1,010 results match your criteria: "Levine Cancer Institute @ Atrium Health; Southeast Radiation Oncology Group. Charlotte[Affiliation]"

Real-World Analysis of Barriers to Timely Administration of Chimeric Antigen Receptor T Cell (CAR T) Therapy in Diffuse Large B-cell Lymphoma.

Transplant Cell Ther

November 2024

Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute, Wake Forest University, School of Medicine, Charlotte, North Carolina. Electronic address:

The implementation of chimeric antigen receptor T (CAR T) therapy in the real-world setting is hindered by logistical and financial barriers, impacting timely access to this life-saving treatment. Clinical trials have reported the time from leukapheresis to CAR T cell infusion (vein-to-vein time) but not the time from CAR T referral to infusion (decision-to-vein time). Herein, we report the barriers to CAR T therapy in a real-world setting.

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Article Synopsis
  • The study aimed to compare the effectiveness and side effects of two chemotherapy regimens, paclitaxel and carboplatin (PC), against bleomycin, etoposide, and cisplatin (BEP) in treating newly diagnosed or recurrent ovarian sex cord-stromal tumors (SCST).
  • In a phase II trial involving 63 patients, the analysis showed that PC did not meet the criteria for being as effective as BEP, with a median progression-free survival of 27.7 months for PC compared to 19.7 months for BEP.
  • Although PC had fewer serious adverse events (77% vs. 90%), the study concluded that it failed to demonstrate non-inferiority to BE
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Treatment of non-small cell lung cancer (NSCLC) has drastically changed in recent years owing to the robust anticancer effects of immune checkpoint inhibitors (ICI). However, only 20% of the patients with NSCLC benefit from ICIs, highlighting the need to uncover the mechanisms mediating resistance. By analyzing the overall survival (OS) and mutational profiles of 424 patients with NSCLC who received ICI treatments between 2015 and 2021, we determined that patients carrying a loss-of-function mutation in neurotrophic tyrosine kinase receptor 1 (NTRK1) had a prolonged OS when compared with patients with wild-type NTRK1.

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Machine Learning for Targeted Advance Care Planning in Cancer Patients: A Quality Improvement Study.

J Pain Symptom Manage

December 2024

Department of Medicine, Duke University Medical Center, Durham, North Carolina; Geriatric Research Education and Clinical Center, Durham VA Health System, Durham, North Carolina. Electronic address:

Context: Prognostication challenges contribute to delays in advance care planning (ACP) for patients with cancer near the end of life (EOL).

Objectives: Examine a quality improvement mortality prediction algorithm intervention's impact on ACP documentation and EOL care.

Methods: We implemented a validated mortality risk prediction machine learning model for solid malignancy patients admitted from the emergency department (ED) to a dedicated solid malignancy unit at Duke University Hospital.

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  • * The study analyzed blood and urine samples from 280 adults with SCA, finding that several biomarkers (like VCAM-1, AGT, KIM-1) were significantly higher in those with PA, particularly urinary AGT, which was the strongest predictor of PA.
  • * The findings highlight the need for further research through longitudinal studies to better understand how these biomarkers can predict the development and progression of CKD in people with SCA.
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The most common subtype of breast cancer is hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer, accounting for 65-70% of all breast cancer cases diagnosed in the United States. Until 2015, single-agent endocrine therapy (ET) was the recommended first-line treatment for metastatic HR-positive, HER2-negative breast cancer. However, the paradigm has since shifted, as targeted therapy is now recommended in combination with ET.

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BACKGROUND Human herpesvirus-8 (HHV-8)-associated diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS), is a rare form of lymphoid malignancy. It poses unique challenges in diagnosis in the setting of human immunodeficiency virus (HIV) infection and concomitant multiorgan dysfunction. CASE REPORT We describe the case of a 26-year-old man who initially presented with pre-syncope and was found to have HIV, with a CD-4 count of 20 cells/μL.

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  • R/R indolent non-Hodgkin lymphoma (iNHL) is often deemed incurable, but a phase 1b/2 study found that combining magrolimab (an anti-CD47 antibody) with rituximab (an anti-CD20 antibody) shows promising antitumor effects.
  • In this study, 46 patients were treated and showed a 52.2% overall response rate, with 30.4% achieving a complete response and median duration of response at 15.9 months.
  • Long-term follow-up (median 36.7 months) revealed no new toxicities or treatment-related deaths, indicating the combination's long-term safety and effectiveness, encouraging further research into CD
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Historically, salvage chemoimmunotherapy with consolidative autologous hematopoietic stem cell transplantation (ASCT) was the only potentially curative therapeutic option for patients with relapsed/refractory large B-cell lymphoma (LBCL). Treatment options were few and outcomes poor for patients whose lymphoma failed to respond to salvage chemotherapy/ASCT and for patients not eligible for ASCT. The approval of chimeric antigen receptor (CAR) T-cell therapy for relapsed/refractory LBCL revolutionized the treatment landscape with unprecedented response rates and durability of responses.

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Article Synopsis
  • - Although multiple myeloma remains incurable, advancements like CAR T-cell therapies have improved patient outcomes dramatically, with success rates for new treatments reaching as high as 97%.
  • - The introduction of BCMA-directed CAR T therapies, particularly idecabtagene vicleucel and ciltacabtagene autoleucel, marks a major shift in treating relapsed or refractory multiple myeloma, despite limitations noted in previous studies.
  • - Ongoing research aims to address the issue of non-durable responses to CAR T therapies, exploring resistance mechanisms and developing clinical trials to enhance efficacy for patients with complex treatment histories.
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The Genomic Landscape of Breast Cancer in Young and Older Women.

Clin Breast Cancer

October 2024

Department of Solid Tumor Oncology and Investigational Therapeutics, Levine Cancer Institute, Atrium Health, Charlotte, NC; Sandra Levine Young Women's Breast Cancer Program, Levine Cancer Institute, Atrium Health, Charlotte, NC.

Background: Young women with breast cancer (YWBC; ≤40 years) often have a poorer prognosis than older women with breast cancer (OWBC; ≥65 years). We explored molecular features of tumors from YWBC and OWBC to identify a biologic connection for these patterns.

Materials And Methods: We retrospectively analyzed the molecular profiles of 1879 breast tumors.

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Benign prostatic hyperplasia (BPH) may decrease patient quality of life and often leads to acute urinary retention and surgical intervention. While effective treatments are available, many BPH patients do not respond or develop resistance to treatment. To understand molecular determinants of clinical symptom persistence after initiating BPH treatment, we investigated gene expression profiles before and after treatments in the prostate transitional zone of 108 participants in the Medical Therapy of Prostatic Symptoms (MTOPS) Trial.

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  • Hydroxyurea is typically the first choice for treating high-risk essential thrombocythemia (ET), but some patients can't tolerate it or don't respond, leading to the use of ruxolitinib as an alternative.
  • A post hoc analysis compared clinical outcomes between patients who continued with hydroxyurea and those who switched to ruxolitinib after experiencing issues with hydroxyurea.
  • Results showed that after switching to ruxolitinib, patients experienced significant reductions in both leukocyte and platelet counts over 48 months, demonstrating that ruxolitinib can be an effective option for patients with ET who are intolerant or refractory to hydroxyurea.
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Primary myelofibrosis (PMF) is the most aggressive of the myeloproliferative neoplasms and patients require greater attention and likely require earlier therapeutic intervention. Currently approved treatment options are limited in their selective suppression of clonal proliferation resulting from driver- and coexisting gene mutations. Janus kinase inhibitors are approved for symptomatic patients with higher-risk PMF.

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Demographics, Utilization, Workflow, and Outcomes Based on Observational Data From the RSNA-ACR 3D Printing Registry.

J Am Coll Radiol

November 2024

Chair, Department of Radiology, University of Arizona College of Medicine, Phoenix, Arizona; Department of Radiology, Banner University Medical Group, Phoenix, Arizona; and Co-chair, 3D Printing Registry Committee, American College of Radiology. Electronic address: https://twitter.com/FrankRybicki.

Purpose: The aim of this study was to report data from the first 3 years of operation of the RSNA-ACR 3D Printing Registry.

Methods: Data from June 2020 to June 2023 were extracted, including demographics, indications, workflow, and user assessments. Clinical indications were stratified by 12 organ systems.

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Planned Dental Extractions After Radiation Therapy.

JAMA Otolaryngol Head Neck Surg

October 2024

Department of Oral Medicine/Oral & Maxillofacial Surgery, Atrium Health, Charlotte, North Carolina.

Importance: Nonrestorable teeth are recommended to be extracted prior to radiation therapy (RT). Occasionally, preradiation extractions introduce unacceptable delays in treatment initiation. Planned dental extractions immediately postradiation presents an alternative strategy, though outcomes are uncertain.

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Chimeric Antigen Receptor T-cell (CAR-T) therapies are transforming the treatment of B-cell lymphoproliferative disorders and multiple myeloma, yet global access challenges and barriers for their implementation persist. Global access disparities persist, particularly for persons living in low and middle-income countries and for underserved populations in high income countries. In this review we address patient-related factors including age, comorbidities, fitness, race and ethnicity, and geographic location for CAR-T access.

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Article Synopsis
  • High-grade immune-related adverse events (irAEs) can limit treatment options for patients with non-small cell lung cancer (NSCLC) and predicting these events is crucial for effective therapy management.
  • A study analyzed 430 NSCLC patients who received immune checkpoint inhibitors (ICIs) to evaluate the occurrence and genetic factors associated with high-grade irAEs.
  • The findings revealed that certain genetic mutations in tumor samples were linked to a higher risk of high-grade irAEs, offering insights for treatment considerations and monitoring strategies.*
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Introduction: The treatment of cancer is associated with high risk for toxicity and high cost. Strategies to enhance the value, quality, and safety of cancer care are often managed independently of one another. Oncology stewardship is a potential framework to unify these efforts and enhance outcomes.

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Purpose: Metastatic pancreatic adenocarcinoma (mPC) remains a difficult-to-treat disease. Fluorouarcil, oxaliplatin, irinotecan, and leucovorin (FFX) is a standard first-line therapy for mPC for patients with a favorable performance status and good organ function. In a phase I study, devimistat (CPI-613) in combination with modified FFX (mFFX) was deemed safe and exhibited promising efficacy in mPC.

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Introduction: Prostate cancer (PCa) is the most diagnosed noncutaneous malignancy and second leading-cause of cancer death in men, yet screening is decreasing. As PCa screening has become controversial, socioeconomic disparities in PCa diagnosis and outcomes widen. This study was designed to determine the current disparities influencing PCa diagnosis in Charlotte, NC.

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Background: Early cancer recognition is key to improving patient outcomes. Diagnosis is often delayed in patients with myeloproliferative neoplasms (MPNs), putting them at risk of thromboembolic events and other complications pre-diagnosis. A clear understanding of the barriers to presentation and diagnosis is required.

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Objective: The Commission on Cancer (CoC) recently introduced a quality metric to optimize time between major head and neck surgery and adjuvant treatment (TAT) ≤6 weeks, as TAT delay adversely impacts patient survival. This study evaluates whether enhanced recovery after surgery (ERAS) for this population reduces the rate of postoperative complications, length of stay (LOS), and TAT.

Methods: Patients undergoing larynx or oral cavity resection with free flap reconstruction, ERAS, and adjuvant treatment after 2018 were compared to a historical pre-ERAS cohort.

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Optimal therapy for the growing number of patients with lenalidomide (LEN)-refractory multiple myeloma in their first relapse remains poorly defined. We therefore undertook a randomized phase 2 study to evaluate the efficacy and safety of combining the oral proteasome inhibitor ixazomib (IXA) with pomalidomide (POM) and dexamethasone (DEX) in this patient population. The overall response rate (ORR) for POM-DEX was 43.

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