Analysis of databases from the human genome project (HGP), the 1000 Genomes Project (1KGP), and The Cancer Genome Atlas (TCGA) revealed bacterial DNA integration into the human somatic genome, particularly in tumor tissues. Fusion genes have also been associated with tumorigenesis and 34 PDGFR fusion genes are linked to hematological malignancies. Here, we determined that a 17-bp homologous sequence in Marinobacter sp. Hb8, Rhodococcus fascians D188, Rhodococcus sp. PBTS2, Micrococcus luteus strain trpE16 and M. luteus NCTC 2665 integrates into the genome of a chronic eosinophilic leukemia patient as part of the linker for the novel CDK5RAP2-PDGFRα fusion gene. The resulting fusion protein that has CDK5RAP2’s self-activating domain and PDGFRa’s tyrosine kinase domain but lacks PDGFRa’s membrane-binding and ligand-dependent activation properties may act together with the integrated bacterial sequence to readily phosphorylate downstream targets, amplify proliferation signals and promote leukemic cancer progression.

Purpose.Approximately half of all radiotherapy (RT) is delivered with palliative intent. Clinical research in palliative RT aims to manage symptoms, improve quality of life (QoL), evaluate supportive care, and determine optimal dose-fractionation schedules. Our aim was to describe the prevalence of palliative research at the Canadian Association of Radiation Oncology (CARO) Annual Scientific Meeting (ASM) over time. Methods. Published abstracts (2003-2021) were independently reviewed by two authors who categorized each as: curative-intent; palliative-intent; pertaining to both populations; or neither. Abstracts were considered palliative if they described incurable malignancy and interventions primarily for symptom control or QoL. Type of study, primary, site treated, and symptoms palliated were recorded. Descriptive and summary statistics were calculated including one-way ANOVA test for trend. Results. 339/4566 abstracts (7.4%, range 2.4-13.9% per year) were classified as palliative. 7.7% (26/339) described phase I-III trials. The main primary site was lung (39/339) and the most common metastatic site was bone (34.2%). QoL, symptom and toxicity outcomes were reported in 31.6% (107/339), 37.8% (128/339) and 17.7% (60/339), respectively. The most common symptom investigated was pain (38/339). The proportion of abstracts classified as curative, palliative or reporting toxicity endpoints demonstrated significant change over time (all p<0.0001). Conclusion. While proportion of palliative themed abstracts has increased with time, there remains a significant gap before equivalence with the prevalence of palliative RT in clinical practice is achieved.

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genitourinary, 4.9% small-cell lung (SCLC), and 3.3% other. Overall median survival after palliative RT was 5.74 months. Patients receiving lower dose per fraction (2Gy/Fx) were more likely to be younger and healthier, yet experienced worse palliative outcomes with higher median PRLSRT, rates of incompletion, and deaths on treatment (Table 1). Breast and prostate were most likely to complete RT (89.1% and 89.6%), while GI NOS and SCLC were least likely (77.6% and 78.6%) (P < 0.001). Upper GI patients were most likely to die on treatment (1.3%), while prostate patients were the least (0.2%) (P < 0.001). PRLSRT ≥50% was observed more frequently in GI NOS (16.6%), upper GI (10.4), NSCLC (10.3%), and skin (9.8%) compared to prostate (2.4%) and breast (2.7%) (P < 0.001). Logistic regression indicated age, race, insurance status, Charlson-Deyo score, primary site, metastatic involvement, bone RT site, and Gy/Fx were significant factors affecting completion rates of RT. Median PRLSRTs were: 14.89% GI NOS, 9.90% upper GI, 9.49% NSCLC, 7.89% skin, 7.18% SCLC, 6.12% lower GI, 5.64% GYN, 5.42% GU, 5.24% HNC, 2.05% prostate, and 2.02% endocrine, and 1.84% breast (P < 0.001). Those receiving 3Gy/Fx and 2Gy/Fx were less likely to complete RT when compared to 4Gy/Fx, with odds ratios of 1.209 and 15.023 respectively (P < 0.001). Patients with SCLC were least likely to complete RT, with a 1.694 odds ratio compared to breast (P < 0.001). Conclusion: For palliative RT for osseous metastases, dose per fraction and primary cancer impact the palliative outcomes of PRSLRT, the likelihood of completing RT, and death during treatment and should be considered to minimize the burden of care and maximize benefits of treatment.