bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract PO3-26-12: Targeting Lipocalin-2 in HER2+ Inflammatory Breast Cancer Using Herceptin-Conjugated Liposomes
Authors: Flores-Colón Marienid , Vivas-Rivera Pablo , Vivas-Mejía Pablo E.
Published: May 2024

Inflammatory breast cancer (IBC) is a rare and aggressive subtype of BC that accounts for 1 to 5% of all types of BC. Due to its inflammatory characteristics and the absence of a palpable mass, IBC is usually confounded with a mastitis. Unfortunately, once properly diagnosed, IBC has already metastasized. A high portion of IBC tumors overexpress human epidermal growth factor receptor 2 (HER2). These IBC patients (HER2+) are treated with Trastuzumab, a monoclonal antibody. However, many IBCs become resistant to this therapy. Thus, there is not an optimal treatment against this horrendous disease. One potential target against IBC is Lipocalin-2 (LCN2), a secreted protein involved in iron homeostasis, immune responses, transport of siderophores, and epithelial cell differentiation. In many aggressive tumors, high levels of LCN2 have been associated with increased cancer cell motility, proliferation, angiogenesis, invasion, and metastasis. LCN2 is aberrantly abundant in IBCs compared with non-IBC patients and cell lines. This information indicates that LCN2 could be a target for IBC therapy. Our research team showed that small interference RNAs (siRNAs) targeting LCN2 effectively reduced the cell proliferation and invasion ability of IBC cells. To systemically deliver siRNA specifically to HER2+ IBC cells, we prepared Herceptin-conjugated liposome loaded with siRNA against LCN2. Trastuzumab conjugated liposomes werecharacterized by using dynamic light scattering to measure the size distribution and the zeta potential. Our formulation displayed sizes of 18.3 and 73.7 nm which could correspond to free DSPE-PEG-(2000) trastuzumab and the trastuzumab-liposome, respectively. To determine the optimal timepoint of liposome internalization into IBC cell lines, we incubated HER2+ IBC3 cells with liposomes for different time-points. Optimal internalization was observed at 24 and 48-hr. To further understand the downstream effectors of LCN2 in IBC cells, we performed RNAseq in siRNA-mediated LCN2 knockdown cells. Further bioinformatics with the RNAseq data, revealed 138 dysregulated genes following LCN2 knockdown as compared with a negative control (NC) siRNA. Particularly, increased STAT1 levels has been associated with to distant metastasis and poor clinical prognosis in cancer. In our study, STAT1 levels decreased after LCN2 silencing. Ingenuity Pathway Analysis (IPA) showed 25 canonical pathways altered in the LCN2 knockdown cells as compared with the NC-siRNA. These results indicate that LCN2 activate molecular pathways involved in cell proliferation, invasion and metastasis in IBC cells.

Citation Format: Marienid Flores-Colón, Pablo Vivas-Rivera, Pablo E. Vivas-Mejía. Targeting Lipocalin-2 in HER2+ Inflammatory Breast Cancer Using Herceptin-Conjugated Liposomes [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-26-12.
Abstract PO3-28-06: YAP1 expression is a good prognostic marker of hormone receptor-positive HER2-negative breast cancer: clinicopathologic analysis using the 21-gene recurrent score
Authors: Park Inho , Lee Yangkyu , Kim Jee Hung , Bae Soong June , Ahn Sung Gwe , Jeong Joon , Cha Yoon Jin
Published: May 2024

Background: YAP1 is a downstream transcription factor of Hippo pathway and considered an oncogene in numerous solid cancers. Oncotype Dx (ODX) test is a multigene test for patients with hormone receptor-positive, HER2-negative (HR+HER2-) breast cancer that provides a risk score (RS), a high RS means high-risk. In this study, we investigated the relation between YAP1 expression and RS in patients with HR+HER2- breast cancer and validated the clinical impact of YAP1 on breast cancer using public datasets. Methods: This retrospective study included 401 patients who received curative-purpose resection of HR+HER2- breast cancer and underwent ODX test between May 2014 and April 2020 at Gangnam Severance Hospital in Seoul, Korea. YAP1 nuclear localization was evaluated using immunohistochemical staining, and clinicopathological parameters including RS were analyzed. Clinical outcome was validated using YAP1 mRNA expression in TCGA-BRCA and METABRIC datasets. Results: High-YAP1 expression was significantly correlated with low ODX RS (OR [odds ratio] 0.373, 95% CI [confidence interval] 0.198-0.703, p=0.002). High expression of YAP1 mRNA correlated with superior clinical outcomes, particularly in patients with ER-positive breast cancer (p < 0.0001, overall survival [OS] in METABRIC; p=0.00085, recurrent-free survival [RFS] in METABRIC; p=0.040, disease-free survival [DFS] in TCGA-BRCA). With different ESR1 mRNA expression thresholds and highly expressed YAP1, patients in the upper 80-, 60-, or 40 percentiles of ESR1 expression levels consistently demonstrated superior OS and RFS in METABRIC as well as DFS in TCGA-BRCA. Conclusion: YAP1 could serve as a prognostic marker as well as a therapeutic target in patients with HR+HER2- breast cancer.

Citation Format: Inho Park, Yangkyu Lee, Jee Hung Kim, Soong June Bae, Sung Gwe Ahn, Joon Jeong, Yoon Jin Cha. YAP1 expression is a good prognostic marker of hormone receptor-positive HER2-negative breast cancer: clinicopathologic analysis using the 21-gene recurrent score [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-28-06.
Abstract PO3-29-05: Clinical risk score to predict overall survival and breast cancer recurrence in phase 3 TAILORx trial and the Surveillance, Epidemiology, and End Results (SEER) Database populations
Authors: Yang Sherry , Yu John , Sinaii Ninet
Published: May 2024

Background: Overall survival (OS) is the gold standard and most relevant endpoint in oncology research and patient care. It underscores a need to develop methods to estimate the likelihood of mortality in breast cancer. Methods: We evaluated molecular and clinical measures that predicted mortality risk using multiple logistic regression and developed a clinical risk score (CS) in 8,905 patients from the phase 3 TAILORx trial. Association of CS with mortality in patients at low, intermediate, and high risks was analyzed by Kaplan-Meier and multivariable Cox proportional-hazards regression analyses. The score was validated in an independent population of 148,301 patients with node-negative, hormone-receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer in the SEER database. Likelihood ratio (LR) test and c-index were used to compare prognostic information provided by CS and a 21-gene recurrence score (RS) to OS, invasive disease-free survival (DFS), recurrence-free interval (RFI), and distant recurrence-free interval (dRFI). Results: The 10-year mortality rates in low-risk, intermediate risk, and high-risk groups were 3.9% (95% CI 3.1 to 4.8), 37.2% (95% CI 23.4 to 51.1), and 75.8% (95% CI 54.1 to 97.4), respectively (P< 0.0001). Compared with low-risk score, intermediate (adjusted HR 45.5, 95% CI 32.2 to 64.9) and high-risk scores (HR 2026, 95% CI 1194 to 3483) were associated with risk of mortality, independent of demographics, tumor grade, RS, tumor size, PR, and treatment factors. The algorithm also predicted DFS, dRFI, and RFI outcomes (P< 0.0001 each), outperforming RS by both LR test and c-index estimate. Its validity was corroborated in the SEER population (intermediate risk: HR 9.3, 95% CI 6.7 to 13.3 and high-risk: HR 125.9, 95% CI 85.2 to 189.6). Conclusions: Clinical risk score robustly predicts risk of mortality in early-stage breast cancer populations. It provides more prognostic information than RS to survival and breast cancer recurrences.

Citation Format: Sherry Yang, John Yu, Ninet Sinaii. Clinical risk score to predict overall survival and breast cancer recurrence in phase 3 TAILORx trial and the Surveillance, Epidemiology, and End Results (SEER) Database populations [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-29-05.
Abstract PO4-03-12: De-escalating treatment with neoadjuvant chemotherapy in early triple-negative breast cancer
Authors: Murillo Serafin Morales , Cudós Ariadna Gasol , Der-Abrain Noemí Tuset
Published: May 2024

Neoadjuvant chemotherapy (NAT) is a standard treatment in early triple-negative breast cancer, but the regimen and duration of this treatment are controversial. We analyze a cohort of early triple negative breast cancer treated with NAT with different schemas to determine its efficacy.

272 patients treated with NAT since 2001 to 2020 were selected. The median age of the group was 57 years (27-85), initial size 30 mm (9-122) and Ki67 expression was 60 (7-100). 107 patients (39.3%) had histologically confirmed initial axillary involvement and the regimens of chemotherapy used were carboplatin AUC 5 + weekly paclitaxel (80 mg/m2) x 4 cycles in 56 cases (21%) (SCHEME A), same scheme followed by 4 cycles of adriamycin 50 mg/m2 + cyclophosphamide 500 mg/m2 in 85 cases (31%) (SCHEME B), Adriamycin 50 mg/m2 + cyclophosphamide 500 mg/m2 × 4 cicles in 44 (16%) (SCHEME C) and Adriamycin 50 mg/m2 + cyclophosphamide 500 mg/m2 × 4 cicles followed by docetaxel 100 mg/m2 × 4 cicles in 87 (32%) (SCHEME D). We achieved a 51% of pathologic complete response (pCR),and a total of 24% of recurrences. The proportion of PCR and recurrence according to the different schemes is represented in the following table.

The clinical factors associated with recurrence were the initial size (OR 8.6), the initial axillary involvement (OR 4.21) and the absence of pCR (OR 8.14), and for patients with pCR it was only the initial axillary involvement (OR 3.4). Patients that received schema A in NAT only presented a total of 5% of recurrence (3/56), only in patients with initial axillary involvement.

The NAT schema with carboplatin AUC 5 + weekly paclitaxel (80 mg/m2) x 4 cycles is safe in patients without initial nodal involvement with high pathologic complete response (62%) and lower recurrence rate (9% in nonPCR and 3% in pCR). Therefore, it could be considered as a standard scheme of neoadjuvant chemotherapy for patients without axillary involvement.

Table. SCHEMA A (20%) B (31%) C (16%) D (32%) Pcr 62% 63% 41% 37% Recurrence in pCR 3% 7% 16% 9% Recurrence in nonpCR 9% 16% 50% 63%

Citation Format: Serafin Morales Murillo, Ariadna Gasol Cudós, Noemí Tuset Der-Abrain. De-escalating treatment with neoadjuvant chemotherapy in early triple-negative breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-03-12.
Abstract PO4-04-04: A Multicenter, Retrospective, Real World Study of Inetetamab Combined with Pyrotinib and Vinorelbine as Treatment for HER2-positive Metastatic Breast Cancer
Authors: Yin Yongmei , Li Wei , Huang Xiang , Jin Nan , Wu Xinyu , Sun Chunxiao , Hua Yijia
Published: May 2024

Background Inetetamab, a new human epidermal growth factor receptor 2 (HER2) targeted antibody to optimize the ADCC effect, has shown great effectiveness in treating HER2-positive metastatic breast cancer. Pyrotinib, another HER2 targeted drug, is a typical representative of TKI drugs, which not only has a strong HER2 antagonistic effect but also can synergize with monoclonal antibodies to amplify the ADCC effect. Here, we investigated the efficacy and safety of inetetamb combined with pyrotinib and vinorelbine as treatment or HER2-positive metastatic breast cancer. Methods From Jan 2020 to July 2023, 77 HER2-positive metastatic breast cancer patients received inetetamb combined with pyrotinib and vinorelbine were enrolled in this study. Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), clinical benefit rate (CBR), and safety profiles were reported. Results The patients’ median age at enrollment was 53 years, 35 patients (45.5%) had hormone receptor-positive disease and 54 patients (70.1%) had visceral metastasis. The median PFS was 10.03 months (95% confidence interval [CI] 6.66 to 13.41 months). ORR was 62.3% (48/77) and CBR reached 77.9% (60/77). The most common adverse event (AE) was diarrhea, occurring in 36 patients (46.8%). While the most common grade III/IV AEs included neutropenia (9[11.7%]), leukopenia (8[10.4%]) and diarrhea (5[6.5%]). No treatment-related serious adverse events or treatment-related deaths occurred. Conclusion The combination regimen of inetetamab combined with pyrotinib and vinorelbine showed an encouraging efficacy and favorable safety in patients with HER2 positive metastatic breast cancer.

Citation Format: Yongmei Yin, Wei Li, Xiang Huang, Nan Jin, Xinyu Wu, Chunxiao Sun, Yijia Hua. A Multicenter, Retrospective, Real World Study of Inetetamab Combined with Pyrotinib and Vinorelbine as Treatment for HER2-positive Metastatic Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-04-04.
Abstract PO4-04-06: Exploring the use of tyrosine kinase inhibitors (TKIs) in the management of HER2-positive metastatic breast cancer post trastuzumab emtansine (T-DM1) therapy failure: Insights from a real-world study
Authors: Yin Yongmei , Sun Chunxiao , Hua Yijia , Jin Nan , Li Wei , Huang Xiang
Published: May 2024

Background

Trastuzumab emtansine (T-DM1) is the established standard second-line treatment for HER2-positive metastatic breast cancer (MBC) patients who have previously received trastuzumab. However, there is ongoing debate regarding the subsequent therapeutic options following T-DM1 failure. This study aimed to evaluate the efficacy and safety of tyrosine kinase inhibitors (TKIs)-based therapy in HER2-positive MBC patients with resistance to T-DM1.

Methods

During the period from September 2018 to October 2021, a multicenter real-world study was conducted, enrolling a total of 53 patients diagnosed with HER2-positive metastatic breast cancer (MBC). These patients underwent TKIs-based therapy following the failure of T-DM1 treatment. The primary focus of the study was on evaluating progression-free survival (PFS) as the main endpoint. Secondary endpoints encompassed objective response rate (ORR), overall survival (OS), clinical benefit rate (CBR), and safety assessments.

Results

A total of 53 patients received TKIs-based therapy as a second-line or later treatment. The median progression-free survival (PFS) for TKIs-based therapy was 11.9 months (95% CI 7.9-15.9). The objective response rate (ORR) and clinical benefit rate (CBR) were found to be 19.6% and 72.5%, respectively. Among patients with brain metastasis (n=12), a median PFS of 10.5 months (95% CI 7.5-13.5) and an intracranial ORR of 33.3% were observed. Patients treated with pyrotinib (n=21) showed improved PFS compared to those treated with lapatinib (n=30), as well as patients who had derived favorable benefit from T-DM1 (PFS ≥ 6 months). Hormone receptor status (HR) and response to T-DM1 were identified as independent factors affecting the effectiveness of TKIs-based therapy. The most frequently reported adverse events included thrombocytopenia (23.6%), diarrhea (15.7%), leucopenia (15.7%), and hand-foot syndrome (15.7%).

Conclusion

TKIs-based therapy demonstrated favorable effectiveness and safety in HER2-positive metastatic breast cancer (MBC) patients who had previously received T-DM1 but experienced treatment failure. This includes patients with brain metastases. Notably, individuals who derived favorable benefits from prior T-DM1 treatment displayed significantly prolonged progression-free survival (PFS) when undergoing subsequent TKIs-based therapy.

Citation Format: Yongmei Yin, Chunxiao Sun, Yijia Hua, Nan Jin, Wei Li, Xiang Huang. Exploring the use of tyrosine kinase inhibitors (TKIs) in the management of HER2-positive metastatic breast cancer post trastuzumab emtansine (T-DM1) therapy failure: Insights from a real-world study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-04-06.
Abstract PO4-25-02: Long-range Deployment of Tumor-antigen Specific Cytotoxic T Lymphocytes Inhibits Lung Metastasis of Breast Cancer
Authors: Xing Yue , Su Shicheng , Song Erwei
Published: May 2024

Effector Immune Cell Deployment (EICD) refers to systemic deployment of anti-tumor effector immune cells in cancer patients, including the priming, circulation, trafficking, activity and fate of the immunocytes, and is a panorama to reflect the generation, distribution and development of anti-tumor immunity. Tumor antigen-specific T cells are the main component of effector immune cells in anti-tumor immune responses, but their systemic deployment in breast cancer patients and the underlying mechanisms remain largely unknown. Here, we identified a cluster of CD8+ T cell exhibiting tissue-resident memory (TRM) phenotype in the tumor-draining lymph nodes (TDLNs) of 487 breast cancer patients, whose abundancy specifically predicts improved lung, but not other target organ metastasis-free survival. Also, high lung CD8+ TRM infiltration is associated with lower metastatic burden in breast cancer patients. Using single-cell RNA sequencing, we observed that in multiple mouse cancer models, CD8+TRM accumulate at early tumor stages when lung metastasis was not identified. Functionally, the CD8+TRM isolated from pre-metastatic lungs of the animals were tumor antigen specific and cytotoxic to the tumor cells. Nevertheless, the abundancy of CD8+TRM in the lungs were dramatically decreased in the lungs upon metastasis establishment. Moreover, in Cd8cre/+ Itgaeloxp/+-diphtheria toxin receptor conditional knockout mice, we unambiguously demonstrated that specific depletion of the CD8+ TRM subset facilitates lung metastasis in vivo, while adoptive transfer of CD8+ TRM successfully inhibited lung metastasis and prolonged survival of the mice. Mechanistically, using cell-tracing techniques in the photo-convertible Kaede-Tg mice, we found that tumor-specific CD8+ TRM were generated in the TDLNs of the mice and were recruited to the lungs via CCL25/CCR9 signaling axis. However, the circulating exosomes secreted by primary tumor cells were taken up by alveolar macrophages and polarized them to release IDO1 and impaired anti-tumor T cell immunity, facilitating lung metastasis. More importantly, inhibition of IDO1 effectively retrieves TRM-mediated protection against lung metastasis. Collectively, we have revealed a cross-talk between tumor cells and the inflammatory environment of distant organs, which could drive lung metastasis by impairing EICD. Our findings also highlight the therapeutic potential of orchestrating EICD in turning “cold” metastatic tumor foci to “hot” ones.

Citation Format: Yue Xing, Shicheng Su, Erwei Song. Long-range Deployment of Tumor-antigen Specific Cytotoxic T Lymphocytes Inhibits Lung Metastasis of Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-25-02.
Abstract PO4-25-09: HER2-Low and Ultra-Low expression in young women with luminal breast cancer in México
Authors: Hernandez Jesus Edgardo Hernandez , Torres César Octavio Lara , Moran Bryan Moreno , Garza Cynthia Villareal , Reyes Fany Iris Porras , Sánchez Víctor Manuel Pérez , Mohar Alejandro
Published: May 2024

Background and objective

HER2-Low in breast cancer is a biomarker with new approaches for prognosis and medical treatment decisions. However, HER2-Ultra-Low is an area of novel research. Our objective was to describe the clinicopathologic characteristics and HER2 expression status of a group of Mexican young patients with luminal breast cancer.

Methods

One hundred and fifty-seven young patients (< 40 years) with luminal breast cancer diagnosed from 2014 to 2020 were included. Clinicopathologic features, hormone receptors, HER2 expression, and tumor infiltrating lymphocytes (TILs) were assessed. We categorized patients in three groups: HER2 negative (n=95, 60.5%), HER2-Low (n=33, 21.0%), and HER2-Ultra-Low (n=29, 18.5%). Descriptive statistics were used to report demographic, clinical and histopathological characteristics. Kaplan-Meier curves and log-rank or Mantel-Cox tests were used to determine survival. Statistical significance was established using a P value < 0.05. This analysis was performed using R (version 4.0.4) through R Studio interface (version 1.4.1106).

Results

The median of age at diagnosis was 36.1 years [range 32.8-38.8], with a median of follow-up of 5.08 years [range 3.58-6.52]. The most frequent histologic type was ductal infiltrating carcinoma (81%), and 49.4% presented grade two of differentiation. T2, N0 and clinical stage II were the most common (45.2%, 44.5, and 48.1%, respectively), and fourteen patients (9.0%) presented clinical stage IV. We found statistically significant differences in Ki67 and total TILs quantification between HER2 negative and HER2-Low. Progesterone receptor levels were higher for HER2 negative and Ultra-Low in comparison to HER2-Low. The total population had a 5-year overall survival of 84.9%. We found statistically significant differences in the median of survival between HER2 groups, with a shorter survival for HER2-Low.

Conclusion

To date, there are no studies that describe the clinical profile and OS of HER2-Low and Ultra-Low in young patients with luminal breast cancer in México. These preliminary findings could indicate the need for further investigation in prognosis, outcomes, and specific treatment in these patients. This study contributes to better understand the clinicopathologic profile of the HER2-Ultra-Low group and its differences with the HER2-Low group.

Citation Format: Jesus Edgardo Hernandez Hernandez, César Octavio Lara Torres, Bryan Moreno Moran, Cynthia Villareal Garza, Fany Iris Porras Reyes, Víctor Manuel Pérez Sánchez, Alejandro Mohar. HER2-Low and Ultra-Low expression in young women with luminal breast cancer in México [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-25-09.
Abstract PO4-28-11: Murine Breast Cancer Cell Culture Supernatant Induces CAF-like and TAM-like Traits in Normal Cells
Authors: Sapkota Biplov , Chintalaramulu Naveen , Pandit Abhishek , Thota Shilpa , Begum Rizwana , Francis Joseph
Published: May 2024

Several studies in the past have demonstrated the role of cell-to-cell interaction (crosstalk) between tumor cells and normal (nontumorigenic) cells in cancer progression and metastasis. Within the tumor microenvironment (TME), these interactions have a potential to transform the phenotypes and the behaviors of normal cells. Application of the 2D in-vitro cultures has been limited due to its inability to replicate the complex in-vivo TME. Conditioned Medium (CM) obtained from cultured cancer cells contains secreted growth factors that potentially regulate the phenotype and the functionality of normal cells. In this study, a culture of normal murine fibroblast NIH3T3 and macrophage RAW 264.7 cells with conditioned medium (CM) obtained from malignant mammary epithelial 4T1 cells (4T1CM) resulted in an altered phenotype with increased cell viability. 4T1CM treated NIH3T3 and RAW 264.7, in comparison with the respective control cells, resulted in an upregulation of the genes including- α-smooth muscle actin (αSMA), IL-10, CD206, and vascular endothelial growth factor (VEGF). In addition, 4T1.CM treated NIH3T3 showed an EMT phenotype as indicated by the regulation of EMT markers such as, E-cadherin, β-catenin, N-cadherin, and Vimentin. Interestingly, an upregulation of cyclooxygenase-2 (COX-2) and programmed death-ligand 1 (PDL-1) was observed in 4T1CM treated RAW 264.7, a tendency towards exhibiting an inhibitory immune response. Intriguingly, NIH3T3 cells conditioned with 4T1CM demonstrated an upregulation of stemness markers including- sex determining region Y-box 2, and Aldehyde dehydrogenase. Collectively, our study suggested a role for 4T1CM in transforming the normal NIH3T3 and RAW 264.7 into cancer-associated fibroblasts (CAFs) and tumor-associated macrophages (TAMs). RNAseq experiments are underway to map differentially expressed genes (DEGs) that potentially regulate the 4T1CM induced transformation of NIH3T3 and RAW 264.7 cells. Furthermore, invitro drug testing in 3D model of these transformed cells to target the pathway intermediates may provide novel therapeutic intervention strategies.

Citation Format: Biplov Sapkota, Naveen Chintalaramulu, Abhishek Pandit, Shilpa Thota, Rizwana Begum, Joseph Francis. Murine Breast Cancer Cell Culture Supernatant Induces CAF-like and TAM-like Traits in Normal Cells [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-28-11.
Abstract PO5-04-02: Combination of trastuzumab competing and non-competing fully human internalizing anti-Her2 monoclonal antibodies drug conjugates increases their inhibitory effect on the growth of HER2 positive metastatic breast cancer cells
Authors: Serrero Ginette , Yue Binbin , Dong Jianping , Hayashi Jun
Published: May 2024

The human epidermal growth factor receptor (HER) family of receptors plays a key role in proliferation stimulator for several human cancers. In particular, HER2 is overexpressed in 15-30% of breast cancers with or without gene amplification with prognostic and predictive implications. HER2 overexpression is associated with shorter disease-free and overall survivals, resistance to hormonal agents and increased risk of brain metastasis. Trastuzumab is a humanized anti-HER2 monoclonal antibody that binds to domain IV of HER2 extracellular domain and blocks its signaling. More recently, two antibody drug conjugates using trastuzumab have been approved: Ado-Trastuzumab-Emtansine (Kadcyla) consisting of trastuzumab conjugated to the drug mertansine DM1 and fam-trastuzumab-deruxtecan-nhki (Enhertu to deliver the topoisomerase inhibitor deruxtecan. We are reporting here the development of fully human internalizing anti-HER2 antibodies with distinct epitopes on the HER2protein which compete or not with trastuzumab for binding to HER2. These monoclonal antibodies have been developed by immunizing fully human (TC-Mab mouse) mice with recombinant HER2 protein. After production of hybridoma secreting fully human immunoglobulins, the screening process included competition with trastuzumab for binding to Her2 by enzyme linked immunoassay and Octet epitope binning and affinity determination as well as internalization assay. Several internalizing antibodies able to compete or not with trastuzumab and with high affinity (Kd ranging from 10−9 M to 10−12 M) were selected. Their ability to deliver a cytotoxic payload in HER2 overexpressing breast cancer cells such as SKBR3, BT474 and AU565 was next investigated. Two groups of antibodies: one competing with trastuzumab and the other one non-competing were further characterized. Data related to these antibodies’ biochemical characteristics as well as their ability to inhibit proliferation in vitro and in vivo in mouse xenografts studies will be presented here. In conclusion, the use of fully human mice to develop monoclonal antibodies provides a powerful and attractive approach to develop fully human monoclonal antibodies against cancer targets by-passing the need for humanization and affinity maturation of antibodies.

This work is supported by 5R44CA224718 SBIR grant from the National Cancer Institute.

Citation Format: Ginette Serrero, Binbin Yue, Jianping Dong, Jun Hayashi. Combination of trastuzumab competing and non-competing fully human internalizing anti-Her2 monoclonal antibodies drug conjugates increases their inhibitory effect on the growth of HER2 positive metastatic breast cancer cells [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-04-02.
Abstract PO5-09-04: Oncotype DX Breast Recurrence Score® analysis in early-stage breast cancer associated with CHEK2, ATM and PALB2 germline pathogenic variants
Authors: Mustafayev Fatma Akkoc , Barrera Angelica Gutierrez , Liu Diane , Arun Banu
Published: May 2024

Background: The 21-gene assay (Oncotype DX Recurrence Score, RS) is the only clinically validated assay to determine the prognosis in hormone-positive, HER2-negative breast cancer (BC) patients treated with endocrine therapy alone by predicting locoregional and distant recurrence. Outcomes of Oncotype RS in BRCA-associated BC has been studied previously, but the results of RS analysis in BC patients with the other BC susceptibility genes have not been documented. This study evaluates the clinical and pathological characteristics of BC patients with ATM, CHEK2 and PALB2 germline pathogenic variants (PV). Methods: Patients with invasive hormone-positive, HER2-negative BC who have had Oncotype DX Breast Recurrence Score® testing and who underwent genetic testing in the Breast Medical Oncology and the Breast Clinical Cancer Genetics Clinic at the University of Texas MD Anderson Cancer Center (MDACC) were identified from the prospectively maintained research database. Clinical and tumor characteristics were analyzed using descriptive statistics. Results: Between 1996 and June 2023, 5652 patients with Oncotype RS were included in this analysis. Amongst those 828 BC patients had genetic testing and 81 patients were found to have a pathogenic variant: 17 patients with a CHEK2 mutation, 10 patients with an ATM mutation, and 18 patients with a PALB2 mutation. Among patients with CHEK2 PV, median Oncotype RS was 17 (5–32) overall, 21 (13–32) for patients age < 50, and 14.5 (5–28) for patients age ≥50 (p= 0.2). Among patients with ATM PV, median RS was 16.5 (3–54) overall, 25 (10–54) for patients age < 50, and 14.5 (3–29) for patients age ≥50 (p= 0.19). Among patients with PALB2 PV, median RS was 26.5 (15–40) overall, 20 (15–40) for patients age < 50, and 31 (26–37) for patients age ≥50 (p= 0.012). Further patient and tumor characteristics are shown in Table 1. Conclusion: This is a single-institutional cohort of hormone-positive, HER2-negative BC patients who had Oncotype RS and who underwent genetic testing. Further analysis on clinical and tumor pathological characteristics and long-term outcome is ongoing.

Table1. Patient and tumor characteristics

Citation Format: Fatma Akkoc Mustafayev, Angelica Gutierrez Barrera, Diane Liu, Banu Arun. Oncotype DX Breast Recurrence Score® analysis in early-stage breast cancer associated with CHEK2, ATM and PALB2 germline pathogenic variants [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-09-04.
Abstract PO5-24-10: Clinical significance and immune landscape analyses of the immune related genes based prognostic signature for HER2 positive breast cancer
Authors: Li Xiaofen , Fu Wenfen , Yu Yushuai , Zhang Jie , Song Chuangui
Published: May 2024

Objective: To date, significant breakthrough has yet to be achieved in immunotherapy for HER2-positive breast cancer (HPBC). In this study, we aimed to construct a risk model for predicting prognosis and therapy response and evaluating the tumor immune landscape in HPBC patients.

Methods: Differentially expressed immune-related genes (IRGs) were used as input to weighted correlation network analysis (WGCNA) to identify modules of highly correlated gene. An optimal prognostic TPBC-IRGs signature were constructed by least absolute shrinkage and selection operator (LASSO) cox regression. Survival analysis and ROC curves were analyzed to identify the predictive value in a training cohort and external validation cohorts. With three GEO datasets and samples from our center, the anti-HER2 therapeutic efficacy in HPBC patients was predicted through this prognostic model. Additionally, the immunotherapy outcome was forecasted using IMvigor210 dataset. We also investigated the connection between high and low-risk populations and immune checkpoints and analyzed immune infiltration levels of these populations with several algorithms. Ultimately, we develop a combined model and nomogram by integrating the risk score with clinical factors.

Results: 11 key genes associated with overall survival (OS) in the blue module were selected for further analysis. A 3-gene signature (CX3CL1, RARB, TANK) based prognostic risk model was developed. The Kaplan-Meier survival curve revealed that patients with high-risk score had shorter OS compared with the low-risk group. The AUC of the training cohort at 1-, 3- and 5-year were 0.718, 0.784 and 0.767. The performance of the risk model was validated with GSE25066 and GSE55348. It’s showed that the risk scores of HPBC who were resistant to trastuzumab were significantly higher than those of patients who were sensitive to trastuzumab. The results indicated that the levels of immune checkpoints expression (such as PD-1, CTLA4 and TIGIT) and immune infiltration were higher in low-risk group than in high-risk group. The combined model showed better prognostic prediction accuracy compared to the clinical model or gene signature alone (1-year AUC=0.910;3-year AUC=0.832;5-year AUC=0.882).

Conclusion: The immune gene-based risk profile and combined prognostic model in this study may hold promise for clinical use in predicting the prognosis and treatment efficacy of HPBC patients.

figure3. Construction of HPBC-IRGs signature based prognostic model.

Citation Format: Xiaofen Li, Wenfen Fu, Yushuai Yu, Jie Zhang, Chuangui Song. Clinical significance and immune landscape analyses of the immune related genes based prognostic signature for HER2 positive breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-24-10.
Abstract PS03-09: Age-related normal breast tissue features differ in women with germline BRCA1/2 mutations
Authors: Grigoriadis Anita , Parreno-Centeno Mario , Chen Siyuan , Verghese Gregory , Lips Esther , Gillett Cheryl , Jones Louise , Pinder Sarah
Published: May 2024

Ageing, a breast cancer risk factor, can be reflected in histologically normal breast tissue (NBT). However, the relationship between age-related histological features and cancer risk is not fully understood. We propose that biological and microscopic features can be identified in seemingly histologically NBT in gBRCA1/2m carriers that are indicative of the earliest tissue changes of breast cancer, potentially as a result of accelerated tissue ageing.

To study NBT, we have put in place a unique and scalable repository, named OASIS, storing currently >2,000 digitised whole slide images (WSI) of H&E-stained NBT from individuals with long clinical follow-up. These tissues are from individuals with a spectrum of risk for developing breast cancer and derived from reduction surgery from non-gBRCA1/2m carriers, risk reducing masectomies, and from contralateral and peri-tumoural NBT from gBRCA1/2m carriers and women with breast cancer.

Across 6 NBT resources, 70 selected WSIs were manually annotated for epithelial cells, fibrous stroma and adipocytes, resembling the "ground truth". Extensive comparisons of different tile sizes, tile overlapping ratios, stain normalisation techniques and deep learning (DL) feature extractors were conducted to implement a Tissue-Classifier, which achieved 95% accuracy in 3-fold cross-validation. Based on the MobileNet architecture, a DL-framework achieved a sensitivity of 81.2% and specificity of 81.8% (84.7% AUC) in predicting Tissue-Age based on discernible histological patterns in healthy women. In gBRCA1/2m carriers, we discovered features of accelerated tissue ageing (e.g. degree of lobule involution), indicating that the biological NBT age differs from their chronological age.

Our DL-based framework robustly captured histological patterns to predict tissue components and age. The global organisation of these patterns showed variations in WSIs of women with different risks of developing breast cancers, which may provide new insights into premalignant alterations in NBT.

Citation Format: Anita Grigoriadis, Mario Parreno-Centeno, Siyuan Chen, Gregory Verghese, Esther Lips, Cheryl Gillett, Louise Jones, Sarah Pinder. Age-related normal breast tissue features differ in women with germline BRCA1/2 mutations [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS03-09.
Abstract PS08-07: BL-B01D1, a first-in-class EGFRxHER3 bispecific antibody-drug conjugate, in patients with Locally Advanced or Metastatic Breast Cancer and other Solid Tumor: Results from a phase 1 study
Authors: Wu Jiong , Zhang Jian , Du Yiqun , Zou Wen , Ding Muran , Yang Hui , Xiao Sa , Wang Hongwei , Zhu Hai , Olivo Martin , Zhu Yi
Published: May 2024

Background:

BL-B01D1 is a first-in-class novel antibody drug conjugate (ADC) consisting of an EGFRxHER3 bispecific antibody bounded to a novel TOP-I inhibitor payload via a cleavable linker. We now present safety/efficacy data from a phase I study of BL-B01D1 in breast cancer.

Methods:

This study included patients (pts) with locally advanced or metastatic breast cancer (BC) and other solid tumors. BL-B01D1 was administered intravenously at doses of 2.5mg/kg Day 1 & Day 8 every 3 weeks (D1D8Q3W) or 5.0mg/kg Day 1 every 3 weeks (D1Q3W) during dose escalation (D-ESC, i3+3) based on the information obtained during the first-in-human study in solid tumors. A subset of pts will be enrolled in the dose-expansion (D-EXP) phase.

Results:

As of June 26, 2023, 42 pts were enrolled and received at least one dose (D-ESC, n=8; D-EXP, n=34) of BL-B01D1. Only one DLT of febrile neutropenia was observed at 5.0mg/kg D1 Q3W, maximum tolerated dose (MTD) has not been reached. D-EXP was conducted at 2.5mg/kg D1D8 Q3W. Forty-one pts with BC and 1 pt with non-small cell lung cancer (NSCLC) were enrolled in this study. The most common TRAEs ( >10%, all grade/≥ G3) were leukopenia (67%/24%), neutropenia (55%/33%), anemia (55%/26%), thrombocytopenia (60%/24%), nausea (38%/0%), vomiting (38%/0%), stomatitis (31%/2%), asthenia (29%/0%), hypokalemia (21%/5%), aspartate aminotransferase increased (19%/0), alanine aminotransferase increased (19%/0%), decreased appetite (19%/0%), hypertriglyceridemia (19%/0%), hyperglycemia (19%/0%), hyperglycemia (17%/0%), weight decreased (14%/0%), diarrhea (12%/0%), epistaxis (12%/0%), hypercholesterolemia (12%/0%). No ILD was observed. Twenty-four pts. were evaluable for efficacy (at least 1 tumor assessment). Updated information will be provided during the meeting.

Conclusions:

BL-B01D1 demonstrated encouraging efficacy in metastatic/locally advanced breast cancer that have failed standard of care, especially in pts with TNBC. The safety profile showed adequate safety and tolerability.

Clinical trial information: NCT05470348.

Efficacy in Patients with Breast Cancer 1 Including pts whose PRs were not yet confirmed but still under treatment.

Citation Format: Jiong Wu, Jian Zhang, Yiqun Du, Wen Zou, Muran Ding, Hui Yang, Sa Xiao, Hongwei Wang, Hai Zhu, Martin Olivo, Yi Zhu. BL-B01D1, a first-in-class EGFRxHER3 bispecific antibody-drug conjugate, in patients with Locally Advanced or Metastatic Breast Cancer and other Solid Tumor: Results from a phase 1 study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS08-07.
Abstract PS15-07: Proxalutamide plus Endocrine Therapies in Women with HR+/HER2-/AR+ Metastatic Breast Cancer: A Phase Ic Study
Authors: Li Hui-Ping , Song Guohong , Jiang Hanfang , Liang Xu , Wang Xiaojia , Yang Hua , Zhang Lili , Tong Youzhi
Published: May 2024

Abstract Background: Resistance to endocrine therapy (ET) and cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) is a major obstacle to the management of hormone-receptor (HR)+/human epidermal growth factor receptor 2 (HER2)- metastatic breast cancer (mBC). Targeting the AR signaling pathway has been demonstrated with promising results in this population. This phase Ic study aimed to assess the safety, efficacy, pharmacokinetic (PK), and pharmacodynamic (PD) characteristics of the combination of proxalutamide, a high-affinity AR antagonist, with ETs in androgen receptor (AR)+/HR+/HER2- mBC. Methods: Patients in part 1 regimen-finding phase received proxalutamide plus specific ETs (letrozole [cohort A], exemestane [cohort B], or fulvestrant [cohort C]) and were assessed for dose-limiting toxicity (DLT), PK, PD, and anti-tumor activity. Part 2 expansion phase evaluated the safety and efficacy of proxalutamide plus fulvestrant. The primary endpoint was safety and tolerability. Results: Between June 18, 2019, and Sep 15, 2022, 38 (18 in part 1 and 20 in part 2) patients were treated. Efficacy analysis indicated that the ORR was 16.7% (2/12, 95% CI, 2.1%-48.4%) for cohort C and 15.0% (3/20; 95% CI, 3.2%-37.9%) for part 2. Patients achieved a median progression-free survival (PFS) of 6.4 months (95% CI, 2.7-19.3) in cohort C while an mPFS of 11.0 months (95% CI, 5.5- not estimable) in part 2. In part 1, no DLTs were reported. Grade 3 or more treatment-emergent adverse events (TEAEs) were observed in 11 (29.7%) patients (7 [18.9%] in part 1 and 4 [10.8%] in part 2) and mainly included neutrophil count decreased (8.1%) and platelet count decreased (5.4%). Seven (18.9%) had serious AEs (4 [10.8%] in part 1 and 3 [8.1%] in part 2)[1]. PD results showed a greater reduction of estradiol in cohort C compared with that in cohort B. In addition, proxalutamide was absorbed rapidly into the body with the plasma concentrations of proxalutamide and metabolites reaching a nearly steady state on day 29. Patients with AR/ER of ≤1 seemed to achieve longer PFS over those of >1 (8.4 months vs. 4.1 months). Conclusions: These findings suggested favorable clinical outcomes and safety profiles of the combination of proxalutamide and fulvestrant in AR+/HR+/HER2- mBC patients who have progressed on the first-line therapy, and maybe with better efficacy in patients with lower AR/ER ratio.

Trial registration: NCT20191063

Citation Format: Hui-Ping Li, Guohong Song, Hanfang Jiang, Xu Liang, Xiaojia Wang, Hua Yang, Lili Zhang, Youzhi Tong. Proxalutamide plus Endocrine Therapies in Women with HR+/HER2-/AR+ Metastatic Breast Cancer: A Phase Ic Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS15-07.
Abstract PS18-03: The Association between Food Deserts, Food Swamps, and Postmenopausal Breast Cancer Mortality in the United States
Authors: Bevel Malcolm , Tsai Meng-Han , Parham April , Andrzejak Sydney , Jones Samantha , Moore Justin
Published: May 2024

Purpose:

Breast cancer (BRCA), the 4th leading cause of cancer death in the United States (U.S.), is one of 13 obesity-related cancers. Healthy food consumption is a protective factor shown to decrease obesity risk and postmenopausal BRCA mortality, respectively. However, residing in geographical areas with no access to healthy food options (food deserts) or unhealthy food options (food swamps) reduces access to healthy foods and has been severely understudied. We examined the relationship between residing in food swamps and deserts with postmenopausal BRCA mortality.

Methods:

We conducted an ecological analysis utilizing 2010 – 2020 Center for Disease Control and Prevention postmenopausal BRCA mortality data (restricted to 45+ years old) and aggregated 2012 – 2020 data from the U.S. Department of Agriculture Food Environment Atlas data. Food swamp score (FS) was calculated as the ratio of fast-food and convenience stores to grocery stores and farmer’s markets. Food desert score (FD) was calculated as the proportion of residents living more than one mile (urban) or 10 miles (rural) from a grocery store and household income ≤ 200% of the federal poverty threshold. We categorized FD and FS to low, moderate, or high; higher scores indicated counties with poorer healthy food resources. Multilevel generalized mixed effects models were used to estimate the mentioned association.

Results:

2,280 counties/county equivalents with high postmenopausal BRCA mortality rates had higher percentage of non-Hispanic (NH)-Black population (5.80 vs. 2.08), poverty rates (17.2 vs. 14.2), and high food swamp scored areas (39.0 vs. 24.5) versus counties/county equivalents with low postmenopausal BRCA mortality rates (p-value < 0.0001). After adjusting for age, percentage of NH-Blacks per county, and poverty rate, we found 42% increased odds of having high postmenopausal BRCA mortality rates among U.S. counties/county equivalents with high food swamp scores (adjusted odds ratio [AOR] = 1.42; 95% CI: 1.14 – 1.78).

Conclusions:

Sampled U.S. counties with the poorest food swamp environment had significantly increased odds of postmenopausal BRCA mortality. We suggest that local policymakers and community stakeholders should employ sustainable approaches at combating obesity and BRCA by increasing healthier accessible food sources (e.g. creating more walkable neighborhoods and community gardens).

Citation Format: Malcolm Bevel, Meng-Han Tsai, April Parham, Sydney Andrzejak, Samantha Jones, Justin Moore. The Association between Food Deserts, Food Swamps, and Postmenopausal Breast Cancer Mortality in the United States [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS18-03.