/objectives. This study aims to analyse the speed differences between men and women in the 400 meters during the Paris 2024 Olympic Games. Average speeds in each segment of the race were evaluated, highlighting gender variations and performance across the different rounds of the competition. Methods. A descriptive observational study was conducted using data from 208 athletes (50% women). Average speeds per 50-meter segments were analysed across all rounds (heats, semifinals, and final), applying Student's t-tests to compare results between genders. The significance level was set at p < .05. Results. The average speeds showed significant differences between sexes in all segments of the race (p < .05). The largest difference was observed in the first 150 meters, where men outpaced women by a margin of 0.97 km/h. By 250 meters, the difference decreased to 0.43 km/h. In the final rounds, the winners reached maximum speeds of 36.87 km/h (men) and 32.48 km/h (women). Conclusion. Men exhibit a biomechanical advantage in the race's early stages, while both sexes strategically adjust their pacing in the final rounds. These findings suggest that gender differences in performance are linked to both physiological and biomechanical factors.
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Hou, Xiaoyan, and Kongmei Dong. "Cultivation of Subconsciousness and Its Training Effect in Physical Education Teaching and Training." Wireless Communications and Mobile Computing 2022 (February 11, 2022): 1–12. http://dx.doi.org/10.1155/2022/1263423.
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The detection and tracking technology of moving human body is a hot and difficult point in the research of computer vision technology. Most of the current human body tracking systems use PC as the basic framework, through the calculation and analysis of the video data obtained by the camera. Subconscious is the consciousness that exists in our mind, but we do not realize it. It can stimulate the potential of athletes through the cultivation of subconsciousness, so that athletes can achieve better results. The main purpose of this paper is to explore the training and training effect of subconsciousness in physical education teaching and training. This paper mainly introduces the overview of subconsciousness, the characteristics of subconsciousness, and the cultivation of subconsciousness in physical education training. In this paper, from the track and field major of our school, we selected 48 people whose physical fitness is basically the same, and the results of 400-meter and 800-meter races are similar. The 48 people were randomly divided into four groups: control group 1, control group 2, subconscious group 1, and subconscious group 2. Control group 1 and control group 2 were given traditional physical education for 3 months, while subconscious group 1 and subconscious group 2 were given auditory stimulation for 3 months. Three months later, the physical fitness test, 400-meter race results, and 800-meter race results of the two groups of students were compared and analyzed. The experimental results show that, after three months of physical education training, the results of B1 group and B2 group in 400 m race were 52.35 s and 51.98 s, respectively. The results of group B1 and group B2 were 1.6 s and 1.8 s faster than those of group A1 and group A2 in the 400 m race, and the scores were increased by 3.1% and 3.4%, respectively. The average scores of physical fitness test of the subconscious group and the control group were 79.39 and 69.85, respectively. The average score of the physical fitness test of the subconscious group was 9.5 points higher than that of the control group, and the score was increased by 9.54%. It is proved that the cultivation of subconsciousness in physical education teaching and training can stimulate students’ interest in sports teaching and training and stimulate students’ sports potential, so as to improve the effect of students’ sports teaching and training.
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Miftakhudin, Heru Heru, Abdul Sukur, and Fajar Vidya Hartono. "Change Of Direction (Cod) Turning Renang 1500 Meter Gaya Bebas." Jurnal Ilmiah Sport Coaching and Education 7, no. 2 (2023): 84–89. http://dx.doi.org/10.21009/jsce.07211.
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ABSTRAK
 Penelitian ini bertujuan untuk memberikan gambaran mendalam tentang perubahan arah (change of direction atau CoD) yang terjadi saat melakukan teknik turning dalam olahraga renang 1500 meter gaya bebas oleh para atlet renang pelajar. Metode penelitian yang digunakan adalah pendekatan deskriptif dengan analisis kuantitatif untuk menggambarkan fenomena perpindahan arah yang terjadi selama perlombaan renang 1500 meter.Populasi dalam penelitian ini adalah delapan atlet pelajar yang merupakan anggota pusat pelatihan olahraga di DKI Jakarta. Untuk mengumpulkan data, dilakukan total sampling terhadap seluruh populasi yang ada. Hasil penelitian menunjukkan bahwa dalam perlombaan renang 1500 meter gaya bebas, terdapat total 29 kali perubahan arah atau CoD yang dilakukan oleh para atlet.Perubahan arah ini terjadi pada jarak-jarak tertentu, yaitu pada 50 meter, 100 meter, 150 meter, 200 meter, 250 meter, 300 meter, 350 meter, 400 meter, 450 meter, 500 meter, 550 meter, 600 meter, 650 meter, 700 meter, 750 meter, 800 meter, 850 meter, 900 meter, 950 meter, 1000 meter, 1050 meter, 1100 meter, 1150 meter, 1200 meter, 1250 meter, 1300 meter, 1350 meter, 1400 meter, dan 1450 meter dari awal perlombaan. Total waktu yang dibutuhkan oleh para atlet untuk menyelesaikan seluruh perlombaan adalah sekitar 103.90 detik, yang setara dengan 1 menit 43 detik dan 90 milidetik (01’43”90).Selain itu, waktu yang dihabiskan dalam setiap perubahan arah atau CoD juga dianalisis. Hasilnya menunjukkan bahwa rata-rata waktu yang dibutuhkan oleh atlet dalam setiap perubahan arah adalah sekitar 3.23 detik, dengan nilai minimum sekitar 3.11 detik dan nilai maksimum sekitar 3.52 detik.Kesimpulannya, penelitian ini mengungkapkan bahwa dalam perlombaan renang 1500 meter gaya bebas, terdapat total 29 kali perubahan arah dengan total waktu 103.90 detik, atau setara dengan 01’43”90 menit, dan waktu rata-rata dalam setiap perubahan arah adalah sekitar 3.23 detik. Informasi ini dapat menjadi acuan penting bagi para pelatih dan atlet untuk meningkatkan efisiensi dalam perubahan arah selama perlombaan renang 1500 meter.
 Kata kunci: Renang,Gaya Bebas,Turning
 ABSTRACT
 This research aims to provide an in-depth description of the change of direction (CoD) that occurs when performing turning techniques in 1500-meter freestyle swimming student swimming athletes. The research method used is a descriptive approach with quantitative analysis to describe the phenomenon of direction changes that occur during the 1500-meter swimming competition. The population in this study were eight student-athletes who were members of the sports training center in DKI Jakarta. To collect data, total sampling was carried out on the entire population. The results of the research show that in the 1500-meter freestyle swimming competition, there were a total of 29 changes in direction or CoD made by the athletes. These changes in direction occurred at certain distances, namely at 50 meters, 100 meters, 150 meters, 200 meters, 250 meters, 300 meters, 350 meters, 400 meters, 450 meters, 500 meters, 550 meters, 600 meters, 650 meters, 700 meters, 750 meters, 800 meters, 850 meters, 900 meters, 950 meters, 1000 meters, 1050 meters, 1100 meters, 1150 meters, 1200 meters, 1250 meters, 1300 meters, 1350 meters, 1400 meters and 1450 meters from the start of the race. The total time required by the athletes to complete the entire race was approximately 103.90 seconds, which is equivalent to 1 minute 43 seconds and 90 milliseconds (01’43”90). In addition, the time spent in each change of direction or CoD was also analyzed. The results show that the average time required by athletes for each change of direction is around 3.23 seconds, with a minimum value of around 3.11 seconds and a maximum value of around 3.52 seconds. In conclusion, this research reveals that in the 1500 meter freestyle swimming competition, there are a total of 29 times changing direction with a total time of 103.90 seconds or the equivalent of 01'43”90 minutes, and the average time for each change of direction is around 3.23 seconds. This information can be an important reference for coaches and athletes to improve efficiency in changing direction during a 1500-meter swimming race.
 Keywords: Swimming, Freestyle,Turning
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Abdulhassan, Zahaa, and Intisar Hameed. "The Effect of Special Speed Exercises on The Variables of The First Arc of 400-Meter Hurdles Race Under 20 Years of Age." Journal of Physical Education 36, no. 3 (2024): 869–79. https://doi.org/10.37359/jope.v36(3)2024.2033.
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The research aims to prepare special speed exercises in the variables of the first arc of running the 400 m hurdles under 20 years of age and to identify the effect of special speed exercises in the variables of the first arc of running the 400 m hurdles under 20 years of age. To achieve the goal, the researchers used the experimental method by designing one group with two pre-and post-tests to suit the research problem. The research community included elite runners in the youth 400 m hurdles event for the year (2021-2023) and those with similar levels, numbering (8) athletes, who are of a community of origin. The sample was chosen intentionally and consisted of (6) players, representing 75% of the original population. After the tests and variables to be studied were determined, the researchers conducted the exploratory experiment as well as the pre-test, and then the exercises were applied during the training units. After completing the training units, the researchers conducted the post-test on the sample, and the researchers used the statistical package (Spss) (arithmetic mean, Standard deviation, paired samples t-test. The researchers concluded that special speed exercises contributed to increasing the rate of explosive power, as well as having a positive effect on the variables related to the first arc investigated, and that relying on the use of more specialized. exercises by mechanical principles and laws contributes to improving the level of the runner in terms of abilities and indicators related to effectiveness. As well as that training the athlete according to the centrifugal principle had a positive impact in standardizing the training intensity for 400m/hurdles event runners, The researchers recommend the need for trainers to rely on regulating training intensity according to mechanical indicators and laws that are specific to effectiveness, and the need to pay attention to the mechanical aspects that constitute a factor influencing the success of the event, in addition to paying attention to special speed training because it effectively affects the variables of the first arc and achieving 400-meter hurdles event
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Bani Adam, Farid, Ika Nilawati, Aristiyanto Aristiyanto, and Nur Amin. "PANJANG TUNGKAI BERHUBUNGAN DENGAN KECEPATAN BERLARI SPRINT 60 METER SISWA KELAS V - VI di SDN KEBONAGUNG 01." Sports Collaboration Journal 1, no. 2 (2023): 54–57. http://dx.doi.org/10.35473/scj.v1i2.2768.
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Short distance sprinting is a race where athletes use full speed over distances of 60 meters, 80 meters, 100 meters, 200 meters and 400 meters. A runner must know the basics of sprinting techniques so that the runner can get maximum results. The aim of this research was to determine the relationship between leg length and 60 meter sprint running speed for students in classes V-VI at SDN Kebonagung 01. This research used a survey method with a total sampling technique of 20 students. The data collected for the leg length variable used a meter, sprint speed used a stopwatch and a meter. Data analysis used the Spearman's Test correlation test. The results of this research included the 60 meter sprint for class V-VI students at SDN Kebonagung 01, which resulted in the speed of 14 students in the men's category (70%), the speed of the women's category in 6 students (30%). Based on the correlation test, the results showed that there was a relationship between leg length and running with a p-value of 0.02. The conclusion of this research is that there is a relationship between leg length and running in students at SDN class V-VI Kebonagung 01. ABSTRAK Lari sprint jarak pendek adalah suatu perlombaan dengan atlet yang menggunakan kecepataan penuh dengan jarak 60 meter, 80 meter, 100 meter, 200 meter, dan 400 meter. Seorang pelari wajib pengetahui dasar-dasar teknik lari sprint supaya pelari tersebut mendepatkan hasil yang maksimal. Tujuan dalam penelitian ini adalah untuk mengatahui hubungan panjang tungkai dengan kecepatan lari sprint 60 meter siswa kelas V-VI SDN Kebonagung 01. Penelitian ini menggunakan metode survei dengan teknik total sampling pada 20 siswa. Pengambilan data yang digunakan pada variabel panjang tungkai menggunakan meteran, kecepatan lari sprint menggunakan stopwatch dan meteran. Analisis data menggunakan uji korelasi Spearman’s Test. Haisl Penelitian ini antara lain lari sprint 60 meter siswa kelas V–VI SDN Kebonagung 01 mendapatkan hasil kecepatan kategori Putra 14 siswa (70%), kecepatan kategori Putri 6 siswi (30%). Berdasarkan uji korelasi didapatkan hasil bahwa terdapat hubungan antara panjang tungkai dengang berlari dengan nilai p-value 0.02. Kesimpulan dari penelitian ini adalah terdapat hubungan antara panjng tungkai dan berlari siswa SDN kelas V-VI Kebonagung 01
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Ali Nouri Ali. "The Effect of Psychological Program of some Relaxation Exercises and Mental Visualization on the Achievement of Player Runners (400)." Mustansiriyah Journal of Sports Science 3, no. 3 (2024): 32–44. http://dx.doi.org/10.62540/mjss.2021.03.03.03.
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In view of scientific progress in all fields around the world, including the sports field, as numbers and levels have developed in all sports, including athletics, which had the largest share of distinctive numbers, especially short jogging activities, and this development comes through the use of many training methods and linking training with many sciences Different sports Including psychology, the research problem came through the suffering of many of the 400-meter-long runners free from psychological unpreparedness before participating in the competition, which negatively affects their level of achievement in the race and the main research goal came in preparing some relaxation exercises and mental visualization that relieves competition pressure and reduces anxiety The race is before participating, which helps to improve achievement. As the curriculum consisted of a set of psychological exercises for mental and muscular relaxation and mental visualization, which helps to eliminate competition anxiety from athletes, making the athlete psychologically prepared before participating in the competition. As the researcher concluded the importance of these exercises in developing many psychological skills of the athlete, including the ability to face anxiety and build an integrated mental perception, which helps in the optimal performance within the race. Accordingly, the researcher recommended the importance of introducing psychological programs such as relaxation and mental visualization with the training process.
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Biswas, Pradyut Kumar, Muntadher Mohammed Ali, Humam Fadhil kurdi, and Hasan Hadi Muhi. "The effect of metabolic conditioning (MetCon) and crossfit training on certain physical abilities and performance in the 400-meter freestyle race." International Journal of Yogic, Human Movement and Sports Sciences 10, no. 1 (2025): 402–9. https://doi.org/10.22271/yogic.2025.v10.i1f.1752.
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السعودي, ا. م. د. نجلاء محمد, та ا. م. د. احمد محمد دراج. "الخصائص الزمنية لخطوة الحاجز في سباق 400 متر حواجز للرجال " دراسة حالة" Time characteristics of the hurdle step in the men’s 400-meter hurdles race “ a case study”". المجلة العلمية لعلوم الرياضة 13, № 1 (2024): 84–101. http://dx.doi.org/10.21608/mkod.2024.268821.1404.
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Yuan, Yaqun, Zhehui Luo, Chenxi Li, Eleanor Simonsick, Eric Shiroma, and Honglei Chen. "Olfaction and Physical Function in Older Adults: Findings From Health ABC." Innovation in Aging 4, Supplement_1 (2020): 530–31. http://dx.doi.org/10.1093/geroni/igaa057.1710.
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Abstract The present study aims to investigate poor olfaction in relation to physical functioning in community-dwelling older adults and potential sex and race disparities. The analysis included 2511 participants aged 71-82 years (51.7% women and 38.4% blacks) from the Health Aging, and Body Composition (Health ABC) study. Olfaction was tested with the 12-item Brief Smell Identification Test (BSIT). Physical function measures included the Short Physical Performance Battery (SPPB), the Health ABC Physical Performance Battery (HABCPPB), gait speed of 20-meter walk, fast 400-meter walking time, grip strength, and knee extensor strength, repeatedly assessed annually or biennially for a follow-up of seven years. We analyzed each of these physical function measures using mixed models, adjusting for demographics, lifestyle, and comorbidities. For all measures except grip and knee extensor strength, poor olfaction was clearly associated with poorer physical performance at baseline and a faster decline over time. For example, at baseline, the multivariate adjusted SPPB was 8.23 ± 0.09 for participants with poor olfaction and 8.55 ± 0.09 for those with good olfaction (P = 0.02), after seven years of follow-up, the corresponding scores decreased to 6.46 ± 0.12 and 7.36 ± 0.10 respectively (cross-sectional P&lt;0.001, and P for olfaction-by-year interaction &lt; 0.001). For grip and knee extensor strength, similar differences were suggested but didn’t reach statistical significance. The overall results were similar by sex and race. In summary, poor olfaction is clearly associated with faster decline in physical functioning in older adults and future studies should investigate its potential health implications.
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Brown, Joshua, Reiko Sato, and John Morley. "1469. Effect of pneumonia and pneumonia hospitalization episodes on mobility in older adults: results from the Lifestyle Interventions and Independence for Elders (LIFE) Study." Open Forum Infectious Diseases 7, Supplement_1 (2020): S736. http://dx.doi.org/10.1093/ofid/ofaa439.1650.
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Abstract Background Mobility is a cornerstone of healthy aging. Pneumonia may impact mobility through damage to physiological systems as well as increased inflammation, which has been associated with reduced physical functioning. The objective of this study was to assess the impact of pneumonia on objectively measured physical functioning in a sample of older adults. Methods This was a post-hoc analysis of the Lifestyle Interventions and Independence for Elders (LIFE) Study provided by the National Institute on Aging’s AgingResearchBiobank. Participants with pre-existing mobility concerns aged 70-89 years were randomized to physical activity or health education interventions. Outcomes included the ability to complete a 400-meter walk and gait speed (meters/second, m/s) and were assessed every 6 months from baseline up to 42 months. New health events were assessed at each visit including overall pneumonia events and pneumonia hospitalizations. Repeated measures regression models evaluated the ability to walk 400-meters and gait speed as separate outcomes controlling for age, sex, race, education, past medical history, the occurrence of other health events, and a cumulative deficit frailty index. Results There were 1,635 LIFE Study participants with N=9,872 follow-up measures during the study period. Among these, 174 (10.6%) had a pneumonia event which included 96 hospitalization events. Those with pneumonia events during follow-up were mostly similar to those without pneumonia events at baseline, except for higher prevalence of past hospitalizations and respiratory problems. Any pneumonia event was associated with an adjusted mean gait speed of 0.67 (0.63-0.71) m/s vs. 0.70 (0.66-0.73) m/s in those without pneumonia and 0.60 (0.55-0.64) in those with pneumonia hospitalization. Similarly, pneumonia events were associated with 84% [odds ratio = 1.84 (1.45-2.23)] and pneumonia hospitalizations with 200% [odds ratio = 3.00 (2.48-3.52)] increases in the odds of not being able to walk 400-meters compared to those without pneumonia events. Conclusion Pneumonia-related health events were associated with subsequent reduced mobility measured by 400-meter walk tests and gait speed. Preventing pneumonia may be an important component of maintaining physical functioning in older adults. Disclosures Joshua Brown, PharmD, PhD, Pfizer, Inc (Consultant, Grant/Research Support) Reiko Sato, PhD, Pfizer, Inc (Employee, Shareholder) John Morley, MD, Pfizer, Inc (Consultant)
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Rooks, Ronica, Mirza Ishrat Noor, and Elizabeth Vasquez. "RACE, PRODUCTIVE ACTIVITIES, AND COGNITIVE FUNCTIONING IN THE HEALTH ABC STUDY." Innovation in Aging 8, Supplement_1 (2024): 1154. https://doi.org/10.1093/geroni/igae098.3699.
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Abstract Productive activities (working and volunteering) promote older adults’ purpose in life, physical activity, and social support and may improve cognitive functioning. We hypothesized older adults working or volunteering will have higher cognition, and each productive activity will attenuate the relationship between race and cognition. We used the Health ABC study, a cohort of community-dwelling, well-functioning Black (48.4%) and White (51.6%) older adults aged 70-79 in year 1 (n=2,996). Our linear mixed-effects models included race, working or volunteering, gender, age, education, smoking, the 400-meter walk, diabetes, and racial interactions with each productive activity in year 1 and the Teng 3MS in year 11. In our working model, working and its racial interaction were not significant. Older Black vs. White adults scored -4.4 points lower; women, a high school degree or some post-secondary education, and former vs. never smokers related to higher; and each additional year of age and diabetes related to lower 3MS scores. In our volunteering model, volunteering was not significant. Older Black vs. White adults scored -5.2 points lower; women, a high school degree or some post-secondary education, and former vs. never smokers related to higher; each additional year of age and diabetes related to lower; and older Black vs. White volunteers scored 2.0 points higher 3MS scores. While racial disparities in 3MS scores existed in both models, older Black volunteers were cognitively protected. Our policy implication is to invest in older adults’ volunteering as social determinant interventions to maintain cognitive functioning and reduce racial disparities.
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الحسيني, محمد الحسيني المتولي, та خالد محمد الصادق سلامه. "تأثير المدخلات التدريبة المتزامنة علي الكفاءة اللاهوائية والبدنية ومتغيرات الأداء لسباق400متر The Impact of Concurrent Training Inputs on Anaerobic and Physical Efficiency and Performance Variables in the 400-Meter Race". المجلة العلمية لعلوم الرياضة 16, № 1 (2024): 241–63. https://doi.org/10.21608/mkod.2024.331333.1488.
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Schmidt, Marcus, Tobias Alt, Kevin Nolte, and Thomas Jaitner. "Comment on “Hurdle Clearance Detection and Spatiotemporal Analysis in 400 Meters Hurdles Races Using Shoe-Mounted Magnetic and Inertial Sensor”." Sensors 20, no. 10 (2020): 2995. http://dx.doi.org/10.3390/s20102995.
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The recent paper “Hurdle Clearance Detection and Spatiotemporal Analysis in 400 Meters Hurdles Races Using Shoe-Mounted Magnetic and Inertial Sensor” (Sensors 2020, 20, 354) proposes a wearable system based on a foot-worn miniature inertial measurement unit (MIMU) and different methods to detect hurdle clearance and to identify the leading leg during 400-m hurdle races. Furthermore, the presented system identifies changes in contact time, flight time, running speed, and step frequency throughout the race. In this comment, we discuss the original paper with a focus on the ecological validity and the applicability of MIMU systems for field-based settings, such as training or competition for elite athletes.
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Mastalerz, Andrzej, Monika Johne, Anna Mróz, et al. "Changes of Anaerobic Power and Lactate Concentration following Intense Glycolytic Efforts in Elite and Sub-Elite 400-meter Sprinters." Journal of Human Kinetics 91 (April 15, 2024): 165–74. http://dx.doi.org/10.5114/jhk/186074.
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400-m races are based on anaerobic energy metabolism, they induce significant muscle fatigue, muscle fiber damage, and high blood lactate (LA) concentration. Despite extensive research on sprint training, our understanding of the training process that leads to world-class sprint performance is rather limited. This study aimed to determine differences in LA concentration and anaerobic power using jumping tests after an intense glycolytic effort in a group of elite and sub-elite 400-m runners. One hundred thirty male runners were divided into two groups: elite (n = 66, body mass = 73.4 ± 7.8 kg, body height = 182.1 ± 6.2 cm, age = 20.8 ± 4.0 y) running the 400-m dash below 50 s and sub-elite (n = 64, body mass = 72.0 ± 7.1 kg, body height = 182.1 ± 5.2 cm, age = 20.8 ± 4.0 y) with a 400-m personal best above 50 s. The power of the countermovement and the sequential squat jumps was measured in two sets after a warm-up, followed by two intermittent 30-s Wingate tests. LA concentration was measured eight times. It was observed that elite athletes achieved significantly higher power in both types of jumps. The maximum post-exercise LA concentration was significantly lower in the sub-elite group after the 3rd, the 6th, the 9th, and the 20th min after the cessation of two Wingate tests (p < 0.001). The rate of LA accumulation after exercise and the rate of LA utilization did not differ between the groups. It can be concluded that elite and non-elite runners differ in higher LA production but not in LA utilization. Anaerobic power and LA concentration seem to differentiate between 400 elite and sub-elite performance.
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المروعي, أ. د. عصام احمد. "This research aims to identify the effect of hypoxic training on some physiological and physical variables and the level of digital achievement for the 400-meter freestyle race. The research sample included 10 of some of the Hodeidah University’s college team team runners for the academic year 2017/2018 from athletics students who were chosen intentionally. The researcher used... Experimental approach.The results showed that the training program that was conducted using hypoxic exercises led to the development of the special physiological abilities of the members of the research sample.Thus, the validity of the second hypothesis, which states:“There are statistically significant differences between the pre- and post-measurements of the experimental group in the physiological variables (pulse, vital capacity, respiratory cyclic endurance) in favor of the post-measurement. The researcher attributes the reason for this to the effect of the proposed training program using hypoxic exercises, and Adel Helmy Shehata, 1994, agrees with that.” M (10), Ashraf Al-Sayyid Suleiman 1995 (6) The proposed training program for them had an impact on the level of digital achievement among the research sample.Thus, it has been possible to verify the validity of the third hypothesis, which states: “There are statistically significant differences between the pre- and post-measurements of the experimental group at the digital level of the 400-meter race. In favor of the post-measurement.”The effect of hypoxic training on some physiological and physical variables and the level of digital achievement in the 400 m freestyle race." مجلة جامعة الملكة أروى العلمية المحكمة 1, no. 21 (2024): 23. http://dx.doi.org/10.58963/qausrj.v1i21.174.
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يهدف هذا البحث الى التعرف على تأثيرتدريبات الهيبوكسيك على بعض المتغيرات الفسيولوجية والبدنية ومستوى الإنجاز الرقمى لسباق 400 م حرة وقد اشتملت عينة البحث على 10 من بعض متسابقي فرق منتخبات الكليات لجامعة الحديدة للعام الجامعى 2017م / 2018م من الطلاب لاالعاب القوى تم اختيارهم عمدياً ، وقد استخدم الباحث المنهج التجربي. وقد أظهرت النتائج ان البرنامج التدريبى الذى تم بإستخدام تدريبات الهيبوكسيك أدى الى تطوير القدرات الفسيولوجية الخاصة لدى افراد عينة البحث. وبهذا يكون قد تحقق صحة الفرض الثانى الذى ينص على : "توجد فروق دالة احصائية بين القياسين القبلى والبعدى للمجموعة التجريبية فى المتغيرات الفسيولوجية (النبض ، السعة الحيوية ، التحمل الدورى التنفسى) لصالح القياس البعدى. ويرجع الباحث السبب فى ذلك إلى تأثير البرنامج التدريبى المقترح بإستخدام تدريبات الهيبوكسيك ويتفق مع ذلك كلاً من عادل حلمى شحاته 1994 م (10) ، اشرف السيد سليمان 1995 (6) ان البرنامج التدريبى المقترح لهم اثر على مستوى الإنجاز الرقمى لدى عينة البحث. وبهذا يكون قد أمكن التحقق من صحة الفرض الثالث الذى ينص على :"توجد فروق دالة احصائية بين القياسين القبلى والبعدى للمجموعة التجريبية فى المستوى الرقمى لسباق 400 متر . لصالح القياس البعدى
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Flávio Ignácio Bachini, Leonardo Macedo, Luis Carlos Oliveira Gonçalves, Adenilda Cristina Honório França, Eduardo Luzia França, and Aníbal Monteiro De Magalhães Neto. "Gênero e hidratação como mediadores relevantes para restauração de processos inflamatórios em atletas jovens." Europub Journal of Health Research 2, no. 1 (2021): 21–43. http://dx.doi.org/10.54747/ejhr-002.
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Objetivos: Poucos estudos tem dado a devida importância ao estado de hidratação e as alterações hematológicas em menores de 18 anos. O presente estudo investigou estas alterações em menores de 18 anos na prova de 3000 metros para ambos os gêneros. Método: Foram incluídos os seis melhores participantes das Olimpíadas Nacionais do Ensino Médio (menores de 18 anos) no Brasil. Trata-se de um estudo observacional e transversal. Os atletas correram 3.000 metros em uma pista oval de 400 metros. Foi realizado leucograma total e específico, eritrograma e contagem de plaquetas em quatro diferentes tempos (jejum, pré, pós e recuperação). Os cálculos de comparação entre tempos, apresentados, foram adaptados do modelo matemático de variação percentual. Resultados: Quando comparadas as médias em relação a cada tempo, pode-se notar que os eritrócitos, hemoglobina, hematócrito, leucócitos totais e basófilos aumentaram significativamente após a corrida para ambos os gêneros. Além disso, as plaquetas também aumentaram para ambos os gêneros sem significância. O coeficiente de correlação de Pearson mostrou importante interação leucócitos-plaquetas. Os homens recuperaram seu estado de hidratação em quase metade do tempo em relação as mulheres. Em relação ao sistema imune e resposta inflamatória, as atletas do gênero feminino tiveram um aumento relativo de mais que o dobro para leucócitos e não recuperaram estes valores, além de apresentarem um aumento de eosinófilos neste mesmo tempo, enquanto os atletas do gênero masculino apresentaram diminuição. As mulheres apresentaram um aumento de quase o dobro para linfócitos, enquanto os homens tiveram este comportamento para os fagócitos. Conclusões: O exercício induz alteração do estado de hidratação e sistema imune, tendo diferenças em relação ao gênero. Quando bem conduzido, gera efeitos antiinflamatórios a longo prazo. Quando não há controle sobre o volume, intensidade e recuperação pode causar imunossupressão e promover a suceptibilidade para infecções. Foi possível observar que os atletas do gênero masculino tem um menor estresse inflamatório e recuperam o seu estado de hidratação e a resposta inflamatória mais rápido que as meninas após uma corrida de 3000 metros.
 
 Objectives: Few studies have given due importance to the hydration status and hematological alterations in children under 18 years of age. The present study investigated these alterations in children under 18 years old in the 3000 meters test for both genders. Method: The six best participants of Brazil's National High School Olympiads (under 18 years old) were included. This is an observational and cross-sectional study. Athletes ran 3,000 meters on a 400 meters oval track. Total and specific white blood cell count, erythrogram, and platelet count were performed four times (fasting, pre, post, and recovery). The time comparison calculations presented were adapted from the percentage variation mathematical model. Results: When comparing the means for each time, it can be noted that erythrocytes, hemoglobin, hematocrit, total leukocytes, and basophils increased significantly after the race for both genders. Furthermore, platelets also increased for both genders without significance. Pearson's correlation coefficient showed a significant leukocyte-platelet interaction. Men regained their hydration status in almost half the time compared to women. Regarding the immune system and inflammatory response, female athletes had a relative increase of more than double for leukocytes and did not recover these values, in addition to showing an increase in eosinophils simultaneously, while male athletes showed a decrease. Women showed an increase of almost double for lymphocytes, while men showed this behavior for phagocytes. Conclusions: Exercise induces changes in hydration status and immune system, with differences concerning gender. When done well, it generates long-term anti-inflammatory effects. When there is no control over volume, intensity, and recovery, it can cause immunosuppression and increase infection susceptibility. It was observed that male athletes have lower inflammatory stress and recover their hydration status and inflammatory response faster than girls after a 3000 meter run.
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Johnson, Candon, Robert Schultz, and Joshua C. Hall. "Specialization and Performance: Evidence from NCAA 4 × 400 m Relay Times." Economies 8, no. 4 (2020): 96. http://dx.doi.org/10.3390/economies8040096.
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This paper investigates the impact of having open 400 meter (400 m) runners on NCAA relay teams. Using data from 2012–2016 containing the top 100 4 × 400 m in each NCAA Division relay times for each year, it is found that more 400 m specialists lead to an increase in the overall performance of the team, measured by a decrease in relay times. The effect is examined across Division I–III NCAA track teams. The results are consistent across each division. We view this as a test of the role of specialization on performance. Using runners who specialize in 400 m races should increase overall team performance as long as specialization does not lead to an inefficient allocation of team human capital. An additional performance measure is used examining the difference between projected and actual relay times. Divisions I and II are found to perform better than projected with an increase in 400 m runners, but there is no effect found in Division III.
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Falbriard, Mathieu, Maurice Mohr, and Kamiar Aminian. "Hurdle Clearance Detection and Spatiotemporal Analysis in 400 Meters Hurdles Races Using Shoe-Mounted Magnetic and Inertial Sensors." Sensors 20, no. 2 (2020): 354. http://dx.doi.org/10.3390/s20020354.
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This research aimed to determine whether: (1) shoe-worn magnetic and inertial sensors can be used to detect hurdle clearance and identify the leading leg in 400-m hurdles, and (2) to provide an analysis of the hurdlers’ spatiotemporal parameters in the intervals defined by the hurdles’ position. The data set is composed of MIMU recordings of 15 athletes in a competitive environment. The results show that the method based on the duration of the flight phase was able to detect hurdle clearance and identify the leading leg with 100% accuracy. Moreover, by combining the swing phase duration with the orientation of the foot, we achieved, in unipedal configuration, 100% accuracy in hurdle clearance detection, and 99.7% accuracy in the identification of the leading leg. Finally, this study provides statistical evidence that contact time significantly increases, while speed and step frequency significantly decrease with time during 400 m hurdle races.
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Falbriard, Mathieu, Maurice Mohr, and Kamiar Aminian. "Reply to Comments: Hurdle Clearance Detection and Spatiotemporal Analysis in 400 Meters Hurdles Races Using Shoe-Mounted Magnetic and Inertial Sensor." Sensors 20, no. 10 (2020): 2993. http://dx.doi.org/10.3390/s20102993.
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Al-Fadhli, Sari Abdul Karim, Juma Mohammed Awad, and Adel Awad Karhout. "Effect of composite training according to a target time for the 400 meters race in the development of the first and second 200 meters and reduce the time difference between them before." Modern Sport 15, no. 1 (2016): 62–72. https://doi.org/10.54702/2708-3454.1523.
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D'Aiello, Angelica, Rasim A. Gucalp, Vafa Tabatabaie, Haiying Cheng, Noah A. Bloomgarden, and Balazs Halmos. "Thyroid dysfunction in lung cancer patients treated with immune checkpoint inhibitors (ICI): Role of race, gender, and concurrent chemotherapy in a multiethnic urban cohort." Journal of Clinical Oncology 38, no. 15_suppl (2020): e21622-e21622. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e21622.
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e21622 Background: Immune-related adverse events (irAE) associated with ICI have been reported, but remain poorly understood. We sought to characterize patterns of thyroid dysfunction—one of the most common irAE—in a large cohort of ethnically-diverse lung cancer patients treated with ICI. Methods: A retrospective chart review of lung cancer patients receiving an anti-PD1 or PD-L1 agent from January 2016 to July 2019 was performed. Subjects included had normal baseline thyroid function. Thyrotoxicosis and hypothyroidism was defined as thyroid-stimulating hormone level less than 0.4 and greater than 4.6, respectively. Time to event analysis with inverted Kaplan Meier curves and log-rank tests were used to compare thyroid dysfunction among race, gender, and treatment subgroups. Results: We identified 256 subjects: 206 had normal baseline thyroid function and 76 went on to develop thyroid dysfunction. Rates of thyroid dysfunction by one year occurred at similar frequencies among all races. Thyrotoxicosis occurred at significantly higher rates in Black (25, 31.7%) than in White (8, 12.9%) and Hispanic (7, 16.7%) subjects. In contrast, hypothyroidism occurred more often in White (13, 21.0%) and Hispanic (18, 42.9%) than in Black (12, 15.2%) subjects. Gender and concurrent chemotherapy showed no significant association with thyroid dysfunction. Of subjects with thyrotoxicosis (N = 42), hypothyroidism followed in 33.3% (N = 14) with 1 subject receiving methimazole and 13 levothyroxine. In those subjects, median time to thyrotoxicosis and hypothyroidism was 4.0 and 7.2 weeks, respectively. Conclusions: Despite the higher prevalence of non-ICI-related thyroid disease among females and the anticipated immunosuppressive effect of chemotherapy, neither gender nor chemotherapy correlated with thyroid dysfunction; however, race did. Black subjects exhibited significantly higher rates of thyrotoxicosis. Our findings are consistent with prior research showing that thyrotoxicosis, including Graves’ disease, occurs more often in Blacks. While the pathogenesis of ICI-related thyroid dysfunction is unclear, the early onset of thyrotoxicosis demonstrated by our study calls for careful monitoring, especially for particular races. [Table: see text]
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B., Shobana, Sasi Krishnan G., Prasath A. K. Hari, and M. Nair Resmi. "Comparative Study of Peak Expiratory Flow Rateamong Power Loom Workers In Relation To Gender Distribution in RuralArea in Salem District." International Journal of Pharmaceutical and Clinical Research 16, no. 12 (2024): 198–203. https://doi.org/10.5281/zenodo.14591778.
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<strong>Introduction: </strong>Occupational exposure in power loom industries is a known risk for respiratory diseases. This study aimed to compare Peak Expiratory Flow Rate (PEFR) between male and female power loom workers and assess the impact of gender, years of exposure, and workplace conditions on respiratory function. <strong>Materials and Methods: </strong>The study involved 250 power loom workers from rural Salem, Tamil Nadu. Demographic, socioeconomic, and occupational data were collected via a structured questionnaire. PEFR was assessed using Wright’s Peak Flow Meter, and statistical analysis compared PEFR values by gender and exposure duration. <strong>Results and Discussion: </strong>Significant gender differences in PEFR were observed, with males consistently showing higher PEFR values compared to females. In the 16–20 years exposure category, males predominated in the higher PEFR ranges (351–400 lpm, 401–450 lpm), while females were primarily in the lower ranges (251–300 lpm, 351–400 lpm). As exposure duration increased, PEFR values declined in both genders, with the most significant decline observed in females, highlighting the cumulative effects of prolonged exposure. The findings emphasize the compounded respiratory health risks for females due to dual exposure, and the overall decline in lung function over time for both genders. <strong>Conclusion:</strong> This study highlights significant gender-based differences in PEFR among power loom workers. Implementing preventive measures like improved ventilation, use of protective equipment, and regular health monitoring can help mitigate respiratory health risks in this vulnerable population.
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Opravil, Milos, Andrew M. Hill, Ralph DeMasi, and Debra Dawson. "Prediction of HIV-1 RNA Suppression and its Durability during Treatment with Zidovudine/Lamivudine." Antiviral Therapy 3, no. 3 (1998): 169–76. http://dx.doi.org/10.1177/135965359800300307.
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To predict the probability of long-term viral suppression during treatment with zidovudine and lamivudine, human immunodeficiency virus type 1 (HIV-1) RNA values were retrospectively pooled for 1083 patients from six randomized, double-blind clinical trials. All analyses of HIV-1 RNA were obtained using the Roche Amplicor assay or its earlier prototype. Time to loss of response was evaluated by Kaplan-Meier analysis; Cox proportional hazards models were used to assess the influence of baseline variables. Among 523 patients with ≤6 months of prior zidovudine treatment, the probability of HIV-1 RNA suppression below 400 copies/ml at 48 weeks was 71% in those with baseline HIV-1 RNA <5000 copies/ml, but only 14% in those with HIV-1 RNA between 50000 and 200000 copies/ml. Among 560 patients with >6 months of prior zidovudine treatment, the rates of sustained viral suppression were lower, but also significantly associated with the baseline HIV-1 RNA. Multivariate analyses showed no independent effect of CD4 cell count, age, sex, race, or CDC disease stage on the probability of sustained HIV-1 RNA suppression. When patients with ≤6 months of prior therapy were stratified based on the magnitude of HIV-1 RNA nadir achieved during treatment, those who reached a nadir of <400 copies/ml retained this response for significantly longer time periods than the ones who only achieved partial viral suppression. In conclusion, baseline HIV-1 RNA levels and the duration of prior zidovudine therapy strongly predict the antiretroviral efficacy of zidovudine/lamivudine. The baseline parameters should influence the choice of the antiretroviral regimen.
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Milić, Ognjen, Srđan Ostojić, and Veljko Vukićević. "Kinematic analysis of elite Portuguese swimmer with loco motor disability between Charcot-Marie-Tooth disease and arm amputees – Review study." Innovative Technologies in Sport and Physical Activity 3, no. 2 (2024): 3–6. https://doi.org/10.56886/itspa.241201.
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The aim of this study was to compare biophysical characteristics of Paralympic swimmers. This case study includes two swimmers with loco motor disability classes S9, according to functional classification by international Paralympic committee – IPC. These swimmers completed a 7 x 200m crawl stroke protocol with increasing speed 0.05 05m s-1 in each level and 30s interval. Interval speeds were based on 400m race speed. VO2 consumption was measured each 200 meter directly and continuously with a telemetric portable gas analyzer (K4 b2, Cosmed, Rome, Italy) connected to a respiratory snorkel (AquaTrainer Snorkel, Cosmed, Rome, Italy). The trails were recorded on 6 video cameras each 200m swim. If the swimmer reached the Lactate plateau before completing the seventh repetition, the test was stopped. Test showed that CMT swimmer achieved a lower oxygen consumption than amputee swimmer when they reach their max speed. Video analysis of 17 and 18 body segments helped us to define some stroke parameters. Results indicated that the right arm showed larger joint angle than left. Also, amputee swimmer had larger linear displacement. Swimmers performed active drag test 10 ± 1.3s, vertical 5.4 ± 1.4 horizontal floating time 6.5 ± 1.5 and glide distance 6.6 ± 0.5m. Keywords: biomechanics, front crawl swimming, loco-motor displacement
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Milić, Ognjen, Srđan Ostojić, Igor Poposki, Veljko Vukićević, Bojan Kačar, and Omodoyinsola Ajibade. "Kinematic and biophysical analysis of elite Portuguese swimmer with loco motor disability between Charcot-Marie-Tooth disease and wrist amputee." Innovative Technologies in Sport and Physical Activity 4, no. 1 (2025): 3–8. https://doi.org/10.56886/itspa.250605.
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The aim of this study was to compare biophysical characteristics of Paralympic swimmers. This case study includes two swimmers with loco motor disability classes S9, according to functional classification by international Paralympic committee – IPC. These swimmers completed a 7 x 200m crawl stroke protocol with increasing speed 0.05 05m s-1 in each level and 30s interval. Interval speeds were based on 400m race speed. VO2 consumption was measured each 200 meter directly and continuously with a telemetric portable gas analyzer (K4 b2, Cosmed, Rome, Italy) connected to a respiratory snorkel (AquaTrainer Snorkel, Cosmed, Rome, Italy). The trails were recorded on 6 video cameras each 200m swim. If the swimmer reached the Lactate plateau before completing the seventh repetition, the test was stopped. Test showed that CMT swimmer achieved a lower oxygen consumption than amputee swimmer when they reach their max speed. Video analysis of 17 and 18 body segments helped us to define some stroke parameters. Results indicated that the right arm showed larger joint angle than left. Also, amputee swimmer had larger linear displacement. Swimmers performed active drag test 10 ± 1.3s, vertical 5.4 ± 1.4 horizontal floating time 6.5 ± 1.5 and glide distance 6.6 ± 0.5m. Keywords: biomechanics, front crawl swimming, loco-motor displacement
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Zagami, Paola, Yara Abdou, Alexis Caroline Wardell, et al. "Distribution and outcomes of HER2-low and HER2-zero metastatic breast cancer in Black and younger women." Journal of Clinical Oncology 41, no. 16_suppl (2023): 1109. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.1109.
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1109 Background: Black and younger patients with breast cancer (BC) have higher mortality. This racial disparity has been attributed to different BC biology, access to care, and treatment. With the advent of new antibody-drug conjugates (ADC) for metastatic BC (MBC), “HER2-negative” has been subdivided into HER2-low (IHC 1+ or 2+/ISH-negative) and HER2-0 (IHC 0). Little is known about these subcategories among Black and younger women with MBC. Methods: Clinical characteristics, treatment, and outcomes of patients diagnosed with HER2-negative MBC between 2011-2022 and with follow-up through a progression-free survival event on first-line therapy (PFS1) were retrieved from the UNC Metastatic Breast Cancer Database; hormone receptor (HR) and HER2 categories were by clinical criteria from the pathology report. Analyses were limited to HER2-negative BC and stratified/controlled by HR status. Fisher’s exact tests were used to compare HER2 status across race and age. The Kaplan Meier method and log-rank tests, as well as Cox proportional hazards models estimated PFS1. Results: The cohort included 772 MBC patients (56% HER2-low and 44% HER2-0), 22% Black women and 30% < 50 years old at MBC diagnosis. There were no differences in proportion with HER2-low by race or age (p>0.5). Patients with HER2-low had better observed median PFS1 compared to HER2-0, however, most of these differences were non-significant: overall (HR+ 12.2 vs 9.8m, p=0.11, HR- 4.3 v 3.3m, p=0.29) and within race and age categories (see table). In Cox modeling, Black women had worse PFS1 (p=0.03), that was no longer apparent after adjusting for HR status (p=0.1), there was no difference by age. Patients with HER2-0 had worse PFS1 (p=0.0005), which remained after adjusting for HR status (p=0.05). In a multivariable model comparing HER2-0 to HER2-low, adjusting for race and HR status, PFS1 remained shorter in the HER2-0 group (hazard ratio: 0.84, CI 0.692 – 1.015, p=0.07). Among those treated with uniform first-line therapy, better PFS1 was observed in HER2-low disease. This included 137 HR+ MBC treated with ET + CDK4/6i (mPFS1 14.3 v 10.3m, p=0.33) and 170 HR- MBC treated with chemotherapy (mPFS1 4.0 v 3.1m, p=0.22) with no variation by race or age. Conclusions: Within HER2-negative MBC, distribution of HER2-low and HER2-0 cancers does not differ by race and age. The clinical benefit of first-line therapy is strongly driven by HR status regardless of race and age, and is greater in HER2-low cancers although this cohort did not include HER2-directed ADCs. [Table: see text]
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Wiseman, Kacey M., Laura Berbert, Michele DeGrazia, John Pilcher, Peter W. Forbes, and Mary Poyner Reed. "A Retrospective Look at Peripheral Intravenous Catheter (PIVC) Dwell Times in Pediatric PopulationCE." Journal of the Association for Vascular Access 29, no. 1 (2024): 43–55. https://doi.org/10.2309/java-d-23-00025.
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Highlights Catheter failure is a serious matter challenging the delivery of high-quality care for pediatric patients. Insertion modality, patient race, and an intensive care unit or emergency department setting are predictive of catheter failure and removal. Peripheral intravenous catheter insertion under ultrasound guidance had an estimated dwell time of 6.5 days compared to 4.0 days when transillumination was used. Abstract Background: Peripheral intravenous catheter (PIVC) insertion is one of the most common medical procedures experienced by pediatric patients. A high incidence of catheter failure (CF) and associated sequelae are widely documented. Methods: This single-center retrospective study was conducted at a freestanding pediatric academic center. Electronic health records were reviewed to identify variables predictive of PIVC dwell time. PIVCs inserted by the vascular access team using either ultrasound guidance (USG) or transillumination during an inpatient admission in October–December 2019 were analyzed. Results: The sample included 743 PIVCs. Survival time, or dwell time, was estimated with the Kaplan-Meier survival curve. PIVCs inserted with USG demonstrated an estimated median dwell time of 6.5 days (95% CI: 5.8, 8.0); those inserted with transillumination had an estimated median dwell time of 4.0 days (95% CI: 3.1, 5.2). Factors predictive of dwell time were insertion modality, race, and patient care setting. Catheter removal associated with failure is 1.87 (95% CI = [1.24, 2.8], P = 0.003) times more likely when the PIVC insertion modality is transillumination compared to USG. Odds of CF are 1.76 (95% CI = [1.19, 2.6], P = 0.004) times more likely in a Black/African American patient than a White patient. Odds of patients in an intensive care unit or emergency department setting are 1.34 (95% CI = [1.03, 1.7], P = 0.029) times more likely to have catheter removal due to failure than in a floor/nonemergency unit. Conclusions: Understanding factors contributing to CF gives clinicians the knowledge to improve practice and mitigate harm in pediatric patients.
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Barsouk, Adam, Omar Elghawy, Jonathan Henry Sussman, Jessica Xu, Ronac Mamtani, and Lin Mei. "Survival disparities by race in advanced urothelial carcinoma (aUC): A real-world analysis." Journal of Clinical Oncology 43, no. 5_suppl (2025): 668. https://doi.org/10.1200/jco.2025.43.5_suppl.668.
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668 Background: Retrospective population data suggest poorer survival for non-White aUC patients. However, data on survival disparities in the era of immuno- and targeted therapies is limited. Methods: This cohort study used Flatiron Health’s nationwide de-identified electronic health record (EHR)-derived database. 7,244 patients (pts) were identified. Pts who started systemic therapy for aUC from 1/1/2017 to 5/1/2024 and had a recorded race were included. Baseline demographics, including social determinants of health (SDOH) score, performance status (PS), disease characteristics, treatment history, and clinical outcomes were abstracted. Progression free survival (PFS) and overall survival (OS) were compared between Black, White and Asian patients via Kaplan-Meier log-rank analysis and Cox proportional hazards models. Independent sample t-tests and chi-square analyses were used for univariate comparisons. P-values < 0.05 were considered statistically significant. Results: A total of 2,388 pts with aUC were identified, with 1.4% Asian, 5.2% Black, 14.4% “other,” and 78.9% White. In 1L, 17.9% received immunotherapy (IO) monotherapy, 4.2% received enfortumab vedotin + pembrolizumab (EVP), 37.5% received carboplatin-based regimens (carbo), 27.8% cisplatin-based regimens (cis), and 12.5% other chemotherapy (p=0.317). ECOG PS>1 at diagnosis was associated with non-White race (p=0.022). Black patients received treatment at an academic center (41.0%) more often than White patients (25.6%; p<0.001). Black pts had lower SDOH score compared White (p<0.001). Asian (HR0.73, p=0.3) and Black (HR1.07, p=0.3) pts had similar PFS to White pts, as well as similar OS with HR0.85(p=0.4) and HR1.05(p=0.4), respectively. On Cox univariate analysis, there was no significant 1L PFS difference between White, Asian, and Black pts on cis (n=665, p=0.3), carbo (n=895, p=0.7), EVP (n= 25, p=0.8), or IO (n=428, p=0.3). OS was not significantly different by race for any 1L therapy. Conclusions: In a large real-world database, race did not affect overall aUC survival. Baseline characteristics and survival by race. Black (n=124) White (n=1884) Asian (n=33) Other (n=344) Sig (p) Baseline Characteristics ECOG PS 0-1 (%) 55.5 64.6 58.2 62.1 0.027 2-4 (%) 18.5 15.5 19.4 15.2 Academic treatment center (%) 36.6 25.9 13.4 13.2 <0.001 Mean SDOH score (0-5) 2.27 3.26 3.38 2.97 <0.001 1L Treatment IO (%) 23.8 16.4 20.0 17.5 0.317 EVP (%) 5.7 3.9 4.4 4.0 Carbo (%) 32.9 36.5 37.4 38.0 Cis (%) 27.4 29.2 27.8 29.8 Other (%) 10.2 14.0 10.4 10.7 Survival 1L mPFS (m) 5.2 4.6 5.1 4.2 0.300 mOS (m) 5.3 6.9 8.7 5.2 0.400 Sig values (p<0.05) in bold.
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Kwak, Jae-Yong, Hawk Kim, Jeong A. Kim, et al. "Efficacy and Safety of Radotinib Compared with Imatinib in Newly Diagnosed Chronic Phase Chronic Myeloid Leukemia Patients: 12 Months Result of Phase 3 Clinical Trial." Blood 126, no. 23 (2015): 476. http://dx.doi.org/10.1182/blood.v126.23.476.476.
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Abstract Background Radotinib is a second generation BCR-ABL1 tyrosine kinase inhibitor (TKI) developed by IL-YANG Pharm. Co., Ltd (Seoul, South Korea) and approved by the Korea FDA for the treatment of chronic phase chronic myeloid leukemia (CML-CP) patients who have failed prior TKIs. We conducted the randomized, open-label, phase 3 study to assess the efficacy and safety of radotinib, as compared with imatinib, for the first-line treatment of newly diagnosed CML-CP. Methods Based on baseline demographics and Sokal risk score, 241 patients were randomized 1:1:1 to radotinib 300 mg twice daily (bid) (n=79), radotinib 400 mg bid (n=81), or imatinib 400 mg once daily (qd) (n=81). The primary endpoint was the rate of major molecular response (MMR) by 12 months and molecular response was assessed by RQ-PCR at baseline and every 3 months. Secondary endpoints were the rate of complete cytogenetic response (CCyR), MR4.5 by 12 months, and the rate of progression to accelerate phase or blast crisis. Results All three study groups were well balanced with baseline age, gender, race and Sokal risk score. With minimum follow-up of 12 months, the proportions of patients receiving a study drug were 86.3% (69/79) in radotinib 300 mg bid group, 71.6% (58/81) in radotinib 400 mg bid group, and 81.5% (66/81) in imatinib 400 mg qd group. By 12 months, rates of MMR were significantly higher in patients receiving radotinib 300 mg bid (51.9%, P = .0044) and radotinib 400 mg bid (45.7%, P = .0342) compared with imatinib (29.6%). The median time to MMR among responders were shorter on radotinib 300 mg bid (5.7 months) and radotinib 400 mg bid (5.6 months) than imatinib group (8.2 months). The MR4.5 rates by 12 months were also higher for both radotinib 300 mg bid (15.2%) and 400 mg bid (13.6%) compared to imatinib (8.6%). The CCyR rates by 12 months were also higher for radotinib 300 mg bid (91.1%, P = .0120) compared with imatinib (76.5%). There was no progression to accelerated phase or blast crisis in all groups by 12 months. Discontinuation due to adverse events (AEs) or laboratory abnormalities occurred in 7 (8.8%), 16 (19.8%), and 5 (6.2%) patients for radotinib 300 mg bid, radotinib 400 mg bid and imatinib, respectively. Grade 3/4 thrombocytopenia occurred in 16.5% of patients receiving radotinib 300 mg bid, in 13.6% for radotinib 400 mg bid, and in 19.8% receiving imatinib. And grade 3/4 neutropenia occurred in 19.0%, 23.5%, and 29.6% for radotinib 300 mg bid, 400 mg bid and imatinib, respectively. The most common any grade non-laboratory AEs were skin rash (35.4% and 33.3%), nausea/vomiting (22.8% and 23.5%), headache (19.0% and 30.9%), and pruritus (19.0% and 30.0%) in radotinib 300 mg bid and radotinib 400 mg bid, respectively; AEs in the imatinib group were edema (34.6%), myalgia (28.4%), nausea/vomiting (27.2%), and skin rash (22.2%). Overall, grade 3/4 non-laboratory AEs were uncommon in all groups. Conclusions With minimum 12 months follow-up, radotinib demonstrated significantly higher and faster rates of CCyR and MMR than imatinib in patients with newly diagnosed CML-CP. The safety profiles of the radotinib and imatinib were different, and most AEs were manageable with optimal dose reduction. The results of this trial support that radotinib can be one of the standard of care in newly diagnosed CML-CP. Table. Baseline Characteristics, Molecular and Cytogenetic Response Rates Radotinib 300mg BID Radotinib 400mg BID Imatinib 400mg QD (N=79) (N=81) (N=81) Age, median (range), years 45 (20-75) 43 (18-84) 45 (18-83) Gender, n (%) Male 52 (65.8) 47 (58.0) 52 (64.2) Female 27 (34.2) 34 (42.0) 29 (35.8) Sokal risk, n (%) Low 21 (26.6) 22 (27.2) 22 (27.2) Intermediate 38 (48.1) 38 (46.9) 39 (48.2) High 20 (25.3) 21 (25.9) 20 (24.7) MMR by 12 months, % 51.9 45.7 29.6 P = .0044 P = .0342 Cumulative Incidence of MMR by 12 months¢Ó, % 57.0 58.0 35.0 P = .0040 P = .0037 MR4.5 by 12 months, % 15.2 13.6 8.6 CCyR by 12 months, % 91.1 81.5 76.5 ¢Ó Kaplan-Meier estimates of MMR Disclosures Kim: IL-YANG Pharm. Co. Ltd: Research Funding. Kim:Alexion Pharmaceuticals: Research Funding. Chung:Alexion Pharmaceuticals: Research Funding. Choi:Alexion Pharmaceuticals: Research Funding.
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Shaib, Walid Labib, Layal Sayegh, Olatunji Alese, et al. "Resection of pancreatic cancer following induction chemotherapy." Journal of Clinical Oncology 36, no. 4_suppl (2018): 406. http://dx.doi.org/10.1200/jco.2018.36.4_suppl.406.
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406 Background: Survival of resectable pancreas cancer (RPC) treated with resection and adjuvant therapy is 22-28 months (mo). Locally advanced unresectable pancreatic cancer (LAPC) treated with combination chemotherapy have a median survival of 24 mo. The objective of this project is to evaluate the effect of neoadjuvant treatment on survival outcome of localized PC. Methods: Charts of localized PC patients treated at Emory University from 2009 to 2016 were reviewed. Information on demographics, stage and treatment was collected. Survival rates were estimated by Kaplan-Meier method and compared with log-rank test. A Cox proportional hazard model was fitted to estimate the adjusted effect of treatment on overall survival(OS). Results: A total of 415 patients were included; 144 RPC, 158 borderline resectable (BRPC) and 108 LAPC. Stage was determined at the multidisciplinary conference. The median age was 67.7 years (30-92); 49% male, and 63% Caucasians. The median OS for RPC, BRPC, and LAPC was 16.9, 14.6 and 10.9 mo, respectively. Stage, type of chemotherapy and age were significant predictors of OS after adjusting for gender, race, age, surgery, stage, chemotherapy, margins and radiation. Of the 144 RPC, 137 underwent surgery and 3 received neoadjuvant treatment; 73 RPC were followed in outside facility with missing follow up data. Of the 71 RPC treated at Emory; 91% received adjuvant gemcitabine. Of the 158 BRPC, 84 underwent surgery; 44 received FOLFIRINOX neoadjuvant therapy, 23 received gemcitabine/nab-paclitaxel, and 16 received gemcitabine single agent. BRPC patients who underwent resection had a median OS of 18.5 mo (95%CI: 14.2, 26.4), significantly longer than RPC (P = 0.044). Combination chemotherapy was significantly associated with improved OS at 36 mo (38.9%) when compared to single agent gemcitabine (6.3% at 36 mo) (p = 0.009). BRPC patients who received FOLFORINOX and surgery had a median OS of 31.5 mo. Conclusions: Overall survival of BRPC patients who undergo resection after FOLFIRINOX is significantly improved (more than doubled) compared to upfront resection for RPC. Preoperative therapy provides the best approach for systemic disease early in the course of treatment.
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Rahman, Shafia, Alvaro Alvarez Soto, Lindor Qunaj, et al. "Prognostic Factors for North American Adult T Cell Leukemia Lymphoma: Defining Risk Groups Using a Four-Point Score Prognostic System." Blood 136, Supplement 1 (2020): 38–39. http://dx.doi.org/10.1182/blood-2020-141428.
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Introduction: Adult T cell leukemia lymphoma (ATLL) is a rare T cell neoplasm caused by the human T-lymphotropic virus (HTLV-1) virus. Although there are indolent subtypes it is often a highly aggressive and chemotherapy refractory malignancy. We follow one of the largest cohorts in the United States and in this study, we sought to elucidate the prognostic factors associated with inferior survival. Methods: A retrospective analysis of patients diagnosed with ATLL at Montefiore Medical Center was conducted. Subjects included were censored at last point of contact. Variables collected included age, gender, race, ethnicity, ATLL subtype, white blood cell count (WBC), absolute lymphocyte count (ALC), corrected calcium level, lymphadenopathy (LAD) (two or more non-contiguous sites). Associations between WBC, ALC, corrected calcium level, LAD and median overall survival (mOS) were assessed using the Kaplan-Meier method with log-rank test. A four-point prognostic system was designed assigning one point to each: WBC &gt; 11,000; ALC&gt;4000; Corrected Ca≥10.5 and presence of LAD. Three risk groups were assigned based on the number of risk factors as follows: low (0-1 points), intermediate (2 points) and high (3-4 points) (Table 2). Association between these groups and OS was investigated using the Kaplan-Meier method with log-rank test. Results: A total of 61 ATLL subjects were included in this study (table 1). Hypercalcemia (Ca ≥10.5) was observed in 60.6% of subjects at diagnosis and was associated with inferior mOS (234 days) when compared to calcium &lt; 10.5 (747days) (p=0.046), Figure 1A. WBC &gt;11,000 had a strong association with inferior survival (175 days) compared to patients with a WBC ≤11,000 (666 days) (p= 0.0067) (Figure 1B). ALC &gt; 4000 was also associated with inferior mOS (222 days) compared to ALC ≤4000 (666 days) (p=0.015) (Figure 1C). LAD was associated with mOS (188 days) compared with no LAD (847 days) (p=0.022) (Figure 1D). Based on these observations, we designed a prognostic system (0-4 points) (see above) to risk stratify newly diagnosed ATLL patients into: low (0-1 points), intermediate (2 points) and high (3-4 points) risk (Table 2). We divided our cohort into the above-mentioned risk groups and calculated their mOS. Kaplan Meier analysis (Figure 2) revealed a distinct mOS difference between the groups based on their risk score: Low: 419 days, Intermediate: 234 days and High: 181.5 days (p= 0.0042). Conclusions: We identify hypercalcemia (Ca≥10.5), leukocytosis (WBC&gt; 11,000), lymphocytosis (ALC&gt; 4000) and generalized LAD as poor prognostic factors in newly diagnosed ATLL. Using readily available information from basic laboratory and clinical parameters we propose a prognostic system to identify high risk individuals. Further validation will be needed using larger cohorts of this very rare disease. Disclosures Steidl: Aileron Therapeutics: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Stelexis Therapeutics: Consultancy, Current equity holder in private company, Membership on an entity's Board of Directors or advisory committees; Pieris Pharmaceuticals: Consultancy; Bayer Healthcare: Research Funding. Verma:stelexis: Current equity holder in private company; BMS: Consultancy, Research Funding; acceleron: Consultancy, Honoraria; Janssen: Research Funding; Medpacto: Research Funding. Janakiram:Takeda, Fate, Nektar: Research Funding. Shah:Celgene/BMS: Research Funding; Physicians Education Resource: Honoraria.
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Bussies, Parker, Ayi Eta, Andre Pinto, Sophia George, and Matthew Schlumbrecht. "Thrombocytosis as a Biomarker in Type II, Non-Endometrioid Endometrial Cancer." Cancers 12, no. 9 (2020): 2379. http://dx.doi.org/10.3390/cancers12092379.
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Thrombocytosis (platelets ≥ 400K) is a common hematologic finding in gynecologic malignancies and associated with worse outcomes. Limited data exist on the prognostic capability of thrombocytosis in women with high-grade endometrial cancer (EC). Our objective was to describe the associations between elevated platelets at diagnosis, clinicopathologic features, and survival outcomes among women with high-grade, non-endometrioid EC. A review of the institutional cancer registry was performed to identify these women treated between 2005 and 2017. Sociodemographic, clinical, and outcomes data were collected. Analyses were performed using chi-square tests, Cox proportional hazards models, and the Kaplan–Meier method. A total of 271 women were included in the analysis. A total of 19.3% of women had thrombocytosis at diagnosis. Thrombocytosis was associated with reduced median overall survival (OS) compared with those not displaying thrombocytosis (29.4 months vs. 60 months, p < 0.01). This finding was most pronounced in uterine serous carcinoma (16.4 months with thrombocytosis vs. 34.4 months without, p < 0.01). While non-White women had shorter median OS for the whole cohort in the setting of thrombocytosis (29.4 months vs. 39.6 months, p < 0.01), among those with uterine serous carcinoma (USC), this finding was reversed, with decreased median OS in White women (22.1 vs. 16.4 months, p = 0.01). Thrombocytosis is concluded to have negative associations with OS and patient race.
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Farsijani, Samaneh, Jane Cauley, Peggy Cawthon, et al. "ASSOCIATIONS BETWEEN WALKING SPEED AND GUT MICROBIOME DIVERSITY IN OLDER MEN FROM THE MROS STUDY." Innovation in Aging 7, Supplement_1 (2023): 600–601. http://dx.doi.org/10.1093/geroni/igad104.1963.
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Abstract While gut dysbiosis has been linked to frailty in aging, its association with early mobility impairments is unclear. Here, our primary goal was to determine the cross-sectional associations between walking speed and gut microbiome in 740 older men (84±4y) from MrOS with available stool samples and 400m walking speed measured in 2014–16. We also analyzed the retrospective longitudinal associations between changes in 6-meter walking speed (from 2005-06 to 2014-16) and gut microbiome composition among participants with available data (702/740). The gut microbiome composition was determined by 16S sequencing (DADA2 and SILVA). We examined diversity, taxa abundance (by ANCOM-BC), and performed network analysis (by NetCoMi) to uncover microbial communities interactions by walking speed levels. Higher walking speed (m/s) was associated with greater microbiome Shannon α-diversity (R=0.11; P=0.004). Decline in walking speed was associated with lower Shannon α-diversity (R=0.07; P=0.054). Faster walking speed and less decline in walking speed were associated with higher abundance of genus-level bacteria that produce short-chain fatty acids, and possess anti-inflammatory properties, including Paraprevotella, Fusicatenibacter, and Alistipes, adjusting for age, race, site, education, health, marital status, weight, height, physical activity, batch, medications, energy, and fiber intake (P&lt; 0.05). The gut microbiome networks of participants in the first vs. last quartile of walking speed (≤0.9 vs. ≥1.2 m/s) exhibited distinct characteristics, including different cluster numbers, hubs, and centrality measures (P&lt; 0.05). Faster walking speed and its less decline were associated with higher gut microbiome diversity, suggesting potential role of microbiome in preserving mobility in aging.
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Lynn, David, Scott Dawsey, Ubenthira Patgunarajah, et al. "Effect of neutrophil to lymphocyte ratio (NLR) on outcomes with immune checkpoint inhibitors (ICIs) in patients (pts) with metastatic urothelial carcinoma (mUC) in real-world setting." Journal of Clinical Oncology 42, no. 4_suppl (2024): 678. http://dx.doi.org/10.1200/jco.2024.42.4_suppl.678.
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678 Background: Elevated inflammatory biomarkers like the neutrophil to lymphocyte ratio (NLR) has been associated with poor prognosis in several cancers, including UC but there is limited evidence on its role as a prognostic biomarker in patients (pts) with mUC treated with ICIs. We studied the effect of baseline (pre-treatment) NLR on outcomes with ICI in mUC pts in our large cohort of patients with mUC treated with ICIs. Methods: We identified 335 adult pts with mUC at the Cleveland Clinic treated who received >/= 2 cycles of ICI with pembrolizumab (P) or atezolizumab (A) between 2015 and 2023. Patient characteristics including age, sex, race, primary site (bladder vs upper tract UC (UTUC)), tumor histology and pre-ICI treatment NLR values were collected and divided into four quartiles: (NLR <2.7, 2.7-4.0, 4.0-7.1, and >7.1). Impact of NLR on overall survival (OS) and progression free survival (PFS) post ICI start date was studied. OS and PFS were estimated using the Kaplan Meier method and compared by log rank test. Results: Of the 335 pts, NLR values were available for 320 pts. Median age was 73 yrs (35-95) and 76% pts were males. 247 pts (74%) received P and 88 (26%) received A. We found that in the 320 patients with available NLR values, the highest quartile values of NLR >/= 7.1 was significantly associated with worse OS (p=0.01). We did not find a statistically significant impact of NLR on PFS (p=0.06). (Table). Conclusions: In our large real-world cohort of pts with mUC receiving ICI, we report the effect of baseline NLR on outcomes with ICI and that NLR >/=7.1 was associated with significantly worse OS. Further validation studies are warranted to risk-stratify pts with mUC planned for ICI treatment. [Table: see text]
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Abrams, Ross A., Kathryn A. Winter, Karyn A. Goodman, et al. "NRG Oncology/RTOG 0848: Results after adjuvant chemotherapy +/- chemoradiation for patients with resected periampullary pancreatic adenocarcinoma (PA)." Journal of Clinical Oncology 42, no. 16_suppl (2024): 4005. http://dx.doi.org/10.1200/jco.2024.42.16_suppl.4005.
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4005 Background: If 5FU/Capecitabine sensitized radiotherapy (RT) is beneficial in the adjuvant (adj) management of PA after adj chemotherapy (chemo) is controversial. NRG/RTOG 0848 was designed to address this issue. Methods: This was a 2 step NCTN randomized (rndmzd) trial. Step 1 rndmzd patients (pts) to 5 cycles of gemcitabine +/- Erlotinib. Step 2 rndmzd pts to a 6th cycle of the same chemo +/- 5FU/Capecitabine with 50.4 Gy in 28 fractions RT (chemo+CRT). Step 1 eligibility included: R0/R1 resection, M0, ECOG PS 0-1, CA19-9≤180. Step 2 eligibility included > 4 cycles chemo (gem, gem combo, (m)FOLFIRINOX). RT included real time 3D/IMRT treatment (RX) plan review, scoring, and approval. At Step 2, pts stratified by nodal status (+ vs -), CA19-9 (≤90 vs > 90-180), surgical margins (R0 vs R1), and adjuvant chemo. Primary endpoint was OS. Secondary endpoints are DFS and AEs (CTCAEv4). Assuming 17 months median OS (chemo) and hypothesized 22.5 months (chemo+CRT), sample size was 354 pts (HR = 0.76, 80% power, 1-sided α = 0.05, 316 OS events). Due to lower than projected event rate, trial was amended to report at the earlier of (a) 316 observed OS events or (b) 5 years of follow-up time from Step 2 accrual closure (265 OS events, 72% power, same α). OS and DFS were estimated by Kaplan-Meier and arms compared using log-rank test. Multivariable analyses (MVA) used Cox proportional hazards models. Results: Accrual began 11/2009; closed 10/2018. 354 pts rndmzd (174 chemo, 180 chemo+CRT). Median follow-up for all & alive pts = 2 & 7 years, respectively, with 270 OS events. Median age 63, 45% female, 81% white, 13% AA. 83% R0, 26% node negative, 96% CA19-9 < 90. 13% of chemo+CRT pts did not receive RT. AEs were comparable (grade 4: 10% [chemo] vs 11% [chemo+CRT] and 1 grade 5 AE in each arm). Univariate OS/DFS results shown in Table. In initial MVA, RX, CA19-9, surgical margins were not statistically significantly associated with OS or DFS, but nodal status (OS, DFS) and race (OS) were. In further analyses, significant interactions were found between RX and nodal status for both OS and DFS. Node negative pts treated with chemo+CRT had better outcome than chemo pts; node positive pts did not (Table). Conclusions: Chemo+CRT did not improve OS overall, but did improve DFS. Both OS and DFS were improved with Chemo+CRT in node negative pts. Chemo+CRT did not increase Gr 4 or 5 AEs compared to chemo. Clinical trial information: NCT01013649 . [Table: see text]
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Gowda, Karan, Medha Gupta, Adrian Aguliar, et al. "Mortality after Diagnosis of Cardiovascular Disease in Survivors of Adolescent and Young Adult Lymphoma." Blood 144, Supplement 1 (2024): 5128. https://doi.org/10.1182/blood-2024-211291.
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Background: Due to cardiotoxic treatment, cardiac dysfunction is a major morbidity among survivors of adolescent and young adult (AYA) cancer, defined as a primary cancer diagnosis between the ages of 15-39. Although high mortality after cardiovascular disease (CVD) diagnosis has been shown in other cancer survivor populations, this has not been investigated in survivors of AYA cancer. Furthermore, these relationships have been described in mostly White populations, with little focus on individuals from diverse backgrounds. Objective: To evaluate overall survival in survivors of AYA Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) after a diagnosis of CVD and to investigate differences in the CVD-survival relationship by race/ethnicity. Methods: Medical records were reviewed for 825 patients treated at MD Anderson Cancer Center between 2000-2016 who had a primary lymphoma cancer diagnosis between the ages of 15-39. Data abstracted included anthropometric characteristics, demographics, treatment course, vital status, and CVD diagnoses occurring at least 3 months after diagnosis of cancer. CVD diagnoses collected included coronary artery disease, myocardial infarction, angina pectoris, cardiomyopathy, congestive heart failure, pericardial effusion, pericarditis or myocarditis, valvular heart disease, arrhythmia, and transient ischemic attack. Overall survival (OS) was the duration from date of diagnosis to last visit or day of death. OS rates and age at death were calculated based on CVD status. Kaplan-Meier curves were used to estimate survival durations over time by CVD status, and Cox proportional hazards models were fitted to evaluate main effect and stratified associations with OS. Models were adjusted for age at diagnosis, cancer type, sex, race/ethnicity, anthracycline dose &gt; 300 mg/m2, chest radiation exposure, stem cell transplant status, and baseline BMI. Results: Of the 825 patients included in the analysis, 73.7% (608) had HL and 26.3 % (217) had NHL. The most common subtypes of NHL were diffuse large B-cell lymphoma (69.6%) and follicular lymphoma (18.2%). The median age at diagnosis was 28.0 years. 58.5% of patients were White, 26.9% Hispanic, and 14.5% Black. Nearly 25% (23.6%; N=195) had a CVD diagnosis after their cancer diagnosis during the median follow-up time of 9.8 years with the median age at CVD diagnosis being 33.0 years. Patients with CVD had worse survival outcomes than those without (HR: 2.61, 95% CI: [1.70-4.02]). In univariate analysis of risk of death among those with CVD, NHL diagnosis, Black race, underweight at baseline, transplant recipients, and those without chest radiation exposure significantly increased risk factors for death after CVD. However, in multivariable analyses, only transplant status was an independent risk factor. This adverse impact of CVD on survival was consistently observed among patient subgroups when stratified by race/ethnicity, cancer subtype, baseline BMI, and treatment exposures. Of note, the largest effect conferred by CVD on survival when compared to no CVD (HR &gt; 4.0) was among Black patients, NHL survivors, those with a healthy baseline BMI, individuals who did not receive a transplant, patients with an anthracycline dose ≤ 300 mg/m², and those without chest radiation exposure. Conclusion: Survival outcomes were inferior for survivors of AYA lymphoma diagnosed with CVD subsequent to their cancer diagnosis. Our analysis suggests that this burden may not be shared equally based on race/ethnicity and other patient subpopulations.
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Abushalha, Kamelah, Sawsan Abulaimoun, Sarah J. Aurit, Erin Jenkins, and Peter T. Silberstein. "Microsatellite instability in colorectal cancer: An analysis of the National Cancer Database." Journal of Clinical Oncology 39, no. 3_suppl (2021): 134. http://dx.doi.org/10.1200/jco.2021.39.3_suppl.134.
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134 Background: High-frequency microsatellite instability (MSI-H) accounts for roughly 15% of all cases of colorectal cancer (CRC). Studies suggest a significant non-adherence to routine MSI testing in patients diagnosed with CRC despite universal guidelines. Methods: We used the NCDB to identify adults with MSI-H status CRC from 2010-2015 with the following histologic subtypes: mucinous and not otherwise specified adenocarcinoma, and medullary carcinoma. The primary site was localized to the right colon, left colon, and rectum; demographic factors, clinicopathologic features, and treatments were identified. Patients were stratified by site and discrete and continuous variable comparisons were made using the chi-square and Mann-Whitney test, respectively. Survival was examined with the Kaplan-Meier method and a Cox proportional hazards regression model. A logistic regression model was used to examine MSI status. All analyses were conducted with SAS version 9.4. Results: A total of 5364 patients were identified and stratified by site into 3 groups: right colon (n = 4004, 74.6%), left colon (n = 890, 16.59%) and rectum (n = 470, 8.76%). Compared to the left colon and rectum, right colon patients were more likely to be older females with larger tumors and less likely to receive chemoradiation. After adjusting for all else, we found statistical evidence that female vs. male gender (OR = 1.47; 95% CI: 1.24 to 1.73), Black vs. White race (OR = 0.61; 0.45 to 0.83), left vs. right colon (OR = 0.33, 0.27 to 0.41), rectum vs. right colon (OR = 0.08, 0.05 to 0.13), mucinous adenocarcinoma vs. adenocarcinoma (OR = 2.37, 1.92 to 2.93), medullary carcinoma vs. adenocarcinoma (OR = 8.86, 4.56 to 17.22), positive vs. negative k-RAS mutation (OR = 0.49, 0.41 to 0.59), and positive vs. negative CEA status (OR = 0.79, 0.66 to 0.94) were factors associated with MSI-H status. Improved survival was associated were Hispanic white race, stage 1, and free surgical margins within a multivariable context. Factors associated with poor survival: increased Charlson/Deyo score, advanced stage, lymphovascular invasion, and positive CEA status. Conclusions: In settings where resources are scarce and universal testing is not possible, there is a benefit from MSI testing in female patients, those with right-sided colon cancer, mucinous adenocarcinoma, and medullary carcinoma.
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Phan, Paul, Charbel Chidiac, Jaime Shalkow, and Daniel S. Rhee. "Socioeconomic disparities in palliative care utilization among children with late-stage bone and soft tissue sarcomas: A National Cancer Database analysis." Journal of Clinical Oncology 43, no. 16_suppl (2025): 12066. https://doi.org/10.1200/jco.2025.43.16_suppl.12066.
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12066 Background: Palliative care seeks to improve the quality of life for many children living with cancer, but it remains underused. Racial and socioeconomic disparities have been identified in the receipt of palliative care among adult patients with advanced soft-tissue sarcomas and metastatic renal cell carcinoma. Our study seeks to determine if similar barriers exist in palliative care receipt among pediatric patients with late-stage bone and soft tissue sarcomas. Methods: We used the National Cancer Database (NCDB) to perform a retrospective review of children aged 0-25 with Stages III and IV bone and soft tissue sarcomas from 2004 to 2022. We used a 1:1 propensity score matching algorithm to compare the utilization of palliative treatment by race and ethnicity and to balance potential confounding covariates. Kaplan-Meier estimation was utilized for survival analysis. Results: A total of 8,030 patients were included in this analysis. Of these patients, 375 (4.7%) received at least one form of palliative treatment, including surgery (n=31), radiation (n=99), chemotherapy (n=55), pain management (n=98), multiple modalities (n=77), and others (n=15). The median age was 16 years (IQR: 12-20). Osteosarcoma (29.2%) was most common, followed by Ewing’s sarcoma (28.1%), non-rhabdomyosarcoma soft tissue sarcoma (21.6%), and rhabdomyosarcoma (21.0%). The 5-year overall survival rate was 14.7% (95% CI 11.2%-19.3%) for patients receiving palliative care versus 44.7% (95% CI 43.6%-45.9%) for those who did not. After propensity score matching, non-Hispanic Black children were found to be less likely to receive palliative care than non-Hispanic White children (3.4% vs. 5.9%, p = 0.047). Hispanic children were also less likely to receive palliative treatment than non-Hispanic White children (2.5% vs. 5.5%, p = 0.007). Conclusions: Hispanic and Black children with sarcomas were less likely to receive palliative care compared to White children. Further research is warranted to understand the impact of other factors contributing to palliative care receipt and how they may be addressed to optimize the quality of life in sarcoma treatment in children. Post-propensity score matching univariate analysis for palliative care use by race and ethnicity. Palliative Care Utilization* RACE ETHNICITY Total (n=1286) Non-Hispanic White (n=643) Non-Hispanic Black (n=643) p-value Total (n=1418) Non-Hispanic White (n=709) Hispanic (n=709) p-value No 1226 (95.3%) 605 (94.1%) 621 (96.6%) 0.047 1361 (96.0%) 670 (94.5%) 691 (97.5%) 0.007 Yes 60 (4.7%) 38 (5.9%) 22 (3.4%) 57 (4.0%) 39 (5.5%) 18 (2.5%) *Patients were matched based on age at diagnosis, sex, insurance status, median income of county of residence, high school graduation percentages of county of residence, mean tumor size, primary tumor sjte, AJCC stage, and presence of metastases at diagnosis.
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Gong, Jun, Jessica Janes, Anoruo Asilonu, et al. "Epidemiology, treatment patterns, and clinical outcomes in de novo oligometastatic hormone-sensitive prostate cancer." Journal of Clinical Oncology 41, no. 6_suppl (2023): 92. http://dx.doi.org/10.1200/jco.2023.41.6_suppl.92.
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92 Background: Oligometastatic hormone-sensitive prostate cancer (omHSPC) represents an advanced prostate cancer subset where metastasis-directed therapy (MDT) and prostate radiation therapy (RT) may improve clinical response and outcomes; however, there is a lack of published data on the epidemiology, clinical outcomes, and current treatment patterns. As such, we conducted a study to better characterize de novo omHSPC in the United States Veterans Affairs Health Care System (VA). Methods: This observational retrospective cohort study utilized chart abstracted data from the VA electronic medical record, as well as data from the VA Corporate Data Warehouse, a central repository of VA patient medical records. We randomly selected 400 men diagnosed with de novo mHSPC from 1/2015-12/2020. omHSPC was defined as up to 5 bone, lymph node, and/or visceral (excluding liver) metastases in total, identified by conventional imaging (bone scan, CT, and/or MRI). We estimated prevalence, described treatment patterns and used Kaplan-Meier methods to estimate overall survival (OS) and time to castration resistance from date of mHSPC diagnosis. The log rank test was used to compare differences in outcomes between omHSPC and non-omHSPC groups. Results: Of the 400 men with de novo mHSPC, 76 (19%) had omHSPC by conventional imaging. Men with omHSPC and non-omHSPC were similar in age, race, Gleason grade group, comorbidities, and metastatic site (bone and lymph node being most common). Men with non-omHSPC had a higher median PSA at mHSPC diagnosis (147.0) than omHSPC (38.3). The percentage of men on first-line (1L) novel hormonal therapy (NHT) use (most commonly abiraterone or enzalutamide) was similar between groups in the 1L setting (22.4% (omHSPC) vs 20.4% (non-omHSPC)), but the percentage of men on a 1L chemotherapy regimen was lower in omHSPC (5.3%) vs. non-omHSPC (13.6%). Overall, there was a higher percentage of men treated with MDT or prostate RT in omHSPC (13.2%) vs non-omHSPC cases (2.5%). Median OS in months (mos) was higher in men with omHSPC (55.3 mos, 95% CI 35.9-79.0) vs. non-omHSPC (25.9 mos, 95% CI 20.5-31.7, p=0.002). Median time to castration resistance was also longer in omHSPC (not reached [NR], 95% CI 42.2-NR) vs. non-omHSPC (29.3 mos, 95% CI 23.7-36.1, p=0.0014). Conclusions: Our study provides real-world insight into the prevalence, treatment patterns and clinical outcomes for omHSPC using a nationally representative VA sample. Approximately 1 in 5 men with de novo mHSPC were oligometastatic, and OS in men with omHSPC was more than double that of non-omHSPC. Although more men with omHSPC compared to non-omHSPC received potential curative therapy, the percentage was still relatively low. Future studies are warranted as several clinical trials are investigating the potential for prolonged responses with aggressive, multimodal therapy inclusive of systemic and local therapies.
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Gupta, Ajay, Allen Buxton, Natalie DelRocco, et al. "Association of baseline clinical factors with outcomes in patients with localized Ewing sarcoma treated on frontline trials with interval compressed chemotherapy (ICC): A report from the Children’s Oncology Group." Journal of Clinical Oncology 43, no. 16_suppl (2025): 10032. https://doi.org/10.1200/jco.2025.43.16_suppl.10032.
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10032 Background: Identifying clinical and biological factors associated with outcomes in localized Ewing sarcoma (ES) will enable risk-stratified clinical trials with the goal of improved outcomes for high-risk patients and decreased treatment toxicity for low-risk patients. The specific aims of this analysis in localized ES patients were 1) to classify extraosseous (EO) primary tumors with subdivisions into deep (viscera, glands, body cavities, muscle, nerves) and superficial (cutaneous and subcutaneous) sites, and 2) to understand the relationship between baseline clinical factors (age, sex, primary tumor site, size (maximum dimension and volume)) and event-free survival (EFS). Methods: The analytic cohort included ES patients treated with ICC on AEWS0031 and AEWS1031. Primary tumor sites were defined as pelvic, non-pelvic, and EO (deep vs. superficial). Post-enrollment EFS was the primary endpoint. Univariate analyses used the Kaplan–Meier method (logrank test). Multivariable analyses used Cox proportional hazards models. To assess the impact of tumor volume as a continuous variable, a subgroup analysis was conducted using AEWS1031 only, as tumor volumes were collected prospectively on this study. Visual exploration of effects of continuous variables on EFS event hazard used restricted cubic splines with 3 knots. Tests were performed at the 5% level. Results: AEWS0031 (n = 628) and AEWS1031 Regimen B (n = 283) yielded 911 patients. In univariate analyses, difference in risk of EFS event was observed between tumor sites ( P = 0.03). EO tumors had the highest estimated EFS compared to pelvic and non-pelvic (5 year EFS 84.7% vs. 72.4% and 75.9%). Superficial EO appeared to be a very low-risk group, albeit interpretations are limited by the small group size and singular event (one second malignant neoplasm among 15 patients). In multivariable analysis of the combined cohort, sex, race, and ethnicity were not prognostic. EO tumors may be associated with decreased hazard compared with non-pelvic bone primaries (HR 0.58, P = 0.07), and tumors ≥200 mL with increased hazard (HR 1.56, P < 0.01). In the subgroup analysis, tumor volume and age were prognostic and in visualizations age was non-linearly related to the hazard of EFS event, increasing until approximately 15 years. Tumor volume was non-linearly related to the hazard of EFS event and increased until approximately 400 mL. Conclusions: Patients with ES and primary tumors ≥200 mL continue to be at higher risk of an EFS event when treated with ICC, and EO tumors may be lower risk compared with other sites. Risk of an event appears to remain constant in ES patients ≥15 years or with primary tumors ≥400 mL. These findings should be validated in prospective trials and tumor biology integrated with clinical factors to improve risk stratification for localized ES.
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Martin, Enrico, Ivo S. Muskens, J. H. Coert, Timothy R. Smith, and Marike L. D. Broekman. "Treatment and survival differences across tumor sites in malignant peripheral nerve sheath tumors: a SEER database analysis and review of the literature." Neuro-Oncology Practice 6, no. 2 (2018): 134–43. http://dx.doi.org/10.1093/nop/npy025.
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AbstractBackgroundCurrently, literature is scarce on differences across all possible tumor sites in malignant peripheral nerve sheath tumors (MPNSTs). To determine differences in treatment and survival across tumor sites and assess possible predictors for survival, we used the Surveillance, Epidemiology, and End Results (SEER) database.MethodsMPNST cases were obtained from the SEER database. Tumor sites were recoded into: intracranial, spinal, head and neck (H&N), limbs, core (thorax/abdomen/pelvis), and unknown site of origin. Patient and tumor characteristics, treatment modalities, and survival were extracted. Overall survival (OS) was assessed using univariable and multivariable Cox regression hazard models. Kaplan-Meier survival curves were constructed per tumor site for OS and disease-specific survival (DSS).ResultsA total of 3267 MPNST patients were registered from 1973 to 2013; 167 intracranial (5.1%), 119 spinal (3.6%), 449 H&N (13.7%), 1022 limb (31.3%), 1307 core (40.0%), and 203 unknown (6.2%). The largest tumors were found in core sites (80.0 mm, interquartile range [IQR]: 60.0-115.0 mm) and the smallest were intracranial (37.4 mm, IQR: 17.3-43.5 mm). Intracranial tumors were least frequently resected (58.1%), whereas spinal tumors were most often resected (83.0%). Radiation was administered in 35.5% to 41.8%. Independent factors associated with decreased survival were: older age, male sex, black race, no surgery, partial resection, large tumor size, high tumor grade, H&N site, and core site (all P < .05). Intracranial and pediatric tumors show superior survival (both P < .05). Intracranial tumors show superior OS and DSS curves, whereas core tumors have the worst (P < .001).ConclusionSuperior survival is seen in intracranial and pediatric MPNSTs. Core and H&N tumors have a worse prognosis.
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Xing, Minzhi, Hasmukh J. Prajapati, Nima Kokabi, Juan C. Camacho, Bassel F. El-Rayes, and Hyun Sik Kim. "Survival trends in unresectable hepatocellular carcinoma and the effect of DEB-TACE: SEER versus tertiary cancer center." Journal of Clinical Oncology 32, no. 3_suppl (2014): 308. http://dx.doi.org/10.1200/jco.2014.32.3_suppl.308.
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308 Background: Long-term survival in patients with advanced unresectable hepatocellular carcinoma (HCC) treated with drug-eluting bead transarterial chemoembolization (DEB-TACE) vs. best supportive care has not been investigated in large-scale population studies. Methods: Under IRB approval, our institute’s cancer registry was queried for patients with advanced unresectable HCC diagnosed from Sept 2005 to Dec 2010, treated with DEB-TACE. Eighteen registries of the U.S. Surveillance, Epidemiology and End Results (SEER) database were queried for patients with advanced HCC not amenable to surgery/radiation diagnosed in the same time period. Baseline characteristics, median overall survival (OS) from HCC diagnosis and median OS from first DEB-TACE were stratified by national/state cohorts. Survival analysis and 95% confidence intervals (CI) were calculated using Kaplan-Meier estimation. Results: A total of 231 patients who underwent DEB-TACE for unresectable HCC (Group A) and 20,897 patients with unresectable HCC who received neither radiation nor cancer-directed surgery (Group B) were included. Both groups were similar for mean age at diagnosis, gender, race, bilobar disease, portal vein thrombosis and mean largest tumor size (p>0.05). Median OS from HCC diagnosis was 21.8 months (Group A; 95% CI, 18.1-25.4) and 4.0 months (Group B; 95% CI, 3.9-4.1), p<0.001. Median OS from first DEB-TACE was 15.0 months (Group A; 95% CI, 9.6-20.4). Interval survival rates from HCC diagnosis for Group A vs. B were: 99% vs. 65% (1 month), 92% vs. 49% (3 months), 75% vs. 36% (6 months), 58% vs. 35% (1 year), 36% vs. 9% (2 years), and 20% vs. 4% (3 years). Conclusions: DEB-TACE in patients with unresectable HCC demonstrated significantly greater median OS and favorable long-term survival rates compared to best supportive care in a population-based study. [Table: see text]
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Palmer, Mathias E., Jennifer J. Gile, Michael H. Storandt, et al. "Outcomes of Patients with Advanced Hepatocellular Carcinoma Receiving Lenvatinib following Immunotherapy: A Real World Evidence Study." Cancers 15, no. 19 (2023): 4867. http://dx.doi.org/10.3390/cancers15194867.
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Background: Lenvatinib, a multikinase inhibitor, is an FDA-approved treatment for advanced hepatocellular carcinoma (HCC) in the first-line setting. Recent trial data have established atezolizumab plus bevacizumab as well as tremelimumab plus durvalumab as preferred first-line treatment options for advanced HCC. The role of lenvatinib following progression on immunotherapy in patients with advanced HCC remains unclear. Methods: We conducted a multicentric, retrospective analysis of patients with advanced HCC diagnosed between 2010 and 2021 at the Mayo Clinic in Minnesota, Arizona, and Florida who received immunotherapy followed by lenvatinib. Median overall survival and progression-free survival analyses were performed using the Kaplan–Meier method, and responses were determined using RECIST 1.1. Adverse events were determined using CTCAE v 4.0. Results: We identified 53 patients with advanced HCC who received lenvatinib following progression on immunotherapy. Forty five (85%) patients had a Child Pugh class A at diagnosis, while 30 (58%) patients were still Child Pugh A at time of lenvatinib initiation. Lenvatinib was administered as a second-line treatment in 85% of the patients. The median PFS was 3.7 months (95% CI: 3.2–6.6), and the median OS from the time of lenvatinib initiation was 12.8 months (95% CI: 6.7–19.5). In patients with Child Pugh class A, the median OS and PFS was 14 and 5.2 months, respectively. Race, gender, and Child Pugh class was associated with OS on multivariate analysis. Discussion: Our study, using real-world data, suggests that patients benefit from treatment with lenvatinib following progression on immunotherapy in advanced HCC. The optimal sequencing of therapy for patients with advanced HCC following progression on immunotherapy remains unknown, and these results need to be validated in a clinical trial.
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Lukusa, L., M. G. Birck, C. S. Moura, et al. "P1129 Comparison of discontinuation/switching between adalimumab biosimilar and originator in Inflammatory Bowel Disease patients: Preliminary data from CAN-AIM." Journal of Crohn's and Colitis 19, Supplement_1 (2025): i2073—i2074. https://doi.org/10.1093/ecco-jcc/jjae190.1303.
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Abstract Background Biosimilar adalimumab (ADA-B) has been approved in Canada for inflammatory bowel disease (IBD) for over eight years, but real-world descriptions of therapy persistence (discontinuation/switching) comparing ADA-B to its bio-originator (ADA-O) are still scarce. We compared discontinuation of ADA-B and ADA-O in IBD. Methods CAN-AIM is a team funded to do high-priority research projects for Health Canada and other stakeholders. Canadian IBD Research Consortium members contributed to CAN-AIM’s prospective pan-Canadian clinical registry of biosimilar/bio-originator users. We enrolled adults with a clinical diagnosis of Crohn’s disease (CD) or ulcerative colitis (UC), starting a bio-originator or corresponding biosimilar from Feb 2009 to Mar 2024. We assessed time to discontinuation through Kaplan-Meier curves with a log-rank test (right-censoring at loss to follow-up or end of study) and reasons for discontinuation. Using multivariable Cox regression, we assessed time to drug discontinuation, comparing ADA-B and ADA-O. Covariates included age, sex, underlying condition (CD/UC), disease duration, race and ethnicity, calendar year, smoking, education, disease activity (moderate or severe: Crohn’s Disease Activity Index ≥220, Harvey-Bradshaw Index ≥8 or Partial Mayo Score ≥5), obesity (body mass index &gt;30), comorbidity, and prior use of other biologics, as well as previous/current corticosteroids and non-biologic immunosuppressants. Results We followed 103 IBD individuals for a median of 5.0 years (interquartile range of 3.6 to 9.2). IBD duration, age, race and ethnicity, and smoking were comparable among the two groups (Table 1). We censored four individuals who changed from ADA-O to ADA-B due to provincial drug insurance formulary requirements. There were 37 (35.9 %) other discontinuations, or 133.9 events per 1000 person-years. The main reasons for discontinuation were secondary loss of response (n=20, 54.1% of 37) and adverse events (n=7, 18.9%). Other reasons included insurance changes (n=2), patient choice (n=1), and unknown or missing reasons (n=7). Median time to discontinuation was 4.0 years (95% confidence interval [CI] 1.4-5.8) for ADA-O and 6.7 (95% CI 3.6-9.2) for ADA-B. Risk of discontinuation was lower in ADA-B versus ADA-O, with a wide CI (adjusted hazard ratio [aHR] 0.46, 95% CI 0.22–0.97 – Table 2). Older age, female sex, UC, higher education, more recent calendar year, and corticosteroids were significantly associated with discontinuation. Conclusion In this real-world IBD analysis, ADA-B was not associated with a greater risk of discontinuation.
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Freudenberger, Devon C., Luke Wolfe, Andrea N. Riner, et al. "Abstract B114: The absolute need for impartial care: Aggressive surgery and local therapy provide equitable care across diverse patient populations for advanced colorectal cancer." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (2023): B114. http://dx.doi.org/10.1158/1538-7755.disp22-b114.
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Abstract Introduction: Survival for patients with peritoneal metastasis from colorectal cancer is poor, but can be improved in highly selected patients with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Advanced cancer states tend to create racial/ethnic disparities. Little is known about racial/ethnic disparities in patients with colorectal cancer peritoneal metastasis managed with CRS/HIPEC. In this study we examine the impact of race/ethnicity of patient outcomes and overall survival after CRS/HIPEC. Methods: Data were extracted from the National Cancer Database 2019 Participant User File for adult patients with colorectal cancer managed with CRS/HIPEC from 2006-2018. Patients were classified by racial/ethnic groups: non-Hispanic White, non-Hispanic Black, Hispanic, and Other. Differences in sociodemographics, treatment course, tumor characteristics, and postoperative outcomes were evaluated using Χ2 and Kruskal-Wallis tests. Kaplan-Meier survival analysis and Log-rank tests were used to assess for differences in survival. Cox Regression was used for evaluating predictors of overall survival. Results: 732 patients with colorectal cancer underwent CRS/HIPEC, of which 573 (78.3%) were White, 91 (12.4%) were Black, 39 (5.3%) were Hispanic, and 29 (4.0%) were Other. There were significant differences by race/ethnicity in patient sex, insurance payor, distance traveled to facility, location, education level, and income. There was, however, no difference in patient age, cancer treatment facility type, or year of diagnosis. Patients had similar amounts of comorbidities with the majority of patients having a Charlson-Deyo score of 0 (p=0.6882). Surgical management with CRS/HIPEC was similar across all groups in terms of median days from diagnosis to surgery. Tumor grade and surgical margins were also similar. Postoperative outcomes including hospital length of stay, rates of readmission, 30 and 90-day mortality were not different. Patients had similar lengths of follow-up. Median overall survival was 40.1 months for White patients, 45.5 months for Black patients, 44.1 months for Hispanic patients, and 64.1 months for Other patients. Overall survival was not statistically different between racial/ethnic groups (p=0.1922). Multivariate survival analysis showed that race/ethnicity was not a predictor of survival; however, tumor grade (Poorly differentiated: HR 2.031 [1.309, 3.151], p=0.0016; Undifferentiated: HR 2.284 [1.297, 4.021], p=0.0042) and surgical margins (R2 resection: HR 1.954 [1.186, 3.221], p=0.0086) were significant predictors of survival. Conclusions: Advanced colorectal disease with peritoneal involvement can be managed aggressively with CRS/HIPEC and improve patient overall survival. Similar outcomes are possible for different racial/ethnic groups despite differences in patient sociodemographic factors. CRS/HIPEC for colorectal peritoneal disease should be viewed as an equitable management option for diverse patient populations. Citation Format: Devon C. Freudenberger, Luke Wolfe, Andrea N. Riner, Vignesh Vudatha, Kelly M. Herremans, Leopoldo J. Fernandez, Jose G. Trevino. The absolute need for impartial care: Aggressive surgery and local therapy provide equitable care across diverse patient populations for advanced colorectal cancer [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B114.
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Hull, Madison, Kari Teigen, Jolonda Bullock, Riyaz Basha, and Kalyani Narra. "Abstract 3056: Characteristics and outcomes of patients with hepatocellular carcinoma diagnosed at John Peter Smith Hospital." Cancer Research 83, no. 7_Supplement (2023): 3056. http://dx.doi.org/10.1158/1538-7445.am2023-3056.
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Abstract Background: The incidence of hepatocellular carcinoma (HCC) is increasing in the US, particularly in individuals infected with hepatitis C (HCV). Although early detection is crucial for better outcomes, at present, there is conflicting evidence regarding HCC screening and its reduction on cancer-related mortality. This study aimed to determine overall survival, prognostic factors influencing survival, and the effects of screening at-risk patients on HCC-related mortality. Methods: A retrospective chart review of patients diagnosed with HCC from 1/1/2018 to 6/4/2021 for the one-year survival analysis and 6/4/2019 for the three-year analysis. Person-time was calculated as the days from the date of diagnosis until the last known encounter or death. The primary exposure of interest was screening within two years prior to the diagnosis date via ultrasound, MRI, and/or CT. Potential covariates were age at diagnosis, race/ethnicity, gender, insurance status, alcohol use disorder, HCV, HBV, and cirrhosis. Kaplan Meier, log rank test, and Cox proportional hazards (CPH) model were used to assess survival curves, survival distributions across screening status, and the effects of additional covariates on prognosis at one and three years, respectively. A backwards stepwise regression was used on the covariates identified via a pre-univariate filtering to construct a multivariable model. Results: There were 165 and 71 patients who met the one- and three- year inclusion criteria, respectively. Survival at one and three years was 38% and 14%, respectively. Median survival for the 165 patients was 265 days (95% CI: 166, 337). Overall, 36% (n=59/163; 2 missing) and 27% (n=19/70; 1 missing) were screened prior to diagnosis. The CPH model showed a statistically significant difference in hazard ratio of death in the first year for those without screening compared to patients with screening (HR: 1.9; 95% CI: 1.2, 3.0; p-value: 0.005). After adjusting for race/ethnicity and insurance type, the CPH model yielded similar results (HR: 2.2; 95% CI: 1.3, 3.6; p-value: 0.002). The CPH model showed a statistically significant difference in hazard ratio of death in three years for those without screening compared to patients with screening (HR: 3.4; 95% CI: 1.7, 7.1; p-value: 0.001). After adjusting for gender, HBV, and race/ethnicity, the CPH model yielded similar results (HR: 2.2; 95% CI: 1.2, 4.0; p-value: 0.009). Conclusion: Overall survival in patients diagnosed with HCC at JPS, a safety-net hospital, is similar to national statistics. Screening in patients at-risk for HCC shows improved survival at one and three years. Further evaluation based on the extent of disease at the time of diagnosis, treatment decisions, and type/timing of screening could be beneficial in determining the outcomes in HCC patients. Citation Format: Madison Hull, Kari Teigen, Jolonda Bullock, Riyaz Basha, Kalyani Narra. Characteristics and outcomes of patients with hepatocellular carcinoma diagnosed at John Peter Smith Hospital [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3056.
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Conley, Hannah L., Raven V. Delgado, Justin D. McCallen, Eleanor Elizabeth Harris, Andrew Wenhua Ju, and Kimberly Rathbun. "Lower survival outcomes in patients receiving an initial cancer diagnosis after presenting to the emergency department." Journal of Clinical Oncology 37, no. 15_suppl (2019): e18122-e18122. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e18122.
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e18122 Background: Survival outcomes in cancer are better in patients who are diagnosed at an early stage, which can potentially be detected through screening and routine visits to a primary care physician. Patients who receive their initial cancer diagnoses following a visit to the Emergency Department (ED) may present at a later Stage when survival outcomes are worse. The characteristics of patients who receive their diagnosis following an ED visit versus those who do not are not well reported in the literature. Methods: A retrospective review was conducted in which a cohort was identified of all patients who presented to the ED in a hospital system in eastern North Carolina from 10/1/2014 to 9/30/2015 with a visit associated with an oncologic ICD-9 code. The chart was reviewed to determine if the initial results that directly led to the cancer diagnosis were obtained through the ED visit. Patient characteristics, cancer characteristics, and survival outcomes were collected. Factors significant on univariate analysis were included in a multivariate analysis. Chi-square tests, Kaplan-Meier log rank tests, and Cox regression analysis were used. Results: Initial diagnosis through the ED was recorded in 38.5% of patients (n = 400/1039). Median overall survival following diagnosis was lower in individuals diagnosed through the ED (13 vs. 41 months, p < 0.001), in men (21 vs. 35 months, p < 0.001), and in patients with a Charlson Comorbidity Index (CCI) of ≥9 (18 vs. 37 months, p < 0.001) on univariate analysis. Patients diagnosed through the ED were more likely to be Stage IV (p < 0.001). There was no association on multivariate analysis between the rate of diagnosis through the ED or overall survival with insurance status or race; however, it was difficult to determine the insurance status of a patient at the time of the initial ED visit, possibly due to retroactive coverage and other issues. Conclusions: Patients who received a cancer diagnosis through the ED have significantly shorter overall survival times from diagnosis. This remained significant when controlling for CCI, gender, age, and Stage. Further investigation into the public health factors that may contribute to patients receiving their cancer diagnosis in the ED is needed. A prospective study may be needed to record the insurance status at the initial ED visit.
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Meeks, Marshall W., Henry S. Park, James B. Yu, Kenneth B. Roberts, Francine Foss, and Lynn D. Wilson. "A Novel Prognostic Index for Ocular Adnexal Lymphoma." Blood 128, no. 22 (2016): 3597. http://dx.doi.org/10.1182/blood.v128.22.3597.3597.
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Abstract Background: Ocular adnexal lymphoma (OAL) is a rare malignancy with a heterogeneous patient population. We sought to identify prognostic factors for OAL and to incorporate them into a novel prognostic index by using a large national database. Methods: We identified patients diagnosed with histologically confirmed OAL in 1973-2013 using all registries of the Surveillance, Epidemiology, and End Results database. Patients with regional or distant disease at diagnosis were excluded. Indolent histologies were defined as follicular, marginal zone, small lymphocytic not otherwise specified, and lymphoplasmacytic. We determined the association between OAL histology, orbital site, and overall survival (OS) using adjusted proportional hazards analysis and Kaplan-Meier estimates. Relative survival (RS) was calculated relative to a matched cohort of patients categorized by race, gender, and age using the SEER*Stat Program. Results: Among the 3,070 patients included, 941 (30.6%) had conjunctival tumors, 418 (13.7%) had lacrimal gland tumors, and 1711 (55.7%) had orbital-not otherwise specified tumors. Indolent histology was present in 2,073 (67.5%) patients. The 10-year OS and RS were 61% and 86%, respectively. In univariable and multivariable models, conjunctival site location (P<0.001) and indolent histology (P<0.001) were both associated with superior OS. Three primary OAL prognostic groups were identified: Group I (indolent histology, conjunctival location), Group II (indolent histology, non-conjunctival location or aggressive histology, conjunctival location), and Group III (aggressive histology, non-conjunctival location). The adjusted 10-year hazard ratios for OS were 1.4 (95% CI, 1.1-1.7, P<0.001) and 3.1 (95% CI, 2.5-4.0, P<0.001) for groups II and III, respectively, compared to group I. Groups I, II, and III had 10-year OS of 75%, 61%, and 37%, respectively, and 10-year RS of 96%, 89%, and 55%, respectively. Conclusions: Both conjunctival location and aggressive histology were independent predictors of survival. Our proposed prognostic index could have implications on OAL staging and management, though it must first be externally validated. Disclosures No relevant conflicts of interest to declare.
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Liu, Angela, Marshall Mazepa, Elizabeth Davis, et al. "African American Race Is Associated with Decreased Relapse-Free Survival in Immune Thrombotic Thrombocytopenic Purpura." Blood 134, Supplement_1 (2019): 1066. http://dx.doi.org/10.1182/blood-2019-131064.
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Background: Immune thrombotic thrombocytopenic purpura (iTTP) is a potentially fatal hematologic disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, and ischemic organ impairment. The incidence of iTTP is higher among African-Americans (AA), however, differences in presentation and outcomes have not been fully investigated. In a multi-center cohort of patients with iTTP from the United States Thrombotic Microangiopathy (USTMA) Consortium, we tested the hypothesis that AA race is an independent predictor of poor outcomes including iTTP related mortality and relapse. Methods: We queried data from the USTMA iTTP registry, which currently includes data from 785 individual patients from 15 institutions across the United States. Data from at least one iTTP episode are available for 734 patients. The cohort is 35.1% (N = 272) White, 58.7% (N = 455) African American, 0.4% (N=3) Asian, 1.8% (N=14) Hispanic, and 4.0 % (N=31) other/unknown race. We restricted our analyses to AA and White participants because of small numbers in the other groups. We compared presenting features and treatments using the chi-squared test and t-test for categorical and continuous variables, respectively. A relapse was defined as a recurrent iTTP episode occurring at least 30 days after last therapeutic plasma exchange. To evaluate relapse-free survival, we included only patients enrolled in the registry at their first TTP episode (144 White and 246 AA) since patients presenting with a relapse as their index episode are already confirmed to have relapsing iTTP. Kaplan Meier analysis was used to compare relapse-free survival in White and AA patients, and a Cox regression model was developed to evaluate the independent effect of race on relapse, adjusting for potential confounders including age, sex, and the use of rituximab. Results: Demographics and presenting features of 390 individuals (144 White and 246 AA) presenting with a first episode of iTTP are shown in Table 1. Presenting symptoms including fever, confusion, seizure, memory deficits, stupor, headache, stroke, chest pain, abdominal pain, fatigue, and dark urine were similar between Whites and AA except for petechiae, which were more frequently documented in Whites (28.8% vs 17.7%, p=0.011). Presenting laboratory studies were also comparable though AA had a higher rate of elevated serum troponin (50.6% vs 32.5%, p=0.003), lower hemoglobin level (8.27 ± 0.13 vs 8.81 ± 0.19, p=0.0176) and platelet count (20.3 ± 1.2 vs 26.2 ± 3.2, p=0.0432). In addition to therapeutic plasma exchange and corticosteroids, rituximab was administered to 23.7% of White patients and 22.7% of AA during their first iTTP episode (P=0.815). Median time to platelet count recovery (days of daily plasma exchange until normal platelet count for two consecutive days) was shorter in AA compared with White patients [5 (IQR 4, 10) vs. 8 (IQR 5, 14), log rank P = 0.004]. AA race remained a significant predictor of the shorter time to platelet count recovery [HR 1.44 (95% CI 1.12, 1.85), P=0.004] after adjusting for rituximab therapy [HR 0.60 (95% CI 0.0.46, 0.80), P<0.001], female sex [HR 0.95 (95% CI 0.73, 1.22), P=0.669], age [HR 0.99 (95% CI 0.99, 1.01), P=0.682], platelet count [HR 1.00 (95% CI 0.99, 1.04), P=0.820] and LDH at presentation [HR 1.00 (95% CI 1.00, 1.00), P=0.525]. Death during the first episode occurred in 8.9% of White patients and 5.5% of AA patients (P=0.206). Relapse-free survival after the first episode of iTTP was lower in AA than White patients (Figure 1). AA race was associated with the reduced relapse free survival [HR 1.79 (95% CI 1.08, 2.98), P=0.024] in a Cox regression model adjusted for age [HR 1.00 (95% CI 0.98, 1.01), P=0.683], sex [HR 0.96 (95% CI 0.60, 1.54), P=0.867], and rituximab therapy [HR 0.93 (95% CI 0.55, 1.59), P=0.806]. Conclusion: African Americans with iTTP have a higher relapse rate and shorter relapse free survival after the first episode of the disease compared with Caucasian patients, which is independent of age, sex and rituximab therapy. Contrary to our hypothesis, acute outcomes of iTTP (time to platelet count recovery and mortality) were not worse in AA patients. The factors contributing to the higher relapse rate in AA with iTTP need to be further investigated. Our findings suggest that AA patients may also benefit from closer follow up. Disclosures Farland: Sanofi: Membership on an entity's Board of Directors or advisory committees. Metjian:Sanofi: Membership on an entity's Board of Directors or advisory committees. Raval:Bayer, Inc: Research Funding; Sanofi: Membership on an entity's Board of Directors or advisory committees. Liles:Shire: Other: PI on clinical trial Sickle cell ; Imara: Other: PI on Clinical trial- Sickle cell ; Novartis: Other: PI on clinical trial Sickle cell . Baumann Kreuziger:CSL Behring: Consultancy; Vaccine Injury Compensation Program: Consultancy. McCrae:Dova Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Pfizer Pharmaceutical: Membership on an entity's Board of Directors or advisory committees; Rigel Pharmaceutical: Membership on an entity's Board of Directors or advisory committees; Sanofi Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees. Zheng:Alexion: Speakers Bureau; Ablynx/Sanofi: Consultancy, Speakers Bureau; Clotsolution: Other: Co-Founder; Shire/Takeda: Research Funding. Cataland:Alexion: Consultancy, Research Funding; Ablynx/Sanofi: Consultancy, Research Funding. Chaturvedi:Shire/Takeda: Research Funding; Sanofi: Consultancy; Alexion: Consultancy.
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Waheed, S., B. McClune, F. Buadi, K. Wright, and D. Przepiorka. "The effect of changes in the treatment paradigm for chronic lymphocytic leukemia: A tumor registry study." Journal of Clinical Oncology 24, no. 18_suppl (2006): 16000. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.16000.
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16000 Background: In the early 1990s, several new agents became available for treatment of chronic lymphocytic leukemia (CLL), leading to a shift in the treatment paradigm with the hope of improving long-term survival. To determine if that outcome has been achieved, we performed a retrospective analysis of survival of patients in our community. Methods: The hospital tumor registry was queried to identify patients with CLL diagnosed 1980 to 2004. Zip code at diagnosis was used to assign a median household income based on census data. Survival was estimated by the method of Kaplan and Meier. Comparisons between the two groups were made by chi square. Hazard ratios for mortality were calculated in a Cox proportional hazard model using a backward stepping procedure retaining factors having a p-value < 0.1. Results: There were 192 patients with a diagnosis of CLL for analysis. The study cohort was comprised of 58% males and 42% females of median age 67 years (range, 39–96 years) at diagnosis. Fifty-three (28%) were <60 years of age, 29% were 60–69 years old, 26% were 70–79 years old, and 18% were >79 years at diagnosis. The group was 71% caucasian and 29% African American. Seventy-five (39%) patients had a household income greater than the median for the state, and the remainder had lesser incomes. There was a significant increase in the proportion of African Americans diagnosed >1990 compared to those diagnosed ≤1990 (40% vs 19%, p = 0.002), but there were no differences between time periods in gender, age, age category or income category. On multivariate analysis, factors predicting mortality differed between time periods as shown in the table. Median survival was 4.0 years for all patients, 3.9 years for the early group and 4.1 years for the later group (p = NS). Conclusion: We conclude that with changes in the treatment paradigm for CLL, gender and race are no longer prognostic for mortality, and the relative hazard for death is less amongst those 60–69 years and >79 years old, but there is no difference in survival for patients overall. [Table: see text] No significant financial relationships to disclose.