and p63) were incorporated. A nomogram was developed based on variables selected in multivariate analysis. The bootstrapping method (1000 repetitions) was applied to internally validate the nomogram Result: After a median follow-up of 32 (range, 5-122) months, disease recurrence was observed in 197(37.1%) out of the 531 patients, with a median recurrence-free survival (RFS) of 19 (95% CI, 16.63-21.37) months. Most patients (n¼136; 69.0%) had thoracic recurrence, followed by brain recurrence (n¼41; 20.8%), bone recurrence (n¼41; 20.8%), abdominal recurrence (n¼14; 7.1%), and neck recurrence (n¼13; 6.6%). Sex, tumor size, Ki67, and N stage were independent indicators of thoracic recurrence. Tumor size, N stage, CK20, and Syn were independent indicators of brain recurrence. N stage and Ki67 were independent indicators of bone recurrence. N stage was the independent indicator of abdominal recurrence and neck recurrence. Tumor size, Ki67, CK20, and N stage were independently associated with overall recurrence, and thus a nomogram predicting the 1-, 2-, and 3-year RFS probability was developed based on these four factors. The concordance index (C-index) was 0.723 (95% confidence interval, 0.675 to 0.771) and the calibration curves displayed good agreement between the predicted RFS and the actual observation. Conclusion: Independent prognostic indicators based on clinic-pathological parameters and routinely used IHC markers were identified to predict overall and site-specific recurrence, which may help to identify optimal candidates for adjuvant therapies and design individualized surveillance strategies among patients with completely resected EGFRpositive NSCLC

BackgroundCOVID-19 Convalescent plasma (CCP) is safe and effective, particularly if given at an early stage of the disease. Our study aimed to identify an association between survival and specific antibodies found in CCP.Patients and MethodsPatients ≥18 years of age who were hospitalized with moderate to severe COVID-19 infection and received CCP at the MD Anderson Cancer Center between 4/30/2020 and 8/20/2020 were included in the study. We quantified the levels of anti-SARS-CoV-2 antibodies, as well as antibodies against antigens of other coronavirus strains, in the CCP units and compared antibody levels with patient outcomes. For each antibody, a Bayesian exponential survival time regression model including prognostic variables was fit, and the posterior probability of a beneficial effect (PBE) of higher antibody level on survival time was computed.ResultsCCP was administered to 44 cancer patients. The median age was 60 years (range 37-84) and 19 (43%) were female. Twelve patients (27%) died of COVID-19-related complications. Higher levels of two non-SARS-CoV-2-specific antibodies, anti-HCoV-OC43 spike IgG and anti-HCoV-HKU1 spike IgG, had PBE = 1.00, and 4 SARS-CoV-2-specific antibodies had PBEs between 0.90 and 0.95. Other factors associated with better survival were shorter time to CCP administration, younger age, and female sex.ConclusionsCommon cold coronavirus spike IgG antibodies anti-HCoV-OC43 and anti-HCoV-HKU1 may target a common domain for SARS-CoV-2 and other coronaviruses. They provide a promising therapeutic target for monoclonal antibody production.

Background COVID-19 Convalescent plasma (CCP) is safe and effective, particularly if given at an early stage of the disease. Our study aimed to identify an association between survival and specific antibodies found in CCP. Patients and Methods Patients >18 years of age who were hospitalized with moderate to severe COVID-19 infection and received CCP at the MD Anderson Cancer Center between 4/30/2020 and 8/20/2020 were included in the study. We quantified the levels of anti-SARS-CoV-2 antibodies, as well as antibodies against antigens of other coronavirus strains, in the CCP units and compared antibody levels with patient outcomes. For each antibody, a Bayesian exponential survival time regression model including prognostic variables was fit, and the posterior probability of a beneficial effect (PBE) of higher antibody level on survival time was computed. Results CCP was administered to 44 cancer patients. The median age was 60 years (range 37-84) and 19 (43%) were female. Twelve patients (27%) died of COVID-19-related complications. Higher levels of two non-SARS-CoV-2-specific antibodies, anti-HCoV-OC43 spike IgG and anti-HCoV-HKU1 spike IgG, had PBE = 1.00, and 4 SARS-CoV-2-specific antibodies had PBEs between 0.90 and 0.95. Other factors associated with better survival were shorter time to CCP administration, younger age, and female sex. Conclusions Common cold coronavirus spike IgG antibodies anti-HCoV-OC43 and anti-HCoV-HKU1 may target a common domain for SARS-CoV-2 and other coronaviruses. They provide a promising therapeutic target for monoclonal antibody production.

A 74-year-old white male was diagnosed with squamous cell carcinoma in 2013. Six months after Mohs surgery, he underwent a left superficial parotidectomy, left neck dissection, and excision of the left postauricular lymph node after confirmation of lymphatic spread. Pathology from the left parietal scalp lesion revealed multifocal invasive squamous cell carcinoma. Extranodal tumor extension was noted in a postauricular lymph node and left parotid gland, and he was diagnosed with stage IV squamous cell carcinoma.Despite receiving adjuvant radiation therapy from December 2013 to March 2014 to the right neck and scalp, a skin graft after 5 months was confirmed to have squamous cell carcinoma. Positron emission tomography-computed tomography showed metastatic disease at the level of cricoarytenoid cartilage and bilateral parotid glands. Cetuximab was discontinued, as he had an anaphylaxis episode after the first dose, and he later underwent localized radiation to his left temple.He returned after a year with multiple cutaneous nodular masses over the left face and neck, with a large ulcerated necrotic area over the left temporal region (Figure). Due to the lack of further chemotherapy options, he was started on pembrolizumab.Anti-programmed death ligand 1 testing from the tumor showed a staining distribution of 1%-24% and a staining intensity of 1þ, with a low positive result. Next-generation sequencing assay showed genomic alterations in AKT3 E17K,

Hypertension control remains an issue for older Chinese immigrants because of the unique cultural health practices they use to manage their hypertension. Limited health education information on how to manage hypertension is available in Chinese. Because San Francisco has a large population of older Chinese immigrants, development of culturally sensitive educational material is important to help this population to achieve better blood pressure control. The purpose of this study was to develop and pilot test an innovative, culturally based CD-ROM with a focus on hypertension education and management, directed to the older Chinese immigrant population. The results of this pilot study found that the content of CD-ROM was culturally acceptable for the target population. Given a lack of educational material in Chinese in the United States, this CD-ROM has a potential to be used for a large population of Chinese elders in the United States.

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Background: Pulmonary embolism (PE) is a potentially lethal condition commonly suspected in patients with malignancy. Computed Tomography Pulmonary Angiography (CTPA) is increasingly used in the diagnosis of PE, and guidelines have incorporated various screening tools including the Modified Geneva and Wells criteria to facilitate exclusion of pulmonary embolism. There is an increased risk of venous thromboembolism in patients with active malignancy and therefore an increased suspicion in patients who present to the emergency department (ED) with concerning symptoms. Methods: This is a retrospective analysis at a single tertiary care institution. All patients initially diagnosed with an active malignancy since 2005 and underwent a CTPA between January 2010 and October 2015 were reviewed. Patients were excluded if the CTPA was performed in the setting of trauma, a history of benign malignancy, or if the diagnosis of malignancy was made subsequent to the CTPA. Data collected included patient demographics, clinical presentation, type of malignancy and treatment regimen received. The modified Geneva and Wells criteria were applied to all patients independent from the initial ED risk assessment for a PE. Results: There were 796 patient records reviewed, of which 162 patients met inclusion criteria. Out of these 162 patients, only 8 (4.9%) were found to have a pulmonary embolism. All patients with a positive CTPA had an intermediate risk per the Geneva criteria while only 62.5% had an intermediate risk per the Wells criteria. Of the 154 patients with a negative CTPA, 71.5% and 78.7% had an intermediate risk; 22.5% and 18.7% were classified as low risk based on Wells and Geneva criteria, respectively. The median age of patients was 59 years old, and the majority were male (58%). The most common malignancies in which a CTPA was ordered were lung cancer (27.7%) followed by breast cancer (14.9%) and prostate cancer (6.8%). Despite a negative CTPA, 82 out of 154 patients (53%) were admitted to the hospital. Conclusion: Pulmonary embolism is commonly associated with and frequently suspected in patients with active malignancy. The incidence of PE over a 5-year period in oncology patients was 5% in our emergency department. In total, 18.7% to 22.5% of patients could have avoided a CTPA if scoring was based on the Wells or Geneva criteria. Based on the review at our institution, the modified Geneva and Wells criteria are not adequate, and a new tool needs to be developed for risk stratification for the diagnosis of PE specifically in patients with active malignancy. Disclosures No relevant conflicts of interest to declare.

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