Highlights d Proteogenomics characterization of 218 pediatric brain tumor samples of 7 histologies d Proteomic clusters reveal actionable biological features spanning histological boundaries d Proteomics reveal downstream effects of DNA alterations not evident in transcriptomics d Kinase activity analyses provide insights into pathway activities and druggable targets

ObjectivesDetermine the safety, feasibility and initial efficacy of a multicomponent telerehabilitation programme for COVID-19 survivors.DesignPilot randomised feasibility study.SettingIn-home telerehabilitation.Participants44 participants (21 female, mean age 52 years) discharged home following hospitalisation with COVID-19 (with and without intensive care unit (ICU) stay).InterventionsParticipants were block randomised 2:1 to receive 12 individual biobehaviourally informed, app-facilitated, multicomponent telerehabilitation sessions with a licenced physical therapist (n=29) or to a control group (n=15) consisting of education on exercise and COVID-19 recovery trajectory, physical activity and vitals monitoring, and weekly check-ins with study staff. Interventions were 100% remote and occurred over 12 weeks.Primary and secondary outcome measuresThe primary outcome was feasibility, including safety and session adherence. Secondary outcomes included preliminary efficacy outcomes including tests of function and balance; patient-reported outcome measures; a cognitive assessment; and average daily step count. The 30 s chair stand test was the main secondary (efficacy) outcome.ResultsNo adverse events (AEs) occurred during testing or in telerehabilitation sessions; 38% (11/29) of the intervention group compared with 60% (9/15) of the control group experienced an AE (p=0.21), most of which were minor, over the course of the 12-week study. 27 of 29 participants (93%; 95% CI 77% to 99%) receiving the intervention attended ≥75% of sessions. Both groups demonstrated clinically meaningful improvement in secondary outcomes with no statistically significant differences between groups.ConclusionFully remote telerehabilitation was safe, feasible, had high adherence for COVID-19 recovery, and may apply to other medically complex patients including those with barriers to access care. This pilot study was designed to evaluate feasibility; further efficacy evaluation is needed.Trial registration numberNCT04663945.

723 Background: Active modification of surrounding stroma is a critical mechanism of tumor cell growth in pancreatic ductal adenocarcinoma (PDAC). There is some early translational evidence that losartan (L) and vitamin D (D) may affect the tumor microenvironment and supportive stroma in PDAC to help restore a physically and biologically tumor-suppressive stroma. These effects of potentially stroma-modifying drugs have not been established in the clinical management of metastatic PDAC (mPDAC), where there have been limited advances in treatment and prognosis remains poor. Methods: This is a single center, retrospective analysis of patients with mPDAC treated at Fox Chase Cancer Center from 2010 to 2019. All data including L and D use were extracted from the medical record. Patient characteristics were compared across subgroups using Chi-square tests, Fisher’s exact tests, and Wilcoxon rank sum tests. The primary outcome was overall survival (OS) from the time of metastatic diagnosis. Kaplan-Meier curves and log-rank tests were used to compare unadjusted OS across subgroups. Cox proportional hazards models were used to characterize OS adjusted for age at metastatic diagnosis, sex, initial stage at diagnosis, performance status, Charlson Comorbidity Index (CCI), hypertension, and renal disease. Results: 518 patients were included; a majority were male (54.1%), White (82.4%), and diagnosed with de novo mPDAC (54.6%). About half of patients had hypertension (53.5%) and few had renal dysfunction (5.6%). 153 (29.5%) patients were taking D and 41 (8%) patients were taking L. Women were more likely to take D than men (p < 0.001) and White patients were more likely to take L than other races/ethnicities (p = 0.006). Median OS since metastatic diagnosis for patients taking L was 11.4 months compared to 9.6 months for patients not taking L (p = 0.07). Median OS for patients taking D was 11.3 months compared to 8.7 months for those not taking D (p = 0.10). A Cox proportional hazards model adjusting for confounders, however, showed that both L (HR 0.66, p = 0.02) and D (HR 0.81, p = 0.04) were significantly associated with improved OS from time of metastatic diagnosis. Conclusions: This large retrospective study demonstrates potential clinical and survival benefit of L and D in conjunction with mPDAC treatment. L and D are safe, well tolerated, and widely used in general medical practice. These results support further investigation of the stroma-modifying potential of L and D, as well as conducting prospective trials with these agents to further validate these findings.

e24013 Background: Geriatric Assessment (GA) can help oncologists determine fitness of their older patients for cancer therapy. Our objective was to identify gaps that exist in the care of older adults with gastroesophageal cancer (GEC). Methods: Patients age 65 or older with any stage of GEC were consented and completed a self-administered GA. The patient’s provider completed a baseline assessment (PA) and abnormalities detected by both assessments were centrally reviewed and compared. Geriatric domains assessed include functional status, nutrition, comorbidities, psychological distress, cognition, social support, chemotherapy toxicity risk, and financial toxicity. Any abnormalities found within an evaluated domain were considered in the analysis. Providers reviewed patient GA alongside indicated interventions and identified those they would implement. We compared the proportions detected/not detected by PA vs GA using McNemar’s test for paired data, and we measured agreement using Kappa statistics. This is an interim report of an ongoing trial with total accrual goal of 100 older adults with GEC. Results: 33 patients were enrolled at the time of the interim analysis, majority were male (22, 67%), median age 74 (65-91), with stage III (9, 50%) disease treated with combination chemotherapy (12, 36%). Cancer site was distributed between gastric (45%), esophageal (36%), GEJ (18%). 90% of patients had ECOG status 0 or 1. GA detected 164 abnormalities in geriatric domains, mean 5 per patient, and PA detected 104 abnormalities, mean 3 per patient (see Table). Significant difference in abnormality identification between GA and PA were seen in domains of nutrition, chemotherapy toxicity risk, financial toxicity and psychological distress. 37% of patients had abnormal TUG score and those patients were more likely to have other geriatric abnormalities detected by GA (6.2 vs 4.4). Providers for 28 patients (85%) indicated they would make at least one change, with the majority being referral to social work. Conclusions: Among older adults with gastroesophageal cancer, GA identifies more abnormalities as compared to routine provider’s assessment in most cases leading to important clinical interventions.[Table: see text]