Overview of approaches to estimate real-world disease progression in lung cancer.

BACKGROUND: Randomized clinical trials of novel treatments for solid tumors normally measure disease progression using the Response Evaluation Criteria in Solid Tumors. However, novel, scalable approaches to estimate disease progression using real-world data are needed to advance cancer outcomes research. The purpose of this narrative review is to summarize examples from the existing literature on approaches to estimate real-world disease progression and their relative strengths and limitations, using lung cancer as a case study. METHODS: A narrative literature review was conducted in PubMed to identify articles that used approaches to estimate real-world disease progression in lung cancer patients. Data abstracted included data source, approach used to estimate real-world progression, and comparison to a selected gold standard (if applicable). RESULTS: A total of 40 articles were identified from 2008 to 2022. Five approaches to estimate real-world disease progression were identified including manual abstraction of medical records, natural language processing of clinical notes and/or radiology reports, treatment-based algorithms, changes in tumor volume, and delta radiomics-based approaches. The accuracy of these progression approaches were assessed using different methods, including correlations between real-world endpoints and overall survival for manual abstraction (Spearman rank ρ = 0.61-0.84) and area under the curve for natural language processing approaches (area under the curve = 0.86-0.96). CONCLUSIONS: Real-world disease progression has been measured in several observational studies of lung cancer. However, comparing the accuracy of methods across studies is challenging, in part, because of the lack of a gold standard and the different methods used to evaluate accuracy. Concerted efforts are needed to define a gold standard and quality metrics for real-world data.

Estatus taxonómico de Talides basistrigata Eaton, 1932 (Lepidoptera, Hesperiidae) y su reincorporación basados en una evaluación integrativa

Talides basistrigata Eaton, 1932, originalmente descrita de Perú, posteriormente fue transferida por Evans (1955) al género Hylephila Billberg, 1820, y considerada como una subespecie de H. phyleus (Drury, 1773), argumentando que basistrigata ocurre en ambientes más secos que los que habita phyleus. Actualmente se mantiene el rango taxonómico propuesto por Evans. El objetivo del presente trabajo es restituir el estatus taxonómico de especie válida para basistrigata con base en un análisis integrativo considerando aspectos morfológicos, ecológicos y genéticos. Se examinó las estructuras genitálicas en ejemplares de basistrigata y phyleus, se obtuvo secuencias del gen mitocondrial COI para ambas especies y se recopiló datos en campo para conocer su comportamiento de oviposición en los alrededores de Arequipa, suroeste de Perú. Como resultado del examen morfológico se halló diferencias notorias entre las estructuras genitálicas de ambas especies, principalmente en los procesos caudales de las valvas, la disposición de las pectinas y la forma del uncus en los machos. Con relación al análisis genético, se halló una distancia genética mayor a 3% entre ambas especies, apoyando así el estatus taxonómico de especie para basistrigata. Adicionalmente, desde una perspectiva ecológica, se registró que ambas especies utilizan distintos mecanismos de oviposición y diferentes plantas hospederas, exhibiendo además simpatría espacial y sincronía temporal en la vertiente occidental de los Andes en Perú. Se redescribe el macho y hembra adultos de basistrigata y se designa su lectotipo.

Talides basistrigata Eaton, 1932, originally described from Peru, was subsequently transferred to the genus Hylephila Billberg, 1820 by Evans (1955) and considered a subspecies of H. phyleus (Drury, 1773), arguing that basistrigata inhabits drier environments than phyleus. Currently, the taxonomic status proposed by Evans is retained. The aim of this study is to reinstate the taxonomic status of valid species for basistrigata based on an integrative analysis considering morphological, ecological, and genetic aspects. Genitalic structures were examined in specimens of both basistrigata and phyleus, mitochondrial COI gene sequences were obtained for both species, and field data were collected to understand their oviposition behaviour in the vicinity of Arequipa city, southwestern Peru. As a result of the morphological examination, notable differences were found between the male genitalia structures of both species, primarily in the caudal processes of the valvae, the arrangement of the pectines, and the shape of the uncus. Regarding the genetic analysis, a genetic distance of greater than 3% was observed between the two species, thus supporting the taxonomic status of species for basistrigata. Additionally, from an ecological perspective, it was recorded that both species employ distinct oviposition mechanisms and different host plants, exhibiting spatial sympatry and temporal synchrony on the western slope of the Andes in Peru. Male and female adults of basistrigata are redescribed, and a lectotype is designated.

Examining the Barriers and Opportunities for Human Papillomavirus Vaccine Delivery in Cancer Care Settings: A Mixed-Methods Study.

Although pediatric, adolescent, and young adult (PAYA) cancer survivors are at increased risks for secondary cancers, their HPV vaccine uptake rates are poor. Therefore, we conducted a mixed-methods study to identify the barriers and opportunities for HPV vaccine delivery among PAYA cancer care providers. We distributed a semistructured questionnaire to a professional organization comprised of PAYA oncology and hematology healthcare providers between April and July 2022. Questionnaire measures included demographic and practice characteristics, HPV vaccine knowledge, willingness, barriers, opportunities, and roles for HPV vaccine delivery. Descriptive characteristics were generated for quantitative data, and content analysis was used to identify themes. A total of 49 providers responded to our survey. A majority were female (68%) and non-Hispanic white (74%). Approximately 76% were oncology or hematology physicians, and most worked in a cancer center or children's hospital (86%). Over half (63%) had been practicing for >15 years, and a majority saw patients ages 11 to 17. Although less than half reported discussing HPV vaccination with their patients, 69% were willing to become involved in HPV vaccine delivery. The most frequently reported barriers identified in our content analysis were related to system-level factors. Furthermore, providers identified opportunities within cancer prevention education, transitions in care, and at the system-level. Although barriers to HPV vaccination persist in cancer care, most providers perceived there to be opportunities to become involved in HPV vaccine delivery. Identifying strategies for PAYA oncology and hematology healthcare providers to adopt a stronger role in HPV vaccination remains a significant opportunity for future implementation research. PREVENTION RELEVANCE: This mixed-methods study is the first to investigate and assess barriers and opportunities for HPV vaccine delivery among PAYA cancer healthcare providers. Our findings can serve as an important framework for future implementation research targeted towards HPV vaccine delivery in cancer clinical settings. See related Spotlight, p. 545.

Human papillomavirus vaccination uptake among childhood cancer survivors in Western New York.

INTRODUCTION: The risk of human papillomavirus (HPV)-associated cancers is significantly higher among survivors of a childhood cancer compared to the general population. Despite this, their HPV vaccine uptake rates are lower. We examined factors related to HPV vaccine uptake among childhood cancer survivors from Western New York over 13 years following the introduction of HPV vaccines. METHODS: Retrospective review of patients diagnosed with invasive or noninvasive cancerous conditions at age 9 or younger treated at Roswell Park Oishei Children's Cancer and Blood Disorder Program. We matched vaccine date information for patients aged 9-26 years between 2006 and 2020 from the New York State Immunization Information System. Demographic and cancer-related information was abstracted from electronic medical records. Cumulative vaccine uptake was assessed by Kaplan-Meier and Cox proportional hazards regression models. RESULTS: A total of 284 patients were included in the analyses. Most were non-Hispanic/White (80.3%) and resided in a metropolitan area (81.7%). Approximately half had leukemia or lymphoma (54.9%), and most received chemotherapy. Females were more likely to initiate the HPV vaccine and did so sooner (median = 5.5 years) than males (median = 5.7 years; log-rank p = .301). Patients who were older at vaccine eligibility and males who received blood product transfusions were significantly less likely to initiate the HPV vaccine. CONCLUSION: While rates of HPV vaccine initiation have been increasing with time among childhood cancer survivors, they remain low overall, with differences seen by treatment and diagnosis. Our findings support the need for further research to optimize HPV vaccine delivery in cancer care.