Text Classification of Cancer Clinical Trial Eligibility Criteria

Automatic identification of clinical trials for which a patient is eligible is complicated by the fact that trial eligibility is stated in natural language. A potential solution to this problem is to employ text classification methods for common types of eligibility criteria. In this study, we focus on seven common exclusion criteria in cancer trials: prior malignancy, human immunodeficiency virus, hepatitis B, hepatitis C, psychiatric illness, drug/substance abuse, and autoimmune illness. Our dataset consists of 764 phase III cancer trials with these exclusions annotated at the trial level. We experiment with common transformer models as well as a new pre-trained clinical trial BERT model. Our results demonstrate the feasibility of automatically classifying common exclusion criteria. Additionally, we demonstrate the value of a pre-trained language model specifically for clinical trials, which yields the highest average performance across all criteria.Comment: AMIA Annual Symposium Proceedings 202

The Role of Radiotherapy In the Management of Massive Intrahepatic Cholangiocarcinoma

https://openworks.mdanderson.org/sumexp21/1005/thumbnail.jp

A Dual Infection Pseudorabies Virus Conditional Reporter Approach to Identify Projections to Collateralized Neurons in Complex Neural Circuits

Replication and transneuronal transport of pseudorabies virus (PRV) are widely used to define the organization of neural circuits in rodent brain. Here we report a dual infection approach that highlights connections to neurons that collateralize within complex networks. The method combines Cre recombinase (Cre) expression from a PRV recombinant (PRV-267) and Cre-dependent reporter gene expression from a second infecting strain of PRV (PRV-263). PRV-267 expresses both Cre and a monomeric red fluorescent protein (mRFP) fused to viral capsid protein VP26 (VP26-mRFP) that accumulates in infected cell nuclei. PRV-263 carries a Brainbow cassette and expresses a red (dTomato) reporter that fills the cytoplasm. However, in the presence of Cre, the dTomato gene is recombined from the cassette, eliminating expression of the red reporter and liberating expression of either yellow (EYFP) or cyan (mCerulean) cytoplasmic reporters. We conducted proof-of-principle experiments using a well-characterized model in which separate injection of recombinant viruses into the left and right kidneys produces infection of neurons in the renal preautonomic network. Neurons dedicated to one kidney expressed the unique reporters characteristic of PRV-263 (cytoplasmic dTomato) or PRV-267 (nuclear VP26-mRFP). Dual infected neurons expressed VP26-mRFP and the cyan or yellow cytoplasmic reporters activated by Cre-mediated recombination of the Brainbow cassette. Differential expression of cyan or yellow reporters in neurons lacking VP26-mRFP provided a unique marker of neurons synaptically connected to dual infected neurons, a synaptic relationship that cannot be distinguished using other dual infection tracing approaches. These data demonstrate Cre-enabled conditional reporter expression in polysynaptic circuits that permits the identification of collateralized neurons and their presynaptic partners

Radiotherapy Advances in Pediatric Neuro-Oncology

Radiation therapy (RT) represents an integral component in the treatment of many pediatric brain tumors. Multiple advances have emerged within pediatric radiation oncology that aim to optimize the therapeutic ratio—improving disease control while limiting RT-related toxicity. These include innovations in treatment planning with magnetic resonance imaging (MRI) simulation, as well as increasingly sophisticated radiation delivery techniques. Advanced RT techniques, including photon-based RT such as intensity-modulated RT (IMRT) and volumetric-modulated arc therapy (VMAT), as well as particle beam therapy and stereotactic RT, have afforded an array of options to dramatically reduce radiation exposure of uninvolved normal tissues while treating target volumes. Along with advances in image guidance of radiation treatments, novel RT approaches are being implemented in ongoing and future prospective clinical trials. As the era of molecular risk stratification unfolds, personalization of radiation dose, target, and technique holds the promise to meaningfully improve outcomes for pediatric neuro-oncology patients

Radiation Therapy in Older Adults With Cancer: A Critical Modality in Geriatric Oncology

Radiation therapy (RT) is a commonly used modality in the treatment of older adults with cancer, and RT represents an attractive oncologic treatment option, providing a noninvasive local therapy with limited systemic side effects. The Journal of Clinical Oncology (JCO) recently published a special series on Geriatric Oncology providing a comprehensive overview of multiple treatment modalities available to older adults with cancer. The purpose of this short review is to highlight the importance of RT in the treatment of older adults and encourage multidisciplinary participation in their care

Using a Clinically Interpretable End Point Composed of Multiple Outcomes to Evaluate Totality of Treatment Effect in Comparative Oncology Studies

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Colorectal Cancer Screening Guidelines: Analysis of the 2019 National Health Interview Survey (NHIS)

https://openworks.mdanderson.org/sumexp21/1022/thumbnail.jp

Policies for waivers of Journal Article Fees

Purpose: Open access (OA) publishing in scientific journals is often associated with significant article processing charges (APCs) that may introduce a disparity for authors in low- and middle-income countries (LMICs). We sought to examine the landscape of global oncologic journal publishing practices, focusing particularly on waiver policies for OA APCs for authors from LMICs. Methods: Journals were identified using the SCImago Journal & Country Rank database. Journals offering OA options with APC data openly available were included. Data tabulated included OA type, APC amount, APC waiver status, continent of origin, primary treatment modality, treatment site-specific modality, and journal impact quartile. Wilcoxon rank sum testing, Chi-square testing, multivariate binary logistic regression modeling, and descriptive data were used for analyses. Results: Two hundred seventy-two journals met inclusion criteria. Overall, 51.5% of oncologic journals offered a LMIC APC waiver. On univariate testing, full OA journals (PP=.024), treatment site-specific (P=.001), and those with lower APCs (PP=.44), with multivariate logistic regression analyses, full OA status (odds ratio (OR) 5.50 [2.42-12.82], PP=.001), treatment site specificity (OR 3.74 [1.87-7.52], P Conclusions: Hybrid OA journals, North American-based journals, and journals requiring higher APCs are less likely to provide fee waivers for LMIC authors. These findings suggest current publication standards may introduce or exacerbate disparities in the shareability and access to international research. Proactive efforts are needed from publishing houses to create equity in global oncologic research