A differential process mining analysis of COVID-19 management for cancer patients.

During the acute phase of the COVID-19 pandemic, hospitals faced a challenge to manage patients, especially those with other comorbidities and medical needs, such as cancer patients. Here, we use Process Mining to analyze real-world therapeutic pathways in a cohort of 1182 cancer patients of the Lausanne University Hospital following COVID-19 infection. The algorithm builds trees representing sequences of coarse-grained events such as Home, Hospitalization, Intensive Care and Death. The same trees can also show probability of death or time-to-event statistics in each node. We introduce a new tool, called Differential Process Mining, which enables comparison of two patient strata in each node of the tree, in terms of hits and death rate, together with a statistical significance test. We thus compare management of COVID-19 patients with an active cancer in the first vs. second COVID-19 waves to quantify hospital adaptation to the pandemic. We also compare patients having undergone systemic therapy within 1 year to the rest of the cohort to understand the impact of an active cancer and/or its treatment on COVID-19 outcome. This study demonstrates the value of Process Mining to analyze complex event-based real-world data and generate hypotheses on hospital resource management or on clinical patient care.

[Advances in Oncology 2019]. / Oncologie.

Driven by highly specialized medicine, research and the quest for personalization of treatments, oncology witnessed substantial advances in 2019. This year numerous treatments have consolidated their importance and broadened their indications. Multiple innovative treatments, currently under study, brought hope for future advances, while biomarkers, such as PD-L1, microsatellite instability (MSI), tumor mutational burden (TMB), BRCA1/2 gene mutations, and homologous recombination deficiency (HRD) allowed better selection and customization of available treatments. This article provides an overview of this year's advances in oncology.

Sous l'égide de la médecine hautement spécialisée, de la personnalisation des traitements et secondée par une recherche énergique, l'oncologie a connu en 2019 des avancées considérables. Cette année, de nombreux traitements ont consolidé leur importance et élargi leurs indications. L'annonce d'une pléthore de traitements novateurs, en étude, est source d'espoir pour l'avenir. Des biomarqueurs simples ou composites, tels que l'expression PD-L1, l'instabilité de microsatellite (MSI), la charge mutationnelle tumorale (TMB), les mutations des gènes BRCA1/2 ou un déficit du mécanisme de la recombinaison homologue des bases (HRD) permettent une meilleure sélection et personnalisation des traitements disponibles. Le but du présent article est de rassembler les avancées oncologiques de l'année.

Links between private habits, psychological stress and brain cancer: a case-control pilot study in France.

Numerous studies have increasingly suggested that medical history and lifestyle factors could be involved in the increase of cancer risk in adults. The issue whether psychological factors can influence the development of cancer has been discussed for many years. In the field of brain cancer, psychological stress has not so far been investigated. We conducted a French case-control pilot study with 122 adult incident cases and 122 controls free of any cancer diagnosis, matched for age and gender, to investigate links between malignant primitive brain tumours (MPBT) and medical history, private habits and psychological stress. Data were collected through self-administered questionnaires, and person-to-person interviews. To complete the psychological stress assessment, 100-mm visual analog scales were used. After adjustment for confounders, we found no significant effect of head trauma, aspartame, tobacco or alcohol consumption, place (rural or urban) of residence, sociodemographic data, and experience of psychological stress at work/home. Our results showed a significant association between MPBT risk and major life events over the past 5 years before diagnosis (OR = 1.90, 95% CI 1.13-3.20), family histories of cancer (OR = 1.90, 95% CI 1.12-3.22), fresh vegetable and fruit intake (OR = 0.29, 95% CI 0.09-0.95), and skipped meals several times per week (OR = 0.35, 95% CI 0.16-0.77). The present study suggests the role of genetic factors in glioma risk, and also suggests that an acute and sudden psychological stress might influence MPBT appearance. Additional large clinical studies are needed to confirm these findings.