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Socio-cultural components related to the cropping, harvesting, and consumption of guayusa (Ilex guayusa Loes) in Amazonian Kichwa communities

Guayusa ( Ilex guayusa Loes) is an Amazonian plant whose leaves contain chemical compounds with therapeutic and energizing properties. For the Kichwa nationality in Napo province, Ecuador, guayusa has traditionally been a fundamental part of their culture. Over the last decade, the export market for the plant has grown, leading to changes in its cropping, management, and use. Using qualitative methods, this study aims to identify and describe practices and beliefs regarding the planting, harvesting, brewing, and benefits of guayusa among Kichwa families today. The analysis shows that Kichwa families maintain some ancestral crop management practices and knowledge of guayusa’s benefits, although its consumption in family and ceremonial contexts has changed. Guayusa consumption now extends beyond familiar and ceremonial spaces and is prepared in various ways. Practices like dream analysis or punishment with tobacco and chili when drinking guayusa are now rare, while Guayusa’s benefits, including its energizing effects and ability to relieve sleepiness, laziness, body aches, and hunger, are highly valued. This study is a pioneer in considering the guayusa plant from a holistic perspective that takes into consideration not only the current socio-cultural aspects related to the plant but also its relationship with the chakra system.

Percutaneous permeation, distribution and absorption of quantum dots

Synergistic Geometric and Interfacial Regulation of Silane‐Modified Biomass Aerogels for Sustainable, Low‐Resistance Particulate Filtration

ABSTRACT Particulate matter pollution poses a threat to public health, necessitating the development of high‐efficiency, sustainable air filters. Bacterial cellulose (BC) aerogels are promising candidates; however, achieving high filtration efficiency can increase air resistance. We present a surface functionalization‐guided strategy for the precise tuning of aerogel surface groups to alter particle capture behavior and improve filtration performance. Using γ‐aminopropyltriethoxysilane (KH550) as a model silane precursor, we demonstrated enhanced electrostatic adsorption and the formation of dendritic deposition patterns that improved the capture of inhalable particulate matter (PM 2.5 ). The BC‐KH550 aerogels exhibited outstanding filtration efficiency (>99%) while maintaining robust mechanical properties and stability under humid conditions. Theoretical simulations revealed that the enhanced electrostatic interactions following surface modification significantly influenced filtration performance, revealing a synergistic effect between surface functional groups and PM. This advanced the fundamental understanding of the structure‐function relationship of modified BC aerogels and provided a blueprint for designing next‐generation sustainable air filters with tunable surfaces.

Modernizing injectable cancer care delivery: A telemedicine-supported home injection model for breast cancer care.

1581 Background: Among the growing population of premenopausal patients with breast cancer, years-long endocrine therapy often requires repeated clinic-administered injections, creating substantial time burden and adherence challenges. This pilot evaluated the feasibility of a telemedicine-supported home injections program designed to improve access, convenience, and patient experience. Methods: Patients were recruited from 4 outpatient medical oncology practices at a comprehensive cancer center between October 2024 and January 2025. Eligibility criteria included a breast cancer diagnosis, an active treatment plan including leuprolide and/or denosumab, and use of the patient portal. Patients proceeded to pilot participation after insurance approval for outpatient administration of medications and (if applicable) acceptability of copay cost. Patients and/or caregivers received in-clinic training by nursing staff on injection preparation and administration, were provided both written and video-based educational material and were followed for up to 2 home injections over a 6-month period, with telemedicine support. The primary outcome was feasibility, assessed by home injection completion rates. Patient and clinician satisfaction were assessed using the Net Promotor Score (NPS) and rates of continued at home injection administration post pilot completion. Patients were also invited to participate in 60-minute semi-structured exit interviews. Results: Of 105 eligible patients, 54 agreed to participate in the pilot and 24 obtained insurance approval for the medication with an acceptable copay. All 24 patients were trained in injection administration of intramuscular leuprolide, of whom 50% had no prior injection experience. Overall, 96% successfully completed one home injection, 79% of patients completed two home injections, and 75% continued home administration after follow-up. Notably, only 1 patient discontinued home injection administration due to telemedicine scheduling related issues. Patients reported high satisfaction, citing time savings and convenience as key benefits. Both patients and providers strongly endorsed the model with highly compelling net promoter scores of 69 and 61, respectively. Conclusions: This pilot demonstrated the feasibility of a telemedicine supported home injection care delivery model for breast cancer patients in the oncology setting, evidenced by high completion rates and patient preference to continue home administration. Educational materials and optional telemedicine visits for initial injections were leveraged to support adherence without increased healthcare utilization. Further evaluation across broader geographic, demographic, and payor mix is warranted to inform scale up. An ongoing pragmatic trial (NCT06954337) is testing this approach as part of an innovative model of care: Enhanced Telehealth.

Determinants of leadership attainment among ASCO Leadership Development Program, 2009–2025.

9037 Background: Determinants of leadership attainment among participants in formal leadership development programs remain poorly characterized. We examined the factors associated with leadership attainment among graduates of the ASCO Leadership Development Program (LDP). Methods: We conducted a retrospective cohort study of ASCO LDP participants from 2009–2025. Leadership attainment following participation in the ASCO LDP was the primary outcome, defined as cancer Center Director, Division Chair, Subspecialty Chief, or Program Director, as identified through publicly available data. Participant characteristics included gender, medical training (American medical graduate [AMG], international medical graduate [IMG]), education (MD, MD/PhD, MD/Master’s), National Cancer Institute (NCI) designation, geographic region (West, Northeast, South, North Central, non-US), and scholarly productivity (h-index). Descriptive analyses were performed overall and by leadership status. Multivariable logistic regression was used to estimate adjusted associations, including gender–NCI designation interaction. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Results: Among 216 eligible participants, 165 (76.4%) attained leadership roles. Participants were predominantly female (n=116, 53.7%), AMGs (n=157, 72.7%), MDs (n=129, 59.7%) and affiliated with NCI-designated centers (n=145, 67.1%). Median h-index was 39 (IQR 25–57), and participants were mostly based in the Northeast (n=77, 35.6%) and West (n=53, 24.5%) regions. Compared with non-leaders, leaders demonstrated higher scholarly productivity, with a higher median h-index (42 [IQR 25–59] vs 29 [IQR 20–44], p =0.042). Using NCI-designated females as the reference group, NCI-designated males demonstrated higher odds of leadership attainment in adjusted models (AOR 2.34, 95% CI 0.96–6.06, p =0.067). Compared with participants from the West, those based in the South demonstrated lower odds of leadership attainment (AOR 0.35, 95% CI 0.12–0.98, p =0.050), independent of gender, education, NCI designation, and year. Leadership attainment remained stable over time, with no consistent temporal trends across subgroups. Conclusions: Leadership attainment in ASCO LDP was stable over time and associated with scholarly productivity and geographic region rather than gender or institutional setting. Adjusted odds of leadership attainment by gender–NCI designation interaction and geographic region. Variable Category Adjusted OR (95% CI) p value Gender × NCI NCI Female Reference — NCI Male 2.34 (0.96–6.06) 0.069 Non-NCI Female 2.04 (0.71–6.43) 0.201 Non-NCI Male 1.17 (0.43–3.32) 0.760 Region West Reference — Northeast 0.64 (0.23–1.65) 0.366 South 0.35 (0.12–0.98) 0.050 North Central 0.45 (0.14–1.49) 0.183 Non-US 0.32 (0.07–1.44) 0.141 Gender × NCI modeled as a combined interaction term (ref: NCI female).

Glucose 6-phosphate dehydrogenase deficiency and skin cancer: A retrospective study assessing cutaneous malignancy risk.

e21576 Background: Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme within the pentose phosphate pathway (PPP) that produces nicotinamide adenine dinucleotide phosphate (NADPH), which can protect from oxidative damage. In cancer, the PPP has been shown to be a source of oxidative stress resistance for tumors. Though, inhibition of G6PD may still have compensatory pathways for cancer survival. Several studies have indicated that G6PD may be an essential redox element for melanoma. Experimental studies including in vitro models have linked G6PD to skin cancer. Additionally, there has been evidence of a protective effect from G6PD deficiency in gastric, hepatocellular, and colorectal cancer; while, breast, prostate, lung, and hematological cancer have had evidence of no difference in risk. To date, there has been no study of skin cancer risk in G6PD-deficient patients. Methods: The TriNetX US database was utilized to provide real-world, de-identified data of 117 million patients. Exposed patients were defined by the International Classification of Disease (ICD-10) coding, D55.0 for G6PD deficiency. The control cohort was defined by having at least 1 annual physical examination (Z00.0) with no history of G6PD deficiency. The cohorts were propensity score matched 1:1 by current age, sex, Hispanic ethnicity, and Black and White race. Results: 15,848 patients met inclusion criteria of G6PD deficiency. After cohort matching, 15,346 patients were included. G6PD-deficient patients did not have significantly different risk of melanoma (relative risk (RR) 1.368, p=0.2964), squamous cell carcinoma (SCC) (RR=1.4, p=0.1019), and overall non-melanoma skin cancer (NMSC) (RR= 0.9018, p=0.4497) compared to unexposed patients. G6PD-deficient patients did have significantly decreased risk of basal cell carcinoma (BCC) (RR=0.625, p=0.0124). Conclusions: We share the first epidemiological results of skin cancer risk in these patients. Our study suggests that individuals with deficiency may not have a difference in overall incidence of skin cancer and melanoma. This finding aligns with prior experimental evidence of lack of impact on primary cutaneous tumors, as well as discussion of potential compensatory pathways. The role of G6PD deficiency in cancer susceptibility has been inconsistent across malignancies, and our results with BCC underscore the heterogeneity of redox biology across tissue types and may align with proposed tumor sensitivity to oxidative stress.

ELEGANT: Elacestrant versus standard endocrine therapy (ET) in women and men with node-positive, estrogen receptor–positive (ER+), HER2-negative (HER2−), early breast cancer (eBC) with high risk of recurrence in a global, multicenter, randomized, open-label phase 3 study.

TPS1153 Background: Adjuvant ET is the standard of care (SOC) for treating ER+/HER2- eBC. Despite advances to optimize adjuvant treatment in high-risk ER+/HER2- eBC, there continues to be risk of local and metastatic recurrence that persists, new therapies with desirable safety profiles are warranted. Elacestrant is a next-generation oral SERD that provides a novel mechanism of action that has shown both SERD (degradative) and SERM (partial agonist) activity that differs from currently available adjuvant ET (Wardell, ERC 2015). In the EMERALD trial, elacestrant significantly prolonged PFS vs SOC ET in the overall population (HR 0.70; 95% CI 0.55-0.88; P=0.0018) and in patients with ESR1m tumors (HR 0.55; 95% CI 0.39-0.77; P=0.0005) (Bidard, JCO 2022). In patients with ESR1m tumors who received prior ET+CDK4/6i ≥12 mo, mPFS with elacestrant was 8.6 vs 1.9 mo with SOC ET (Bardia, CCR 2024). In patients with ER+/HER2− eBC, the SOLTI-1905-ELIPSE and SOLTI-2104-PremiERe trials showed that preoperative elacestrant was associated with a statistically significant mean change of complete cell cycle arrest rate and led to a shift in tumor biology towards a more endocrine-sensitive and less proliferative tumor phenotype in both pre- and post-menopausal women (Vidal, CCR 2025; Bellet, SABCS 2025). Given that elacestrant demonstrated efficacy in mBC regardless of ESR1m status relative to SOC ET and has shown biologic activity in eBC, it is hypothesized that elacestrant can prolong invasive breast cancer-free survival (IBCFS) in patients with high-risk eBC who received prior adjuvant ET±CDK4/6i. Methods: ELEGANT (NCT06492616) is a global, multicenter, open-label Ph3 study designed to evaluate elacestrant vs SOC ET (AI or tamoxifen) in patients with eBC and high risk of recurrence. Patients will be randomized 1:1 to continue SOC ET or to elacestrant for a duration of 5 years. Eligible patients are women/men with ER+/HER2− node-positive eBC who received between 2-5 years of SOC ET±CDK4/6i and have ECOG PS ≤1. Patients who received a prior CDK4/6i or PARP inhibitor must have completed or discontinued these treatments. Pre/perimenopausal women and men will be administered a LHRH agonist. Exclusion criteria include stage IV mBC, inflammatory BC, history of prior invasive BC, history of malignancy within 3 years of randomization date, >6 mo continuous interruption of prior SOC adjuvant ET or discontinuation of adjuvant ET >6 mo prior to randomization, and received prior treatment with SERDs. The primary objective is IBCFS. Key secondary objectives are distant relapse-free survival, overall survival, invasive disease-free survival, safety, PROs-QoL, and PK. Planned enrollment is 4,220 patients; recruitment is ongoing. Clinical trial information: NCT06492616 .

Development of a supportive care intervention for caregivers of head and neck cancer patients: A qualitative needs assessment.

e24107 Background: Caregivers of patients with head and neck cancer (HNC) play a vital role in patient care and recovery, while also experiencing substantial physical, emotional, and logistical burdens for their care. Supportive interventions tailored to the needs of caregivers remain limited. We conducted a qualitative needs assessment to inform the development of a supportive care intervention for HNC caregivers. Methods: Caregivers of patients undergoing treatment for HNC were recruited beginning September 2025 and ending November 2025. Semi-structured interviews were conducted and transcribed verbatim. Interview summaries and transcripts were reviewed to identify major challenges, coping strategies, and preferences related to supportive care interventions. Baseline demographic data were also collected. Results: Participants (N=20) were 89.5% female, had an average age of 57.9, and most endorsed being the spouse of their loved one with cancer (65%). Results indicated that caregivers identified patient nutrition and treatment-related side effects, particularly communication difficulties, as major challenges. Majority of caregivers continued working during the patient’s treatment, which was described by some as a stressor, and others as a coping mechanism. Common stress-management strategies included prayer, physical activity, meditation, therapy, support groups, and use of mobile applications (e.g., Finch and Insight). Caregivers expressed a desire for greater access to practical resources, including nutritional guidance, patient care education (e.g., tracheostomy and medication management), consolidated HNC resources, and self-care strategies. Participants emphasized that caregiver well-being was essential to effective patient care. Preferences for future interventions included early initiation at the start of their loved one’s treatment, continuation through treatment completion, physician or nurse coordinator endorsement, and inclusion of testimonials from prior participants. Conclusions: Caregivers of patients with HNC report multifaceted and largely unmet supportive care needs. Findings from this qualitative assessment will directly inform the development of a caregiver-centered, supportive-care intervention designed to address stress.

Palliative care utilization in metastatic triple-negative breast cancer: A National Cancer Database analysis.

e24073 Background: Metastatic triple-negative breast cancer (TNBC) is associated with aggressive disease biology and poor prognosis compared to other breast cancer subtypes. Although palliative care (PC) has been shown to improve symptom burden and quality of life in advanced cancers, real-world utilization patterns of PC in metastatic TNBC remain poorly characterized. The aim of this study is to characterize patterns in PC utilization among patients with metastatic TNBC. Methods: The National Cancer Database was queried to identify patients diagnosed with metastatic TNBC between 2018 and 2023. PC was defined by NCDB as non-curative treatment, which includes surgery, radiation, systemic, pain management, or any combination. Multinomial logistic regression was used to evaluate associations between PC utilization and sociodemographic factors. Overall survival (OS) was estimated using Kaplan–Meier methods and compared using log-rank tests. Statistical significance was defined as p < 0.05. Results: A total of 9,212 patients with metastatic TNBC were identified. The mean age at diagnosis was 62.2 ± 14.6 years, and the median follow-up was 11.4 months (IQR 4.2–25.2). Overall, 1,799 (19.5%) patients received PC. Among those, the most common modality was systemic therapy (42.9%), followed by radiation therapy (22.8%), multimodal combinations (24.5%), pain management alone (5.6%), and surgery alone (4.2%) Insurance status was associated with PC use. Compared with privately insured patients, uninsured patients were more likely to use PC (OR 1.53, 95% CI 1.14–2.07, p = 0.005). Patients in Medicaid expansion states were also more likely to use PC than those in non-expansion states (OR 1.79, 95% CI 1.46–2.20, p < 0.0001). Facility-level and geographic variation was observed. Treatment at academic centers was associated with higher PC use compared with community cancer centers (OR 1.31, 95% CI 1.01–1.71, p = 0.041). Compared with patients treated in the West, those treated in the Northeast (OR 1.29, 95% CI 1.02–1.63, p = 0.037), Midwest (OR 1.27, 95% CI 1.00–1.61, p = 0.489), and South (OR 1.32, 95% CI 1.02–1.71, p = 0.038) were more likely to receive PC. Age, race, income quartile, educational level, and Charlson-Deyo comorbidity index were not independently associated with PC utilization. Conclusions: In this largest population-level study to date, we found that palliative care utilization remains low among patients with metastatic TNBC, and was associated with insurance coverage, facility type, and geographic region. These findings highlight disparities in access to PC, and underscore the need for more equitable and timely integration of PC among metastatic TNBC patients.

Real-world eligibility for adjuvant CDK4/6 therapy in HR+/HER2− early breast cancer: A comparative analysis of monarchE and NATALEE criteria from a single-institution cohort.

e12532 Background: Adjuvant CDK4/6 inhibitors benefit selected HR+/HER2− early breast cancer (EBC), yet monarchE (high-risk node-positive) and NATALEE (broader stage II–III, including high-risk N0) define eligibility differently. Real-world applicability across treatment settings is unclear. Methods: Retrospective study of consecutive stage I–III HR+/HER2−/low EBC treated at KFMC (Jan-2021–Dec-2023). Exclusions: HER2-positive, TNBC, metastatic at diagnosis, or missing key variables. For neoadjuvant cases, clinical T/N were used; for upfront surgery, pathologic T/N. Strict NATALEE rules were applied (N+, or N0 with T4/T3 or T2 plus G3 or Ki-67≥20% or RS≥26). Outcomes were descriptive: overall eligibility, by setting (neoadjuvant vs upfront), overlap (Both, NATALEE-only, monarchE-only), monarchE Cohorts 1/2, and NATALEE-only composition (N+ vs high-risk N0 and N0 subgroups). Results: Among 418 patients (neoadjuvant 253; upfront 165), overall eligibility was NATALEE 317 (75.8%) vs monarchE 196 (46.9%). By setting, eligibility was higher neoadjuvantly(NATALEE 93.7%, monarchE 64.0%) than upfront (48.5% and 20.6%, respectively). Overlap showed Both 196 (46.9%), NATALEE-only 121 (28.9%), monarchE-only 0, and Neither 101 (24.2%)—indicating monarchE is fully nested within NATALEE under strict rules. monarchE composition: Cohort 1: 162 (38.8%) vs Cohort 2: 34 (8.1%); within Cohort 1, N1 + (T≥3 or G3) 116 (71.6%) and N2–3 46 (28.4%). Within NATALEE-only (n = 121): N1 low-risk: 70 (57.9%) and high-risk N0: 51 (42.1%). High-risk N0 subgroups (n = 51): T4N0 6 (11.8%), T3N0 17 (33.3%), T2N0 G3 10 (19.6%), T2N0 G2+risk 18 (35.3%). Conclusions: In this real-world cohort, three-quarters of HR+/HER2− EBC would qualify for adjuvant CDK4/6 therapy by NATALEE, compared with about half by monarchE. The added candidates are primarily stage II high-risk N0 and N1 with lower-risk features, with eligibility particularly high in the neoadjuvantsetting. These data support broader implementation of adjuvant CDK4/6 therapy.

Efficacy and safety of disitamab vedotin (DV) combined with trastuzumab, and tislelizumab versus chemotherapy (CAPOX) combined with trastuzumab ± pembrolizumab for patients with first-line HER2-high advanced gastric/gastroesophageal junction adenocarcinoma (G/GEJA): A randomized controlled phase 3 trial.

TPS4245 Background: Patients (pts) with HER2-high (defined as IHC 3+, or IHC 2+/FISH+ according to Chinese Society of Clinical Oncology Gastric Cancer Guidelines) advanced G/GEJA continue to face a poor prognosis. Although adding pembrolizumab to trastuzumab and chemotherapy significantly improved overall survival in this pts population with a PD-L1 combined positive score (CPS) ≥1 in the first-line (1L) setting, there remains an unmet need for more effective treatment options. DV (anti-HER2 antibody-drug conjugate) is approved as monotherapy for the treatment of pts with HER2 IHC 2+/3+ advanced G/GEJA in China. In the randomized phase 2 part of the RC48-C027 trial, DV + trastuzumab + an anti-PD-1 agent showed a promising objective response rate (ORR) in 1L HER2-high advanced G/GEJA compared with the control (82.4% vs. 68.8%) (Shen et al. J Clin Oncol. 2025). Building on these results, the open-label randomized phase 3 RC48-C040 trial is designed to assess the efficacy and safety of DV + trastuzumab + tislelizumab versus chemotherapy + trastuzumab ± pembrolizumab in pts with previously untreated, HER2-high, advanced G/GEJA (NCT07315750). Methods: The key eligibility criteria are pts aged 18-75 years with histologically confirmed unresectable locally advanced or metastatic G/GEJA; central lab-confirmed high HER2 expression; no previous systemic treatment for locally advanced or metastatic gastric cancer; and at least one assessable lesion according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. Pts with central nervous system metastasis and/or carcinomatous meningitis are ineligible. The planned sample size is 555. Pts will be randomized (2:1) to receive DV (2.5 mg/kg, intravenously [IV], Q2W) + trastuzumab (staring dose of 8 mg/kg followed by 6 mg/kg, IV, Q3W) + tislelizumab (200 mg, IV, Q3W) or to receive CAPOX (oxaliplatin: 130 mg/m², IV, Q3W for up to 6 doses; capecitabine: 1000 mg/m², orally, BID, days 1-14 every 3 weeks) + trastuzumab ± pembrolizumab (200 mg/kg, IV, Q3W) until occurrence of disease progression, intolerable toxicity, or initiation of new anti-tumor treatment. Randomization will be stratified by HER2 expression (IHC 2+/FISH+ or IHC 3+), PD-L1 expression (CPS < 1 or 1≤CPS < 10 or CPS≥10), and liver metastasis (presence or absence). The primary endpoint is progression-free survival (PFS) assessed by the Blinded Independent Review Committee as per RECIST v1.1. The secondary endpoints include overall survival, investigator-assessed PFS, ORR, disease control rate, duration of response, patient-reported outcomes, adverse events, pharmacokinetic parameters, and immunogenicity. This study started in January 2026; enrollment is ongoing in China. Clinical trial information: NCT07315750 .

Real-world clinicogenomic comparison of early- and average-onset gastric cancer.

e16080 Background: In recent decades, there has been an unprecedented rise in gastric cancer among younger individuals, contrasting with a decline among older individuals. However, the biological underpinnings of gastric cancer in younger individuals remain poorly understood. We described the clinicopathologic and genomic characteristics of early-onset gastric cancer (EOGC) compared to average-onset gastric cancer (AOGC). Methods: We analyzed 311 patients using the multi-institutional prospective Oncology Research Information Exchange Network (ORIEN) database to compare demographic, clinicopathologic, genomic, and survival outcomes between EOGC ( < 50 years; N = 72) vs AOGC ( > 50 years N = 239). Genomic, germline, and RNA sequencing data were analyzed and compared between the cohorts. Mutational and immune signatures were also processed. Results: EOGC patients exhibited significantly higher rates of pain at diagnosis (53% vs 30% p = 0.001 ), but not anemia or reflux. EOGC patients were more likely to present with stage III/IV disease (70% vs 45% p = 0.006 ) and diffuse/signet ring histology (47% vs 16% p = 0.002 ). Consequently, OS was decreased in the younger cohort (HR 1.52; p = 0.03). Somatic mutational load was decreased in young patients. Significantly mutated genes in the entire cohort included CDH1 , ARID1A , TP53 , PIK3CA, but CDH1 was more frequently mutated in the EOGC cohort (40% vs 18% p = 0.006 ). Significant differences in RNA expression were observed, with upregulated epithelial mesenchymal transition (EMT), myogenesis, and apical junction. Immune deconvolution revealed a predominance of M2 macrophages, mast cells, and CD4 + T cell subsets, but no differences between cohorts. Conclusions: Early-onset gastric cancer has unique clinical and genomic features. Pathway dysregulation in EOGC may contribute to tumorigenesis and therapy resistance. This study underscores the necessity for further research into novel therapies, biomarker discovery, and early detection methodologies in younger individuals.

Immune aging within the tumor microenvironment as a predictor of survival in non–small cell lung cancer.

8068 Background: Immune aging has been associated with survival outcomes in patients with lung adenocarcinoma (LUAD), but its relevance within the tumor microenvironment (TME) remains unclear. Methods: Clinical and RNA-sequencing data from the TCGA LUAD cohort were analyzed. Immune aging within tumor tissue was quantified using a predefined 121-gene immune aging–related signature (IAS-121). For primary analyses, patients were dichotomized into high versus low IAS-121 groups based on the median value. Immune cell composition within the TME was inferred using xCell analysis and compared according to IAS-121 status. Overall survival (OS) was assessed using Kaplan–Meier analysis and Cox proportional hazards models adjusted for age, sex, tumor stage, smoking status, and EGFR mutation status. Sensitivity analyses were performed using quartile-based categorization of IAS-121 (lowest vs highest quartile), and external validation was conducted in two independent LUAD cohorts (GSE68465 and GSE50081). Results: A total of 518 patients with LUAD from the TCGA cohort were included. Patients with high IAS-121 had significantly poorer OS compared with those with low IAS-121 (p=0.026). In multivariable analysis using the median cut-off, high IAS-121 showed a non-significant trend toward increased mortality (adjusted hazard ratio [aHR] 1.33; 95% confidence interval [CI], 0.96–1.84). In sensitivity analyses comparing the lowest and highest quartiles of IAS-121, a significant association with OS was observed (aHR 1.87; 95% CI, 1.20–2.92). This association was further confirmed in a pooled analysis of the external LUAD cohorts (GSE68465 and GSE50081), in which higher IAS-121 was independently associated with worse OS (aHR 1.57; 95% CI, 1.02–2.43). Subgroup analyses showed generally consistent associations across age, sex, tumor stage, smoking status, and EGFR mutation status. Tumors with high IAS-121 exhibited reduced enrichment of CD8⁺ T cells and CD4⁺ naïve T cells, along with increased neutrophil enrichment. Conclusions: Immune aging within TME is associated with poorer survival in LUAD. As this study is hypothesis-generating, further investigations integrating tissue- and blood-based measures of immune aging are warranted to clarify its clinical and biological implications. Cox proportional hazards models comparing the lowest versus highest quartile of immune aging score-121 and overall survival in lung adenocarcinoma. 　 TCGA GSE68465 plus GSE50081 HR (95% CI) p HR (95% CI) p Crude 1.648 (1.114 – 2.238) 0.012 2.093 (1.396 – 3.141) <0.001 Adjusted 1.873 (1.200 – 2.924) 0.006 1.571 (1.016 – 2.429) 0.007 Models adjusted age, sex, tumor stage, smoking status, and EGFR mutation status for TCGA dataset and age, sex, tumor stage for GSE68465 plus GSE50081 cohorts. LUAD = lung adenocarcinoma; HR = hazard ratio; CI = confidence level.

Epidemiology and healthcare burden of penile cancer in people living with HIV in the United States.

e17029 Background: HIV- positive patients are known to have worse outcomes with a 4-fold increased risk for death from penile cancers. Despite this, data regarding the prevalence and healthcare utilization of penile cancer among people living with HIV (PLWH) are insufficient. Our study focuses on demographic, clinical and socioeconomic differences between HIV and non-HIV cohorts. Methods: We conducted a retrospective cohort study of adult patients with penile cancer, divided into HIV-positive and HIV-negative patients from the 2016-2022 National Inpatient Sample. Patient demographics, clinical comorbidities, hospital characteristics, and healthcare utilization were compared between groups. Categorical variables were analyzed using chi-square tests and continuous variables using t-tests, with statistical significance defined as p < 0.05, and adjusting for the complex structure of the NIS. Results: Among 15,825 penile cancer patients, 575 (3.6%) were HIV-positive. HIV-positive patients were significantly younger (mean age 55.98 vs. 65.80 years, p < 0.001) and had higher comorbidity burden (Charlson Index 8.51 vs. 5.24, p < 0.001). HIV-positive patients were more likely to be Black (66.09% vs. 9.33%, p < 0.001), have Medicaid (33.91% vs. 14.67%, p < 0.001), and fall in the lowest income quartile (59.62% vs. 32.35%, p < 0.001). They had higher rates of smoking (55.65% vs. 44.03%, p = 0.018), drug abuse (13.04% vs. 2.75%, p < 0.001), cachexia (6.96% vs. 2.23%, p = 0.001), chronic hepatitis B (6.09% vs. 0.13%, p < 0.001), and chronic hepatitis C (6.09% vs. 0.59%, p < 0.001). However, HIV-positive patients had lower rates of obesity (5.22% vs. 17.61%, p < 0.001), diabetes (26.96% vs. 37.05%, p = 0.028), dyslipidemia (22.61% vs. 36.23%, p = 0.007), hypertension (50.43% vs. 64.36%, p = 0.002), and metastatic cancer (24.35% vs. 42.10%, p < 0.001). Mean adjusted total hospital charges were significantly higher for HIV-positive patients ($115,939 vs. $76,717, p = 0.010). Conclusions: PLWH constituted a smaller but important subset of penile cancer patients in the U.S., characterized by younger age, higher comorbidity burden, a higher representation of Black patients and significant socioeconomic barriers including low income and Medicaid enrollment. These findings warrant further work on timely diagnosis and tailored supportive care for patients with penile cancer and HIV with attention to tackling the socioeconomic inequities in resource utilization.

DEB-TACE combined with apatinib and camrelizumab as second-line therapy for unresectable intrahepatic cholangiocarcinoma: A prospective, single-arm, phase II study.

4164 Background: This study aimed to evaluate the efficacy and safety of drug-eluting bead transarterial chemoembolization (DEB-TACE) combined with Apatinib and Camrelizumab as second-line therapy for unresectable intrahepatic cholangiocarcinoma (ICC). Methods: This is a prospective, single-arm, phase II study. Eligible patients were those with unresectable ICC who had progressed after first-line gemcitabine-containing chemotherapy. These patients received DEB-TACE combined with Apatinib and Camrelizumab therapy. The primary endpoints were to assess the objective response rate (ORR) and disease control rate (DCR) in accordance with both Response Evaluation Criteria in Solid Tumors (RECIST) V1.1 and modified RECIST (mRECIST) criteria. Secondary objectives included measuring progression-free survival (PFS), overall survival (OS), and safety profiles. Adverse events (AEs) were graded according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Results: Twenty patients participated in this study. The ORR was 65% (95% confidence interval [CI]: 40.8%–84.6%) per mRECIST and 25% (95% CI: 8.7%–49.1%) per RECIST V1.1. The DCR was 95% (95% CI: 74%–99%) per mRECIST and 85% (95% CI: 62.1%–96.8%) per RECIST V1.1. The median PFS was 7.7 (95% CI: 5.5–9.8) months. The median OS was 13.2 (95% CI: 3.1–23.3) months. Treatment-related adverse events (TRAEs) occurred in all 20 (100%) patients. The most common TRAEs included decreased lymphocyte count, hypertension, and abdominal pain, with grade ≥3 TRAEs manageable via appropriate interventions. Conclusions: DEB-TACE combined with Apatinib and Camrelizumab as second-line therapy for unresectable ICC demonstrated promising efficacy and an acceptable safety profile, providing a viable treatment option for patients with unresectable ICC progressing after first-line gemcitabine-containing chemotherapy. Clinical trial information: NCT04834674 .

Association of prior SARS-CoV-2 infection with advanced cancer presentation in newly diagnosed solid tumors: A real-world data analysis.

10586 Background: Emerging evidence suggests that the impact of SARS-CoV-2 infection may extend beyond acute respiratory illness, with potential implications for cancer biology. Recent proteomic analyses and reviews have highlighted several ways in which SARS-CoV-2 might interact with host pathways relevant to oncogenesis, tumor progression, and cellular plasticity. Taken together, these findings support a plausible biological rationale that COVID-19 infection may influence the clinical behavior or progression of solid tumors, potentially leading to diagnosis at later stages or the emergence of more aggressive phenotypes. In this study, we use real-world data from the TriNetX US Collaborative network to test the hypothesis that patients with solid tumors who have had COVID-19 are more likely to present with advanced-stage disease compared to those without a history of SARS-CoV-2 infection. Methods: We conducted a retrospective cohort study of adults (≥18 years) with newly diagnosed solid tumors, including breast, lung, colorectal, and prostate cancers, between January 1, 2021, and December 1, 2025. Patients were categorized based on documented SARS-CoV-2 infection prior to cancer diagnosis (COVID-positive vs COVID-negative), defined using ICD-10 codes and laboratory-confirmed PCR or antigen testing. Patients with any prior cancer diagnosis were excluded. The primary outcome was aggressive presentation, defined as AJCC Stage IV, M1 classification, or ICD-10 codes C77–C79 within 90 days of diagnosis. To reduce confounding, 1:1 propensity score matching was performed based on age, sex, race, ethnicity, cancer type, and comorbidities, including obesity, chronic lung disease, chronic kidney disease, diabetes, and hypertension. Results: After 1:1 propensity score matching, 201,131 patients were included in each cohort. Aggressive cancer presentation occurred in 16.8% of COVID-positive patients compared with 15.1% of COVID-negative patients. COVID-positive patients had a higher risk of aggressive disease presentation, corresponding to an absolute risk increase of 1.73% (95% CI, 1.50–1.96) and a relative risk of 1.11 (95% CI, 1.10–1.13). The odds of aggressive presentation were also higher among COVID-positive patients (OR, 1.14; 95% CI, 1.12–1.16; p < 0.0001). Conclusions: Prior COVID-19 infection was associated with a higher likelihood of advanced and metastatic cancer presentation at diagnosis, even after adjustment for demographic factors and comorbidities. These findings highlight the potential long-term oncologic impact of the COVID-19 pandemic and warrant further investigation.

Right-sided circulatory failure without pulmonary embolism in hospitalized cancer patients: National burden and inpatient outcomes.

e24033 Background: In hospitalized patients with cancer, acute right-sided circulatory failure is highly attributedto pulmonary embolism. However, right-heart failure may occur in the absence of pulmonaryembolism due to cancer-related inflammation, anemia, pulmonary vascular injury, ortreatment-associated cardiopulmonary toxicity. The burden and prognostic significance ofpulmonary embolism-negative right-sided circulatory failure in contemporary oncologyhospitalizations remain poorly defined. Methods: A serial cross-sectional analysis was conducted using adult hospitalizations with a principaldiagnosis of malignancy in the 2018 to 2022 Healthcare Cost and Utilization Project NationalInpatient Sample with discharge-level survey weighting. Right-sided circulatory failure withoutpulmonary embolism was defined by diagnoses of cor pulmonale or pulmonary heart disease(ICD-10-CM I27*) or right heart failure (I50.81) in the absence of pulmonary embolism (I26*).Outcomes included in-hospital mortality, shock, intensive care unit utilization proxy defined byshock or mechanical ventilation, mechanical ventilation, All Patient Refined Diagnosis RelatedGroup severity, length of stay, and hospitalization cost. Survey-weighted multivariableregression adjusted for demographics, payer, ZIP-code income quartile, admission type, cancersubtype, hospital characteristics, region, and year. Sensitivity analyses excluded all pulmonaryembolism admissions. Results: Among 961,848 unweighted cancer hospitalizations representing approximately 4.6 millionadmissions nationally, right-sided circulatory failure without pulmonary embolism occurred in1.9% of admissions. After adjustment, pulmonary embolism-negative right-sided circulatoryfailure was independently associated with shock (odds ratio 2.24, 95% CI 2.06 to 2.44),intensive care unit utilization (odds ratio 2.10, 95% CI 1.98 to 2.23), mechanical ventilation(odds ratio 2.10, 95% CI 1.96 to 2.25), and extreme All Patient Refined Diagnosis RelatedGroup severity (odds ratio 2.19, 95% CI 2.03 to 2.37). In-hospital mortality was higher (oddsratio 1.57, 95% CI 1.48 to 1.66). Length of stay increased by an adjusted mean of 1.62 days(95% CI 1.47 to 1.77), and hospitalization costs were higher by $5,913 (95% CI $5,079 to$6,747). Associations persisted after exclusion of all pulmonary embolism admissions. Conclusions: Right-sided circulatory failure without pulmonary embolism affects approximately 1 in 50 cancerhospitalizations and is associated with inpatient deterioration, intensive careutilization, prolonged hospitalization, increased costs, and excess mortality. These findingsidentify a distinct pulmonary embolism-negative right-heart failure phenotype with implicationsfor early inpatient recognition and escalation for oncology hospitalizations.

Early detection of pancreatic ductal adenocarcinoma (PDAC) with a multiomic liquid biopsy.

4229 Background: Early diagnosis remains the major unmet challenge in pancreatic ductal adenocarcinoma (PDAC), which accounts for approximately 3% of all cancers but nearly 8% of cancer-related deaths in the United States, reflecting its exceptionally poor prognosis. Overall five-year survival remains below 15%, largely because the majority of patients present with unresectable or metastatic disease at diagnosis. Curative surgical resection is feasible in fewer than 20% of cases. There is a critical need to improve risk stratification and diagnostic triage among high-risk populations, including individuals with pancreatic cystic lesions, chronic pancreatitis, and new-onset diabetes over the age of 50. However, the low short-term incidence of PDAC in these groups limits the feasibility of widespread surveillance using current imaging modalities. Methods: In this study, a spectroscopic blood test has been evaluated as an alternative strategy for PDAC detection. This technology employs infrared (IR) spectroscopy to interrogate blood samples, generating disease-specific spectral signatures sensitive to cancer-associated biochemical alterations. When integrated with machine learning, the approach enables detection by capturing global changes across all biomolecular components of the sample. Initially, spectra from 166 patients with PDAC were classified against those from 459 symptomatic patients with non-cancer diagnoses. The trained algorithms are then independently tested on an additional clinical dataset focused on the higher risk population (n = 975). Results: The initial receiver operating characteristic (ROC) curve reported an area under the curve (AUC) value of 0.84. The diagnostic algorithm reported 92% sensitivity with 52% specificity. Importantly, the model did not seem to be affected by cancer stage. The detection rates with the sensitivity-tuned model were 88% stage I, 94% stage II, 99% stage III and 95% stage IV. Validation testing provided additional confirmation of diagnostic ability in the intended use population. The ROC curve for PDAC versus all control patients reported an AUC of 0.81, and PDAC classified against high-risk non-cancers produced an AUC of 0.83. Conclusions: Earlier detection of PDAC has the potential to substantially improve patient outcomes and survival. While advances in genetic sequencing have enabled the identification of tumor-derived biomarkers—including circulating tumor DNA, exosomes, and microRNA—these approaches are limited in early-stage PDAC due to low tumor burden and weak signal from circulating markers. A spectroscopy-based, multi-omic blood test represents a novel strategy that may overcome these limitations, particularly in high-risk populations.

Quality of life and treatment tolerability of Bria-IMT + CPI in metastatic breast cancer.

1107 Background: Bria-IMT is an allogeneic whole cell immunotherapy expressing tumor associated antigens and GM-CSF to stimulate adaptive and innate immunity. The phase 3 Bria-ABC trial (NCT06072612) evaluates Bria-IMT + retifanlimab vs physician’s choice in MBC w/ no meaningful therapeutic options. Characterization of on-trial pt experience, including quality of life (QOL) and tolerability, remains clinically relevant yet underreported. We evaluated QoL and toxicity to assess feasibility of home self administration. Methods: EORTC QLQ-C30 at baseline (BL) and subsequent visits. Raw item responses were aggregated into domain scores. Changes quantified as absolute point differences; domain scores defined as medians of constituent items. Lower functional/symptom and higher global scores indicate better outcomes. Wilcoxon matched pairs test assessed change from BL. Missing QoL data handled by observed cases approach. QoL evaluated at BL, V3, V6, and V9. TWiST and TOX summarized descriptively. TOX defined as cumulative time w/ grade ≥3 TEAEs w/o progression; TWiST as time w/o grade ≥3 toxicity or progression. TOX and TWiST constitute component health states for planned QTWiST analysis pending mature OS. Results: At submission, 251 pts screened, 173 randomized, 147 treated. 75% Caucasian, 20% other, 5% not reported; median 6 prior lines (2-15); ECOG 2 -6%; intracranial mets 9%; 42% HR+, 37% TNBC, 12% HER2+. Median 5 QoL assessments/pt completed. 127 pts completed ≥2 assessments. Paired data available at V3 52%, V6 17%, V9 6%. Global health medians BL 5.0, V3 5.0, V6 5.0, V9 4.5. Score maintenance/improvement: @V3 63% (p=0.7), V6 62%, V9 71%. Functional domains: role (BL 1.5, V3 2.0, V6 2.0, V9 2.0; maintenance 62.7% [p=0.02], 52.4%, 71.4%). Physical (BL 1.0, V3 2.0, V6 2.0, V9 2.0; maintenance 68.7% (p=0.002), 47.6% (p=0.03), 71.4%), cognitive (BL 1.5, V3 1.5, V6 1.5, V9 1.5; maintenance 63.6%, 61.9%, 85.7%). Emotional (BL 1.5, V3 1.5, V6 1.5, V9 1.5; maintenance 75.8% (p=0.9), 81.0%, 85.7%). Social (BL 1.5, V3 1.5, V6 2.0, V9 2.5; maintenance 58.5%, 75.0%, 57.1%). Symptoms: nausea/vomiting (1.0 throughout; maintenance V3 73%, V6 86%, V9 86%), fatigue median 2.0 all timepoints; maintenance 61%, 67%, 71%), pain (BL/V3 1.5, V6/V9 2.0; maintenance V3 57% [p=0.03], V6 62% [p=0.9], V9 86%). TWiST and TOX restricted mean 3.12 mo and 0.63 mo, respectively; 83.2% and 16.8% of observed follow-up. Pts w global health maintenance demonstrated longer median TWiST v deterioration (4.3 v 2.7 mo). ECOG stable in 78% (n=99). Conclusions: Heavily pretreated MBC pts in Bria-ABC demonstrated stable global health and key functional domains. Findings support sustained QoL in advanced disease. TWiST demonstrates meaningful benefit w/o significant toxicity. Ongoing follow up will further characterize durability of pt-reported outcomes and clinical correlation. Results support decentralized care and potential home self administration. Clinical trial information: NCT06072612 .

First-in-human study of [ ¹¹¹ In] XYIMSR-01 SPECT/CT, a novel carbonic anhydrase IX small molecule in patients with metastatic clear cell renal cell carcinoma.

TPS4635 Background: Clear cell renal cell carcinoma (ccRCC) accounts for approximately 75% of renal cancers and is characterized by von Hippel–Lindau (VHL) inactivation and subsequent upregulation of hypoxia-inducible factor-2α (HIF-2α), leading to overexpression of carbonic anhydrase IX (CAIX) in over 95% of tumors. CAIX represents an attractive theranostic target for molecular imaging and radioligand therapy. XYIMSR-01 is a novel low-molecular-weight CAIX-targeted molecule engineered for rapid clearance, high tumor to background contrast, and potential same-day imaging. Preclinical studies demonstrated strong tumor uptake, favorable biodistribution, and selective retention in CAIX-expressing ccRCC xenografts, supporting clinical translation. Based on these findings, a first-in-human study of indium-111 labeled XYIMSR-01 using single photon emission computed tomography (SPECT/CT) imaging has been initiated in patients with metastatic ccRCC. Methods: This is an investigator-initiated, single-center, phase I study conducted at the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, designed to evaluate the safety, tolerability, and feasibility of [ 111 In]XYIMSR-01 SPECT/CT imaging in patients with metastatic ccRCC. Eligible patients must have histologically confirmed ccRCC, ≥2 measurable metastatic lesions (size of each lesion at least ≥1.5 cm), treatment naïve, and have adequate organ and marrow function. Following informed consent, patients receive a single intravenous injection of 10.5 ± 1 mCi of [ 111 In]XYIMSR-01, followed by whole-body planar and regional SPECT/CT imaging at 2-4, 24 ± 1, and 48 ± 1 hours post-injection. Blood samples are collected at multiple time points up to 48 hours to assess pharmacokinetics, clearance, and metabolic profile. Radiation dosimetry is calculated from serial imaging to estimate absorbed doses to tumor and normal organs. The primary objective is to assess the safety, tolerability, and feasibility of imaging with [ 111 In]XYIMSR-01. Secondary objectives include characterization of biodistribution, radiation dosimetry, and pharmacokinetics. Exploratory analyses will evaluate concordance between [ 111 In]XYIMSR-01 SPECT/CT with standard CT or MRI for lesion detection. The planned sample size is up to 10 patients. Successful completion of the study may support the development of future CAIX-targeted theranostic strategies in ccRCC. Clinical trial information: NCT07062549 .