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Survival in patients with hepatobiliary and pancreatic cancers taking GLP-1 receptor agonist therapy.
e16276 Background: Metabolic syndrome has been identified as an independent risk factor for hepatobiliary and pancreatic cancers. Although it is linked as a causative factor, the impact of treatment directed towards risk-reduction and the result on oncologic outcomes remain limited. Since the introduction of glucagon-like peptide-1 receptor agonists (GLP1), emerging evidence has shown associations with reducing the incidence of several cancers, including endometrial, ovarian and meningioma. To our knowledge, this is the first large-scale study to specifically address survival outcomes in patients with hepatobiliary and pancreatic cancers taking GLP1. Methods: A retrospective cohort study using the TriNetX Research Network from 158 healthcare organizations (HCO) from the Global Collaborative Network was carried out. We identified patients who were diagnosed with hepatocellular carcinoma (HCC), fibrolamellar HCC, cholangiocarcinoma, gallbladder and pancreatic cancer using the ICD-10 code and either received GLP1 treatment or not. Cohorts were balanced using propensity score matching for age at diagnosis, female, Black race, body mass index, comorbidities, and concomitant medications. Kaplan-Meier survival curves were used to assess overall survival (OS). Results: From 01/01/2010-12/31/2025, a total of 337,275 patients who had a hepatobiliary or pancreatic cancer were identified from 38 HCO, of these 4,404 patients started GLP1 after the diagnosis and 332,871 were not on GLP1. After balancing, each cohort had a total of 3,607 patients. Patients using GLP1 were noted to be younger and with more diverse ethnical and racial background. A higher body mass index was reported in those patients taking GLP1. Statistically significant differences were noted in laboratory values showing a lower creatinine, ALT and AST in those taking GLP1. Patients who were diagnosed with a hepatobiliary or pancreatic cancer who were taking GLP1 were noted to have better OS than those who did not [p-value < 0.001]. At 10 years, the median survival for those who received GLP1 was not reached vs 1,133 days for those who didn’t. Survival probabilities for patients using GLP1 vs. not at 6, 12, and 24 months were 92% vs. 77%, 86% vs. 67%, and 80% vs. 56%, respectively. Conclusions: Patients with hepatobiliary and pancreatic malignancies receiving GLP1 therapy demonstrated superior survival outcomes. This survival benefit may be driven by the anti-inflammatory properties of GLP1, mediated through both immunomodulatory pathways and the direct attenuation of oncogenic signaling and proliferation. Beyond gastrointestinal malignancies, emerging evidence suggests that GLP1 exert an effect against various metabolically driven malignancies. Given the expanding clinical indications for GLP1 therapy, further investigation into its broader oncologic effect is warranted.
Adenocarcinoma with cartilaginous and osseous metaplasia: A study of demographic and socioeconomic factors using the NCDB.
e12687 Background: Adenocarcinoma with cartilaginous and osseous metaplasia (ACOM) is a rare malignant tumor where gland-forming cells undergo abnormal transformation into cartilage and bone. Complete surgical removal and chemotherapy are the strongest predictors of lower recurrence and longer overall survival; however, on account of the infrequency of this disease, demographic and socioeconomic data remain scarce. In this cohort study, the National Cancer Database (NCDB) was used to further characterize the demographic and socioeconomic factors in these patients. Methods: A retrospective cohort study utilizing the 2004-2020 National Cancer Database encompassed 212 patients with a confirmed diagnosis of ACOM ICD-O-3 code (8571). Factors including age, sex, race, Hispanic status, highest level of education, insurance coverage, facility type, distance traveled for treatment, and Charleson-Deyo score were evaluated using descriptive statistics. Incidence trends were analyzed using regression modeling. Results: This cancer disproportionately affected women (98.1%). The most common primary site was the upper quadrant of the breast (37.7%). The majority of this cohort were Non-Hispanic (87.7%), were White (74.5%), and lived in metropolitan areas (58.5%). Most patients presented with stage II (39.2%) and stage I (32.1%) disease. Comorbidity burden was low, with a majority of individuals (76.4%) having a Charlson-Deyo score of 0. Nearly half of the patients were privately insured (48.6%). Most individuals were treated using chemotherapy (75.5%) and radiation therapy (51.9%), while few received treatment through hormone therapy (3.8%) and immunotherapy (2.8%). Long-term survival at two, five, and ten years was 90%, 80%, and 70% respectively. Conclusions: To our knowledge, this represents the first NCDB analysis examining ACOM, thereby addressing a gap in literature. Aligning with prior published reports, ACOM mostly affected Non-Hispanic and White patients with tumors found mainly in the upper quadrant of the breast. This study represents the first characterization of socioeconomic factors among ACOM, with the majority of patients living in the metropolitan areas. Further work is needed to clarify how the demographic and socioeconomic characteristics of ACOM affect diagnosis, treatment modalities, and patient survival.
Symptom profiles and cancer stage at diagnosis in gastroesophageal junction adenocarcinoma: An ordinal and clustering analysis.
e16005 Background: Gastroesophageal junction adenocarcinoma (GEJA) is often diagnosed at advanced stages, contributing to poor outcomes. While individual presenting symptoms have been linked to disease severity, less is known about how combinations of symptoms or symptom profiles relate to stage at diagnosis. Methods: We analyzed 250 patients with GEJA staged I–IV at diagnosis. Analyses were restricted to presenting clinical symptoms (e.g., dysphagia, abdominal pain, systemic weight loss), excluding risk factors and surveillance-related variables. Ordinal logistic regression was used to model associations between symptom presence and increasing stage. Penalized ordinal regression (LASSO) was applied for symptom selection, followed by refitting of a reduced ordinal model. Proportional odds assumptions were assessed using the Brant test. Predicted stage probabilities were generated to visualize symptom specific shifts in stage distribution. In parallel, unsupervised clustering approaches, including symptom prevalence heatmaps, stage-specific enrichment analyses, and patient-level clustering using Jaccard distances were used to identify symptom groupings associated with disease stage. Sensitivity analyses compared early (stage I–III) versus advanced disease (stage IV). Results: LASSO identified dysphagia, abdominal pain, and systemic weight loss as the most informative symptoms. In the refitted ordinal model, all three were independently associated with higher stage at diagnosis (ORs ≈ 2.3–3.1). Predicted probability plots demonstrated substantial increases in the probability of stage IV disease when these symptoms were present. Although proportional odds assumptions were partially violated for select symptoms, effect directions were consistent across sensitivity analyses. Symptom clustering revealed distinct stage-associated profiles, with advanced-stage disease characterized by co-occurrence of obstructive and systemic symptoms, while earlier stages showed lower symptom burden. Conclusions: Symptom-only modeling and clustering helped identify clinically meaningful symptom profiles associated with GEJA stage at diagnosis. Combining ordinal modeling with visualization and unsupervised clustering provides intuitive insight beyond single-symptom analyses and may support earlier recognition of advanced disease in symptomatic patients.
Reversible epigenetic control of CD146 phenotypic states in MDA-MB-231 breast cancer cells.
e13010 Background: Previous studies have demonstrated epigenetic regulation of the CD146 ( MCAM ) gene, whose protein product plays a key role in epithelial–mesenchymal transition (EMT). Analysis of MCAM promoter methylation in the triple-negative (TN) breast cancer cell line MDA-MB-231 revealed heterogeneous CpG methylation, suggesting the presence of distinct subclonal populations. This study aimed to investigate the relationship between subclonal CpG island methylation and CD146 expression and to evaluate its relevance across breast cancer molecular subtypes defined by PAM50 classification. Methods: CD146 high and CD146 low subpopulations were isolated by fluorescence-activated cell sorting (FACS). Methylation of 22 CpG sites within the MCAM promoter was assessed using bisulfite sequencing (BGS). CD146 expression was analyzed at the mRNA (RT-PCR) and protein (Western blot) levels. In parallel, bioinformatic analyses of TCGA BRCA clinical datasets were performed, including methylation profiling, differential expression analysis, and correlation analyses between MCAM methylation and EMT-related genes ( SNAI1, TWIST1 ) across luminal A (n = 65), luminal B (n = 27), and basal-like (n = 23) subtypes. Results: CD146 high and CD146 low clones exhibited opposing expression profiles, confirmed by FACS, RT-PCR, and Western blot. Differential methylation between these populations was identified at four CpG sites within the analyzed promoter region, indicating their regulatory relevance. Clinical data analysis revealed strong subtype-specific differences in MCAM methylation. The basal-like subtype showed the lowest methylation levels (mean β = 0.35 ± 0.03), with MCAM expression significantly associated with TN status (p < 0.05). The highest methylation levels were observed in the luminal B subtype (mean β = 0.38 ± 0.04), where significant correlations were detected between MCAM methylation and EMT- related genes methylation (r > 0.4). Such correlations were absent in the basal-like subtype. Conclusions: CD146 expression in MDA-MB-231 cells is epigenetically regulated through promoter methylation. Our findings suggest that this mechanism is part of a broader, subtype-dependent epigenetic program. Consistent with previous reports linking transient CD146 loss to increased cancer cell invasiveness, our results support the concept that dynamic, subclonal DNA methylation changes contribute to tumor heterogeneity and selection of highly invasive cell populations. MCAM promoter methylation may therefore represent a potential biomarker for identifying aggressive breast cancer subtypes.
Predicting fluoropyrimidine cardiotoxicity using a focus beyond routine cardiovascular risk assessment.
12030 Background: Fluoropyrimidines remain backbone of systemic therapy for colorectal cancer (CRC) but are associated with diverse cardiovascular (CV) toxicities ranging from hypertension to heart failure. Current CV risk stratification tools have uncertain predictive value in cancer populations. We aimed to identify clinically actionable predictors of CV complications during fluoropyrimidine-based therapy. Methods: Prospective single-center observational registry included 171 consecutive stage I-IV CRC patients initiating fluoropyrimidine-based chemotherapy between (median follow-up 6.5 months, IQR 3.0-8.0). All patients underwent structured baseline cardio-oncology assessment including CV risk stratification per ESC guidelines, 12-lead ECG, transthoracic echocardiography with global longitudinal strain measurement, and serum biomarkers (NT-proBNP, high-sensitivity troponin I). Primary endpoint was incidence of ≥1 prespecified CV complication. Missing data ( < 5% for laboratory parameters) were addressed via complete-case analysis. Statistical analysis included χ² tests, Mann-Whitney U tests, and multivariable logistic regression with backward elimination (SPSS v28.0, significance p < 0.05). Results: Overall CV complication incidence was 33%. Event spectrum: Blood pressure destabilization (9%), thromboembolism (pulmonary embolism 5%, deep vein thrombosis 3%), arrhythmias 4,3%, coronary ischemia (angina 2.3%), ischemic stroke 0.6%, left ventricular systolic dysfunction (asymptomatic EF decline 1.8%, symptomatic heart failure 0.6%), moderate hydropericardium (2.3%), and isolated biomarker elevation (2.3%). Univariate analysis identified significant associations with CV complications for: diabetes mellitus (DM) (26.8% vs 10.4%, p = 0.006, OR 3.2), obesity (41.1% vs 26.1%, p = 0.047, OR 2.0), age (median 66.3 vs 63.1 years, p = 0.041), and high/very-high baseline CV risk (37.5% vs 14.3%, p = 0.009, OR 3.6). In multivariable analysis adjusting for age, sex, obesity, hypertension, and baseline CV risk category, only DM retained independent predictive value (adjusted OR 3.14, 95% CI 1.35-7.28, p = 0.008). Baseline NT-proBNP elevation correlated with increased all-cause mortality (58.3% vs 22.0%, p = 0.010) despite absence of CV deaths (all 12 deaths from cancer progression). Conclusions: Diabetes mellitus is the strongest independent predictor of CV toxicity in CRC patients receiving fluoropyrimidine chemotherapy, associated with 3-fold increased risk. While baseline CV risk stratification showed univariate association, it lost significance in adjusted analysis, highlighting DM's primacy. Systematic cardio-oncology monitoring appears effective given zero CV mortality. These data support prioritizing diabetic patients for intensified CV surveillance during fluoropyrimidine therapy.
Impact of travel distance on oncologic outcomes after curative-intent surgery for retroperitoneal sarcoma.
e23575 Background: Retroperitoneal sarcoma (RPS) is associated with high rates of recurrence despite optimal surgical management. Although centralization of care in high-volume referral centers is widely recommended, geographic barriers could potentially affect surveillance, early detection of recurrence, and survival. We aimed to evaluate whether travel distance from a patient’s residence to the treating center influences oncologic outcomes after curative-intent surgery for RPS, accounting for histologic heterogeneity. Methods: We conducted a retrospective cohort study of patients with primary RPS who underwent curative-intent resection. Travel distance was defined as the average distance from the patient’s main residence to the treating hospital and dichotomized at 50 km (≤50 km vs > 50 km). Histology was classified according to WHO criteria and grouped as well-differentiated liposarcoma (WDLPS), dedifferentiated liposarcoma (DDLPS), leiomyosarcoma (LMS), and other high-grade sarcomas. Patients with unknown vital status were considered alive and censored at last follow-up. Primary endpoints were recurrence-free survival (RFS) and overall survival (OS), estimated using the Kaplan–Meier method and compared with log-rank tests. Secondary endpoints included documented recurrence rates. Results: Among 78 patients, 33 (42.3%) lived ≤50 km from the treating center (median 27 km) and 45 (57.7%) lived > 50 km away (median 129 km). Liposarcoma predominated, with WDLPS and DDLPS accounting for 71.7% of cases; LMS represented 13% and other high-grade sarcomas 15%, such that more than half of the cohort had high-grade disease. Recurrence rates were similar between groups (42.4% for ≤50 km vs 40.0% for > 50 km, p = NS), as were mortality rates (18.2% vs 11.1%, p = 0.51). Among 76 evaluable patients, median RFS was 54.4 months in the ≤50 km group and 32.9 months in the > 50 km group, without significant difference (p = 0.95). Three- and five-year RFS were 57.1% and 40.4% versus 49.9% and 46.1%, respectively. Median OS was not reached in either cohort; three- and five-year OS were 89.7% and 89.7% for ≤50 km versus 88.6% and 83.4% for > 50 km (p = 0.76). Conclusions: In patients undergoing curative-intent surgery for RPS, a travel distance greater than 50 km was not associated with increased recurrence risk or inferior RFS or OS, even in a population dominated by aggressive histologic subtypes such as DDLPS and LMS. These findings support the safety and effectiveness of centralized sarcoma care models and highlight that intrinsic tumor biology, rather than geographic proximity, remains the principal determinant of oncologic outcomes in retroperitoneal sarcoma.
Implementation of a multidisciplinary biomarker care pathway to reduce somatic sequencing failure rates in a community cancer center.
e23325 Background: Next-Generation Sequencing (NGS) of tumor DNA is critical for guiding targeted cancer therapies, but high rates of specimen failure limit its utility. We sought to evaluate the impact of a quality improvement initiative aimed at reducing these pre-analytic failures. Methods: A Biomarker Care Pathway was developed by the Precision Health team in collaboration with all clinical departments involved in tissue acquisition for NGS at our organization. This Biomarker Care Pathway served as a standardized protocol to maximize tissue quality and quantity for specimens that were known to be sent to NGS, including but not limited to preferred needle gauge, attempting additional needle passes to maximize tissue quantity, suggested incubation times for formalin fixation, and others. We then conducted a pre-post implementation study. The pre-implementation period included all somatic tumor sequencing cases in 2023 (n = 340). Following the implementation of a multidisciplinary Biomarker Care Pathway in January 2024, the post-implementation period included all cases in 2024 (n = 350). The primary outcome was the total sequencing failure rate (Quantity Not Sufficient, QNS). Results: Implementation of the Biomarker Care Pathway resulted in a two-fold reduction in the QNS rate, from 6.2% in 2023 to 2.3% in 2024 (p = 0.01). Additional result types analyzed included Partial QNS (decreased from 4.4% to 2.9%) and Limited Tissue (decreased from 16.8% to 9.4%). Decreases in Limited Tissue, Partial QNS, and QNS rates suggests that implementation of the Biomarker Care Pathway may have contributed to improvements in specimen quality. Complete Profile results increased 72.6% to 85.4% from 2023 to 2024 (p < 0.0001). When tissue is insufficient for a Complete Profile, Limited Tissue results are provided to include the most clinically relevant biomarkers based on histology. Therefore, these Limited Tissue results were combined with Complete Profile results to estimate the number of patients who received a clinically actionable report (89% in 2023 versus 95% in 2024). When Limited Tissue results were instead combined with QNS results and analyzed by organ site of biopsy, decreases were observed for biopsies of the pancreas, liver, colon, and lung among others. Conclusions: A standardized, multidisciplinary Biomarker Care Pathway is a highly effective implementation strategy for reducing NGS failure rates in a community oncology setting. This optimization of pre-analytic workflows significantly increases the number of patients who can potentially benefit from biomarker-driven therapy. N (%) 2023 2024 p-value (two proportion Z-Test)p<0.05 were considered significant. Complete Profile 247 (72.6%) 299 (85.4%) p< 0.0001 Limited Tissue 57 (16.8%) 33 (9.4%) p=0.003 Partial QNS 15 (4.4%) 10 (2.9%) p=0.28 QNS 21 (6.2%) 8 (2.3%) p=0.01 Total Cases 340 (100%) 350 (100%)
Preparedness of internal medicine residents for oncologic emergencies and end-of-life discussions in a community training environment.
9017 Background: Internal medicine (IM) residents often serve as first responders for patients with cancer in community hospitals, where oncologic emergencies frequently present before subspecialty involvement. Yet structured heme-onc and palliative training is limited. Preparedness in community settings - where workflow and resource constraints may heighten gaps between trainee knowledge and confidence - remains under-examined. Methods: We conducted a cross-sectional electronic survey of IM residents at a university-affiliated community hospital (Oct 17 - Nov 18, 2025). It included 14 vignette-based knowledge items, 8 confidence ratings (0-10), and questions on demographics, oncology exposure, and perceived barriers. Primary outcomes were total knowledge score (0-14) and composite confidence scores. Multivariable regression assessed associations between resident characteristics, knowledge, and confidence. Results: Thirty-three of 58 residents participated; mean age was 30.1 years, and 82% had not completed a hematology-oncology rotation. Knowledge was uniformly high (mean 13.0; SD 1.0) across key domains including febrile neutropenia and hospice eligibility. Confidence, however, was substantially lower and more heterogeneous (emergency mean 5.78; end-of-life mean 5.84). Senior trainees demonstrated greater confidence in both domains (β = 1.62 and 1.60; P < .001), and caring for ≥3 oncologic patients in the prior month independently predicted higher communication confidence (β = 1.87; P = .04). Residents identified recurrent barriers: delays in triage (72.7%), limited family availability (72.7%), language barriers (57.6%), and difficulty obtaining early intravenous access (39.4%). Free-text responses emphasized the need for concise reference tools, structured exposure, and simulation-based practice. Conclusions: IM residents demonstrated excellent factual knowledge but substantially lower confidence in managing acute oncologic conditions and conducting serious-illness conversations. Confidence was influenced more by experience and workflow realities than by knowledge alone. Our findings highlight an actionable opportunity. Experiential curricula, streamlined clinical pathways, and integrated oncologic teaching may strengthen frontline preparedness for high-stakes cancer care in community settings. Resident demographics, clinical exposure, and selected barriers (N = 33). Selected measure n/N (%) Resident sex: male 20/33 (60.6%) Resident sex: female 11/33 (33.3%) Training level: PGY-1 15/33 (45.5%) Training level: PGY-2 8/33 (24.2%) Training level: PGY-3 10/33 (30.3%) Oncology exposure: 0–2 cancer patients/month 18/33 (54.5%) Oncology exposure: ≥3 cancer patients/month 10/33 (30.3%) Barrier: workload or paging delays 13/33 (39.4%) Barrier: cultural or linguistic challenges 19/33 (57.6%)
Development of an [18F]-labeled glutamine PET radiotracer to detect serine synthesis pathway activity in HER2-positive breast cancer.
e15070 Background: Serine synthesis pathway (SSP) enzymes PSAT1 and PHGDH are highly upregulated in TP53-mutant breast cancer (BC), particularly basal-type triple-negative disease (TNBC). However, HER2-positive BC also frequently harbors TP53 mutations and is known to exhibit glutamine dependence. Since glutamine is imported into cancer cells and converted to glutamate, which serves as a substrate for PSAT1, glutamine dependence implies SSP activity. We are developing the PET radiotracer [18F]fluoroglutamine (FG) to identify tumors with elevated SSP activity and, ultimately, patients who may benefit from SSP inhibition. While our initial hypothesis focused on TP53-mutant TNBC as [18F]FG-avid and TP53–wild-type luminal BC as non-avid, we now propose extending this work to HER2-positive BC to evaluate whether [18F]FG avidity correlates with TP53 status and/or other molecular features, including ER and PIK3CA status. Methods: Public datasets (METABRIC, TCGA, SCAN-B, GTEx) were interrogated using Breast Cancer Gene-Expression Miner v5.2, muTarget, and GEPIA to examine associations between SSP gene expression and TP53 mutation status. We propose in vitro studies and in vivo xenograft models using HER2-amplified BC cell lines stratified by TP53 mutation status and SSP activity. In parallel, we propose development and validation of cGMP-grade [18F]FG for future clinical PET studies in patients with HER2-positive BC stratified by TP53 status, ER status, and other molecular markers of cancer aggressiveness. Results: In silico analyses demonstrated upregulation of PSAT1 (2.64-fold) and PHGDH (2.37-fold) in TP53-mutant versus TP53–wild-type BC. In contrast, ESR1, GATA3, and FOXA1 expression was reduced (5.4-, 3.3-, and 3.1-fold, respectively). GATA3-mutant tumors, largely ER-positive, showed increased ESR1, GATA3, and FOXA1 expression with corresponding downregulation of PHGDH and PSAT1. PSAT1 represented the largest gene-expression difference between TNBC and non-TNBC. Development of cGMP-grade [18F]FG is underway and is expected to require approximately 12 months for regulatory approval. In the interim, laboratory studies using research-grade tracers are ongoing to assess whether HER2-associated glutamine dependence reflects SSP activity and its relationship to TP53 status. Conclusions: HER2-positive BC may exhibit elevated SSP activity, potentially driven by glutamine dependence and frequent TP53 mutations. [18F]FG PET imaging represents a promising strategy to identify SSP-active HER2-positive tumors and to guide future clinical evaluation of SSP-targeted therapies.
Age-centric insights: A single-center analysis of clinical presentation, treatment approaches, and outcomes in multiple myeloma patients across different age groups.
e19532 Background: Multiple myeloma (MM) accounts for approximately 10% of hematologic malignancies, with a rising incidence in low- and middle-income countries. Age significantly influences disease biology, treatment patterns, and prognosis; however, regional data from South Asia remain limited. Methods: We conducted a retrospective observational cohort study of MM patients diagnosed between December 2010 and March 2023. A total of 218 patients were included using non-probability consecutive sampling and were stratified into three age groups: 30–50 years (n = 44), 51–71 years (n = 140), and >72 years (n = 34). Data were extracted from the Health Information Management System (HIMS). Statistical analyses included Chi-square testing, analysis of variance (ANOVA), and Kaplan–Meier survival analysis using Microsoft Excel 365 and GraphPad Prism version 10.2.3. A p-value <0.05 was considered statistically significant. Results: Male predominance was observed across all age groups. The majority of patients presented with advanced disease (R-ISS II/III: 59.1%, 88.6%, and 94.1% in Groups 1, 2, and 3, respectively). CRAB features varied by age: younger patients more frequently exhibited anemia and renal impairment, whereas older patients had higher rates of hypercalcemia and pathological fractures. CYBORD was the most commonly used induction regimen, while <10% underwent autologous stem-cell transplantation due to financial and logistical constraints. Partial response was the most frequent outcome across all groups (55–64%), with complete/stringent complete responses achieved in only 11–19%. On multivariate analysis, elevated β2-microglobulin, higher bone marrow plasma cell infiltration, creatinine, and absolute neutrophil count predicted inferior survival, while higher serum albumin was protective. Median overall survival was lowest in the youngest cohort (45 months vs. 60–70 months in older groups). Conclusions: In this South Asian cohort, younger MM patients exhibited more aggressive disease biology and inferior survival despite greater physiological reserve, whereas older patients demonstrated higher cytopenias but lower marrow involvement. Limited access to transplantation and novel therapies further constrained outcomes, underscoring the need for age-adapted strategies and improved resource allocation.
A phase 2 study of olutasidenib in combination with azacitidine followed by olutasidenib maintenance after venetoclax plus a hypomethylating agent regimen for <i>IDH1</i> -mutated acute myeloid leukemia (University of California Hematologic Malignancies Consortium Study 2441).
TPS6603 Background: Acute myeloid leukemia (AML) with isocitrate dehydrogenase-1 (IDH1) mutations represents a subset of up to approximately 7-14% of patients. For patients with IDH1m AML ineligible for first line intensive induction, the combination of a hypomethylating agent (HMA) and venetoclax (VEN) is a standard of care based on the VIALE-A study. In patients with IDH1m, the HMA azacitidine (AZA) plus VEN regimen leads to a complete remission (CR) plus CR with incomplete count recovery (CRi) rate of 66.7%, duration of remission (DoR) 21.9 months, and median overall survival (OS) of 15.2 months. However, one of the limiting features of HMA-VEN is myelosuppression, leading to dose delays and reductions, and adverse events (AEs) led to discontinuation in up to 30% of patients on the VIALE-A study. Approaches to increase tolerability and improve outcomes are of interest. Olutasidenib (OLU) is a potent, oral and selective small-molecule IDH1m inhibitor currently approved for relapsed/refractory AML patients with an IDH1 mutation, based on the pivotal cohort of a Phase 1/2 study. Overall, this study showed that OLU alone or in combination with AZA in patients with IDH1m AML was well-tolerated and showed meaningful clinical activity, including in those with prior VEN treatment. We hypothesize that, after achieving a response on HMA-VEN, de-escalating and switching maintenance from HMA-VEN to OLU-AZA followed by OLU monotherapy will lead to improved outcomes for patients with IDH1m AML. Methods: This multicenter investigator-initiated study through the University of California Hematologic Malignancies Consortium (UCHMC) is a phase II single-arm study evaluating the combination of OLU in combination with AZA followed by OLU monotherapy as a switch maintenance approach after HMA-VEN for patients with IDH1m AML. Key eligibility criteria include a diagnosis of IDH1m AML, achievement of CR or CRi to first-line HMA-VEN with no more than 4 cycles of HMA-VEN at the time of enrollment, IDH1m inhibitor naïve, age 18+, and performance status 0-2. The primary endpoint is treatment failure, defined as AML-related death, relapse, or treatment discontinuation due to AE within 12 months from the time of CR/CRi. Secondary endpoints include treatment-related AE, time to treatment failure, relapse-free survival, DoR, OS, and rate of allotransplant. Patients will receive OLU 150mg BID in combination with standard AZA during the first 4 cycles followed by OLU 150mg BID monotherapy until any discontinuation criteria are met. Disease assessments will be performed at baseline, following cycles 4, 8, and 12, and then as clinically indicated. The trial will enroll up to 28 patients across the UCHMC. The trial is currently enrolling. Clinicaltrials.gov ID is NCT07304011. Clinical trial information: NCT07304011 .
Impact of durvalumab treatment duration on survival and healthcare utilization after chemoradiation for lung cancer: A real-world analysis.
e20094 Background: Although durvalumab consolidation after chemoradiation improves survival in lung cancer, the ideal duration of therapy in real-world practice is not well defined. We evaluated clinical outcomes among patients receiving shorter compared with longer courses of durvalumab following chemoradiation. Methods: We conducted a retrospective cohort study using the TriNetX U.S. Collaborative Network, including patients with lung cancer who received concurrent chemoradiation followed by durvalumab consolidation. Patients were categorized based on duration of durvalumab therapy into a FULL cohort, defined as continued treatment for at least 12 months, and a SHORT cohort, defined as earlier discontinuation. Propensity score matching was applied to balance baseline demographic and clinical characteristics. Outcomes of interest included overall survival, hospital admission, critical care utilization, palliative care, emergency care, and prolonged services. Kaplan–Meier survival and risk-based analyses were performed. Results: After propensity score matching, 567 patients were included in each cohort with well-balanced baseline characteristics. Mortality was significantly lower in the FULL cohort compared with the SHORT cohort (28.1% vs 37.4%; risk difference −9.3%, p = 0.001). Patients in the FULL cohort experienced significantly improved overall survival (HR 0.66; 95% CI 0.54–0.81; log-rank p < 0.001), with longer median survival (1795 vs 1292 days). In addition, prolonged services utilization was lower in the FULL cohort (4.4% vs 9.2%; RR 0.48, p = 0.001), along with reduced risk of critical care exposure (HR 0.73; p = 0.012). No significant differences were observed in hospital admissions or emergency department visits. Conclusions: In this large real-world analysis, longer duration of durvalumab following chemoradiation was associated with improved survival and reduced high-intensity healthcare utilization. These findings support the importance of maintaining durvalumab therapy when feasible and underscore the need for strategies to optimize treatment adherence in clinical practice.
Prognostic impact of <i>PIK3CA</i> amplifications and co-occurring mutations detected through circulating tumor DNA (ctDNA) in metastatic breast cancer (MBC).
1036 Background: Activating PIK3CA mutations are established oncogenic drivers and predictive biomarkers in MBC. In contrast, PIK3CA amplifications are rare, poorly characterized, and of unclear clinical significance. Tissue-based studies report a prevalence of 1–7%, but their detection and relevance in ctDNA are largely unexplored. Moreover, whether amplifications interact with co-occurring mutations to define a distinct high-risk subset is unknown. We therefore aimed to characterize the impact of PIK3CA amplifications detected in ctDNA through a multi-institutional cohort of patients (pts) with MBC. Methods: This retrospective study analyzed a multi-institutional cohort of 1579 pts with MBC and baseline ctDNA testing with the Guardant360 NGS panel within a large academic consortium (PMAC). Hormone Receptor positivity (HR+) and HER2 status were defined based on the most recent biopsy. Associations between SNVs, CNVs, and clinical characteristics were assessed using multivariable logistic regression. The impact of prognosis, adjusted for the number of prior treatment lines, was evaluated through Cox regression for overall survival (OS), defined from time of baseline ctDNA collection. Results: Among 1,579 pts, 1,121 (71%) were HR+/HER2–, 214 (13.5%) HER2+, and 244 (15.5%) had triple-negative breast cancer (TNBC). PIK3CA CNVs were detected in 7.7% of pts, and 44.7% harbored a concomitant PIK3CA SNVs. PIK3CA CNVs were significantly enriched in TNBC compared with other subtypes (Odds Ratio [OR] 2.02, p=0.011). In the overall population, PIK3CA CNVs were associated with significantly worse OS (HR 2.46, p<0.001), an effect observed across all subtypes, including HR+/HER2– (HR 2.21, p<0.001), HER2+ (HR 5.23, p<0.001), and TNBC (HR 1.81, p=0.018). In multivariable analysis, PIK3CA CNVs remained independently associated with inferior OS in the overall cohort (HR 1.61, p=0.015) and in HR+/HER2– disease (HR 1.38, p=0.048). Notably, the coexistence of a PIK3CA CNV and mutation identified a subset with particularly poor prognosis. Compared with patients harboring PIK3CA SNVs alone, those with concurrent SNVs and CNVs had significantly worse OS in the overall population (HR 1.80, p=0.002), in HR+/HER2– disease (HR 1.51, p=0.037), and in TNBC (HR 5.72, p<0.001). Conclusions: PIK3CA amplifications detected in ctDNA are relatively frequent in MBC and are associated with significantly worse survival across molecular subtypes. The coexistence of PIK3CA amplification and mutation identifies a distinct high-risk subset with particularly poor prognosis, beyond the effect of mutations alone. Further mechanistic understanding and real-world outcome analyses are needed to determine whether PIK3CA amplifications, alone or in combination with mutations, have predictive relevance for response or resistance to PI3K-pathway inhibitors.
Real-world comparative outcomes of first-generation versus second- and third-generation tyrosine kinase inhibitors in chronic myeloid leukemia: A global propensity-matched analysis.
e18595 Background: Second- and third-generation tyrosine kinase inhibitors (TKIs) are frequently used in chronic myeloid leukemia (CML) due to greater BCR–ABL inhibitory potency; however, real-world comparative effectiveness and safety relative to first-generation TKIs remain incompletely defined. We evaluated clinical outcomes associated with first-generation versus later-generation TKIs in a large multinational real-world cohort. Methods: We conducted a retrospective cohort study using data from 170 healthcare organizations in the TriNetX Global Collaborative Network. Adults (≥18 years) with BCR–ABL–positive CML treated with first-generation TKI (imatinib) or second-/third-generation TKIs (dasatinib, nilotinib, bosutinib, ponatinib, or asciminib) were identified. The index date was initiation of the qualifying TKI within three years of diagnosis. Outcomes were assessed from day 1 to day 1095 post-index. Propensity score matching (1:1) for demographics and comorbidities yielded 6,270 patients per cohort. Outcomes included hospitalizations, arterial thrombotic events, bleeding events, hepatotoxicity, blast crisis, and all-cause mortality. Risk and Kaplan–Meier analyses excluded patients with prior outcomes. Results: Baseline characteristics were well balanced after matching (all standardized differences <0.05). Over a median follow-up of 2.2 years, first-generation TKI therapy was associated with a lower risk of hospitalization (15.8% vs 17.7%; risk ratio [RR] 0.89, 95% CI 0.80–0.99; p=0.028) and improved hospitalization-free survival (hazard ratio [HR] 0.80, 95% CI 0.72–0.90; p<0.001). Bleeding events occurred less frequently with first-generation TKIs (4.7% vs 5.9%; RR 0.80; p=0.004), with superior bleeding-free survival (HR 0.74, 95% CI 0.63–0.87; p<0.001). Hepatotoxicity was rare but less frequent with first-generation therapy (0.2% vs 0.4%; HR 0.49, 95% CI 0.25–0.96; p=0.033). Rates of arterial thrombotic events were similar (4.5% vs 4.5%; p=0.98). Blast crisis occurred more often among patients receiving second-/third-generation TKIs (1.4% vs 2.9%; RR 0.50; p<0.001; HR 0.46, 95% CI 0.36–0.60). Overall mortality was similar by risk analysis (9.8% vs 10.6%; p=0.14), although time-to-death favored first-generation therapy (HR 0.86, 95% CI 0.77–0.96; p=0.005). Conclusions: In this large real-world analysis, first-generation TKI therapy was associated with lower hospitalization rates, fewer bleeding and hepatic adverse events, and comparable overall survival relative to second- and third-generation TKIs. The higher observed incidence of blast crisis among later-generation TKI recipients likely reflects residual confounding by indication, as these agents are preferentially used in patients with higher-risk or treatment-resistant disease.
Myxoid leiomyosarcoma: A population-based NCDB analysis.
e17611 Background: Myxoid leiomyosarcoma is a rare malignant smooth muscle tumor characterized by abundant myxoid stroma and low cellularity. Despite its rarity, it carries a significant clinical burden, with frequent recurrence or metastasis following initial treatment, and may respond differently to chemotherapy and radiation compared to conventional leiomyosarcomas. However, existing evidence is largely derived from small case series and single-institution studies, as the rarity of this cancer has limited population-based analyses examining demographic, clinical, and socioeconomic factors, as well as long-term incidence trends. To address this gap, the National Cancer Database (NCDB) was utilized to examine population-level demographic and clinical characteristics of myxoid leiomyosarcoma. Methods: A retrospective review of cases from the NCDB, between 2004 and 2020, identified 621 individuals with histologically confirmed myxoid leiomyosarcoma (ICD-O-3: 8896). Demographic and socioeconomic characteristics, such as age, sex, race, insurance type, treatment facility, educational level, and Charlson–Deyo comorbidity status, were summarized using descriptive statistical methods. Incidence and survival patterns were evaluated using regression analysis and Kaplan-Meier estimates. Results: The average age at diagnosis was 55 ± 13.2 years. Most patients were female (95.5%), non-Hispanic (89.9%), and White (69.7%). Privately insured patients accounted for 58.8%, with most treated at academic/research institutions (43.6%), followed by comprehensive community (27.4%) and integrated network centers (24.1%). Additionally, 65.3% lived in large metropolitan areas, with a mean distance of 30.1 ± 100.6 miles from the reporting hospital. Primary tumors were most often uterine (C549/C559); 29.1% were stage I and 10.8% stage IV. Tumor sizes ranged 2–400 mm (mean 122.7 mm). Surgery was performed in 92.1% of patients, with 94.7% surviving 90 days; 63% had negative margin resections. Other treatments included radiation (16.3%), chemotherapy (33%), hormone therapy (2.3%), and immunotherapy (0.5%). Long-term survival had 2-, 5-, and 10-year survival rates of 73.4%, 58%, and 47.8%, respectively; overall mean survival was 9.7 ± 0.18 years. Conclusions: This study is the first to address a significant gap in knowledge about myxoid leiomyosarcoma by utilizing a retrospective NCDB analysis. Comparable to existing studies, myxoid leiomyosarcoma is predominant in non-Hispanic female populations. Socioeconomically, the majority of patients come from higher household income quartiles and reside in larger, metropolitan areas. This shows that our cohort aligns with NCDB baseline findings regarding patient demographics for this cancer. Future studies should focus on a better understanding of the impact of demographic and socioeconomic factors on diagnosis, treatment, and overall survival of those with myxoid leiomyosarcoma.
ICONIC (Improving Outcomes Through Collaboration in Osteosarcoma): Insights from a national prospective cohort trial for newly diagnosed osteosarcoma patients.
11524 Background: There has been little change in osteosarcoma (OS) treatment over the last two decades. Understanding management patterns, better understanding of biology and identifying new biomarkers are key to improving outcomes. Methods: ICONIC is a UK-wide prospective observational trial of newly diagnosed OS pts with longitudinal clinical, imaging, tissue and pt experience data collection to address key objectives. These include describing variation in management and outcomes for specific pt groups, establishing an imaging repository to develop imaging biomarkers, analysis of plasma cfDNA, and use of tumor tissue to develop pt-derived models and decode tumor-immune cross talk. Pts were recruited from Oct 2019 to Jan 2025. Progression-free (PFS) and overall survival were analysed using Kaplan-Meier survival statistics and Cox regression. Results: A total of 337 pts were recruited from 27 sites. Median age was 19 (range 3-83); 17% had metastases. In total, 229/253 (91%) pts receiving neoadjuvant treatment had methotrexate, doxorubicin, cisplatin (MAP); 259 underwent surgery, of which 52 (20%) had amputations; 101/161 (63%) of eligible pts received mifamurtide. With median follow-up of 2.5 years, 2-year PFS and overall survival were 57% (95% CI 51-63) and 78% (95% CI 72-83) (Table 1). Age, raised ALP, pelvis or trunk primary sites, metastases and inoperability were associated with worse PFS. Pts with a good pathological response to treatment and ≥2mm resection margin had the lowest risk of local recurrence (p=0.02). A pilot radiomics analysis of 32 pts undergoing resection after MAP, demonstrated baseline tumour volume (p=0.044) pre-treatment T2 Gray Level Non-Uniformity (GLNU) (p=0.002), and post-treatment GLNU difference (p=0.008) to be associated with overall survival. Longitudinal blood samples for cfDNA analysis were collected from 226 pts. Patient-derived primary cultures were successfully developed from 12 pts. Spatially-resolved genomic and transcriptomic analysis of tumor tissue to study genomic evolution and immune evasion is ongoing. Conclusions: ICONIC trial has identified variation in management and outcomes of OS, which will guide future practice and provided a successful platform for imaging and biomarker analysis, which is ongoing. Clinical trial information: NCT04132895 . Pt characteristics and outcomes according to age and primary site. All patientsN=337 <16 yearsN=115 16-24 yearsN=101 25-39 yearsN=60 >40 yearsN=61 Lower limb 228 (68%) 90 (78%) 74 (73%) 34 (57%) 30 (49%) Upper limb 40 (12%) 18 (16%) 9 (9%) 6 (10%) 7 (11%) Craniofacial 23 (7%) 3 (3%) 6 (6%) 7 (12%) 7 (11%) Pelvis/sacrum 22 (7%) 1 (1%) 8 (8%) 4 (7%) 9 (15%) Trunk 12 (4%) 1 (1%) 4 (4%) 5 (8%) 2 (3%) Unknown 12 (4%) 2 (2%) 0 (0%) 4 (7%) 6 (10%) Survival outcome analysis 2-year PFS (95% CI) 57% (51-63) 65% (55-74) 55% (44-66) 60% (45-73) 44% (30-57) 2-year OS (95% CI) 78% (72-83) 77% (66-84) 87% (77-93) 78% (62-88) 64% (49-75)
Efficacy and safety of telpegfilgrastim in the prophylaxis of chemotherapy-induced neutropenia in breast cancer patients: A retrospective study.
e12515 Background: Chemotherapy-induced neutropenia (CIN) is a common complication during cancer chemotherapy, leading to febrile neutropenia (FN), reducing chemotherapy efficacy and increasing infection risk. Telpegfilgrastim, a new type of polyethylene glycol (PEG)-modified human granulocyte stimulating factor (rhG-CSF) with a unique 40KD Y-shaped branched PEG structure. Due to its structural characteristics, the dosage of the drug can be reduced, and it may offer advantages in terms of efficacy and safety. This study aims to evaluate the efficacy and safety of Telpegfilgrastim in preventing CIN in breast cancer patients. Methods: This study retrospectively analyzed 59 breast cancer patients from 01.April.2024 to 01.August.2024 who used Telpegfilgrastim the day after chemotherapy, for the prevention of chemotherapy-induced neutropenia (average age 49 years, 98.31% female, 66.10% coexisting with other tumors). The primary efficacy indicator was the incidence of grade 3/4 neutropenia during the chemotherapy cycle, while secondary efficacy indicators included the rate of antibiotic usage and the incidence of infections. Subgroup analysis compared the differences in the incidence of grade 3/4 neutropenia among different chemotherapy regimens. Results: Among a total of 91 chemotherapy cycles, the incidence of grade 3/4 neutropenia was 12.09% (11/91), and grade 4 neutropenia was 1.10% (1/91). In the first cycle, the incidence of grade 3/4 and grade 4 neutropenia was 13.56% (8/59) and 1.69% (1/59), respectively. The incidence of infection was 3.39% (2/59), and was not caused by low ANC. And the antibiotics usage rate was 5.08% (3/59), with 2 cases used for infection treatment and 1 case used for infectious prophylaxis. Subgroup analysis: Anthracycline-containing regimens showed a higher incidence of grade 3/4 neutropenia across all cycle compared to non-anthracycline-containing regimens (23.53% vs. 5.26%, P = 0.017). Common adverse events included reduced platelet count (27.27%), reduced white blood cell count (18.18%), and anemia (9.09%), and bone pain (3.39%), etc.. Most adverse events were grade 1 (42.42%) or grade 2 (39.39%). The safety is good and no serious adverse events related to the investigational drug have occurred. Conclusions: Telpegfilgrastim effectively prevented the occurrence of grade 3/4 neutropenia in breast cancer patients undergoing chemotherapy, reduced the incidence of infections and the use of antibiotics, with good safety. These data support Telpegfilgrastim as a feasible option for CIN prevention in clinical practice.
An alternative approach to limiting surgical and radiation stress in patients with glioblastoma.
2062 Background: While neuro-oncology has seen global advances in high-tech diagnostics and treatments for brain tumors, these innovations often overlook the principles of the body's adaptive response. Stress acts as a nonspecific driver of cancer progression and is intensified by aggressive therapies. An alternative approach involves harnessing general nonspecific adaptive reactions (GNARs), which are governed by the brain's regulatory systems. These anti-stress GNARs — specifically the reactions of training, calm activation, and elevated activation — form the foundation of "activation therapy" and are considered essential in the comprehensive management of high-grade gliomas (HGG). In glioblastoma, tumor growth exacerbates cerebral hypoxia, leads to endothelial damage, and promotes thrombosis and perifocal edema. During radiation therapy (RT), edema is further aggravated as a deleterious side effect of ionizing radiation on brain tissue. This study aimed to investigate whether adjunctive activation transcranial magnetic therapy (ATMT) can mitigate edema development and improve treatment outcomes. Methods: Data from 50 patients with HGG were analyzed. Using simple randomization, patients were divided into two groups: the Main group (n=25) received standard treatment plus two courses of ATMT during the early postoperative period and during RT; the Control group (n=25) received standard treatment without ATMT. Each ATMT session consisted of two exposures. The first exposure was performed in the morning on the hypothalamic projection area using a frequency algorithm of 0.3 Hz (5 min) – 3 Hz (1 min) – 9 Hz (1 min) with a daily exponential change in induction (B) from 3 to 1 mT (device: "Gradient-4M"). The second exposure was performed 2.5–3 hours later using pulsed ATMT on the perifocal zone of the removed tumor bed with the same frequency algorithm at B=15 mT (device: "Neuro-MSD"). Results: In the early postoperative period (prior to RT), ATMT reduced the frequency of acute stress development by 3.4-fold compared to controls. After the completion of RT combined with ATMT, stress inhibition was observed 1.6 times more frequently than in the control group. The induction of a stable "reaction of calm activation" via ATMT contributed to a decrease in perifocal edema volume by an average of 3.75-fold, compared to 1.04-fold in the control group (p=0.0180). Regression of neurological symptoms after RT was noted in 92% of patients who received two courses of ATMT versus 68% in the control group (p=0.0391). Furthermore, the absence of cognitive impairment after RT was observed in 80% of ATMT patients compared to 24% in the control group (p=0.0002). Conclusions: The adjunctive use of ATMT improves treatment outcomes in patients with HGG by developing and maintaining anti-stress reactions as an alternative to surgical and radiation-induced stress, thereby improving the patients' quality of life.
Guard-01: A randomized, open-label trial of efbemalenograstim alfa as primary prophylaxis for neutropenia during definitive concurrent chemo-radiotherapy.
12060 Background: Concurrent chemoradiotherapy (CCRT), a curative cornerstone for locally advanced malignancies, exerts synergistic antitumor efficacy but is frequently hampered by severe hematologic toxicity (mainly neutropenia), leading to treatment delays, dose reductions and compromised outcomes. GM-CSF, previously evaluated for CCRT-induced hematologic AE prophylaxis, is no longer recommended due to increased immune-related toxicities and limited efficacy. While G-CSF is safe in chemotherapy, high-quality data for long-acting G-CSF as primary CCRT prophylaxis is sparse, creating a critical clinical gap that the Guard-01 study aims to resolve. Methods: This multicenter, randomized, open-label, controlled trial plans to enroll 120 patients undergoing definitive CCRT for locally advanced malignancies. Eligible participants are randomized 1:1 to either the study arm or control arm, stratified by chemotherapy regimen. Study arm patients receive efbemalenograstim alfa ~48 (±4) h post each chemotherapy cycle; control arm patients receive no primary G-CSF prophylaxis, with secondary efbemalenograstim alfa permitted for febrile neutropenia (FN) or dose-limiting neutropenia. The primary endpoint is the incidence of grade 3/4 neutropenia across the entire CCRT course. Results: As of December 2, 2025, 122 patients were enrolled (60 study arm, 62 control arm). The incidence of grade 3/4 neutropenia during the entire treatment course was 16.67% in the study arm versus 53.23% in the control arm, with a significant between-group difference of -36.56% (90% CI: -48.98%, -22.84%; p < 0.0001). Rates were significantly lower in the study arm across the first (5.00% vs. 45.16%; p < 0.0001) and second (12.28% vs. 27.27%; p = 0.0393) chemotherapy cycles. Consistent benefit was observed in subgroup analysis, with a significant difference in paclitaxel- or pemetrexed-based regimens (20.00% vs. 64.52%; p = 0.0004). The study arm had shorter grade 3/4 neutropenia duration (0.62±1.57 vs. 3.27±4.84 days; p < 0.0001) and higher ANC nadir (2.82 vs. 0.94 ×10⁹/L; p < 0.0001). No neutropenia-related chemotherapy dose reductions or discontinuations occurred in the study arm, compared with 6.45% dose reductions and 1.61% discontinuations in the control arm. The most common TEAEs in the study arm were anemia (71.67%), thrombocytopenia (60.00%), and leukopenia (35.00%). Grade ≥3 TEAEs were less frequent in the study arm (41.67% vs. 64.52%), with no grade ≥3 TRAEs reported in either group. Exploratory endpoints include 2-year PFS and OS, with immature data pending longer-term follow-up. Conclusions: Efbemalenograstim alfa significantly reduces the incidence and duration of grade 3/4 neutropenia in patients undergoing definitive CCRT, with consistent efficacy across different chemotherapy regimens and a favorable safety profile. Clinical trial information: ChiCTR2300077504 .
Knowledge about Alzheimer’s disease in medical, nursing, and psychology students in Ecuador: A problem that needs an urgent solution
Background Alzheimer’s disease represents one of the greatest healthcare challenges of the 21st century due to the aging population and its impact on the quality of life of patients and their families. Preparing future healthcare professionals to address this condition is crucial. Aims This article analyzes the level of knowledge about Alzheimer’s disease held by university students in medicine, nursing, and psychology, highlighting the differences and similarities between disciplines and proposing strategies to improve training in this field. Methods A cross-sectional study was conducted with a convenience sample of 1,023 Ecuadorian students: nursing (n = 727, 71.1%), medicine (n = 170, 16.6%), and psychology (n = 126, 12.3%). Participants completed the Alzheimer’s Disease Knowledge Scale (ADKS) and a demographic survey. The percentage of correct answers on the ADKS was used to assess knowledge levels. Results The overall percentage of correct answers was 54.68%, indicating a limited level of knowledge. Medical students obtained the highest mean score (17.44 [SD: 2.864]), followed by psychology (16.28 [SD: 2.348]) and nursing (16.18 [SD: 2.649]). A weak but significant correlation was found between knowledge level and prior contact with people with dementia (P < 0.001). Conclusions Students across all disciplines demonstrated a broad knowledge gap regarding Alzheimer’s disease, although medical students obtained slightly higher scores than psychology and nursing students. The findings highlight the need for improved educational training and curriculum development to enhance dementia knowledge, especially in psychology and nursing programs.