bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences on breast cancer management and surgical approach in six European breast cancer units
Authors: Celebic A. , Halaska M. , Kosovac O. , Stojiljkovic D. , Milovanovic Z. , Miletic N. , Dzodic R. 
Published: March 2020

10737 Background: Paper was aimed to compare differences in pre-operative management, decision on surgery and surgical approach for breast cancer in six European Breast Cancer Units in Italy, France, Czech Republic and Serbia and Montenegro, and to discuss impact of detected differences on outcome of the disease. Methods: The authors of this paper, who have been invited as young visiting/observing/training guests by four prestigious European Breast Cancer Units in Italy and France (National Cancer Institute - Milan, European Institute of Oncology - Milan, Institute Gustave Roussy - Villejuif, Institute Curie - Paris) as fellows of different European and international institutions (EUSOMA, EACR, ESSO, UICC, ESO, FECS, French Government) in the period 2003–2005, tried to detect and compare differences regarding pre-surgical evaluation, decision making and surgical approach for breast cancer as well as to discuss the impact of identified changes on outcome of the disease. The special attention has been directed to inspection of such small details as waiting list for consultation and hospitalisation, way of decision for surgical intervention (individual or oncology meeting/staff), horizontal or oblique incision for mastectomy, duration of hospital stay, sentinel node procedure (blue dye, radioactive tracer or both, one or two-days protocol, imunochistochemistry examinations during frozen section or not), preferred way of breast reconstruction, number of assistants during operation, drainage, preservation of intercostobrachial nerve during axillary surgery, suture, etc. The data were collected according to personal presence in different institutes, observation and asking the questions. Descriptive statistics were used to show the differences among the parameters under comparison. Results: This study which clearly showed a great range of differences, sometimes very significant, in parameters regarding pre-surgical evaluation and surgical treatment of breast cancer. Conclusions: Although being found, and sometimes significant, the observed differences in several parameters regarding pre-operative evaluation and surgical treatment of breast cancer in six European breast cancer units do not have influence to the outcome of the breast cancer. No significant financial relationships to disclose.
Biological characteristics of oestrogen receptor positive early operable primary breast cancer in the elderly
Authors: Ying M. W. , Green A. R. , Agrawal A. , Paish C. E. , Morgan D. A. , Ellis I. O. , Cheung K. L. 
Published: March 2020

10739 Background: Over half of breast cancer are diagnosed at >65 years and increasingly more are diagnosed in the elderly population. However little is known about their biological characteristics, which may be important in therapeutic strategies such as selecting endocrine agents as primary, neoadjuvant or adjuvant therapy. We report the pattern of oestrogen receptor (ER), progesterone receptor (PgR) and HER2 status in a cohort of elderly patients with primary breast cancer (PBC). Methods: All elderly (> 70 years) patients, who had ER positive early operable PBC (< 5 cm) and who refused or were unfit for surgery, were treated with primary endocrine therapy. Standard immunohistochemical staining was performed on core biopsy tumour tissuefor ER, PgR and HER2. Positivity for ER and PgR was defined by H-score ≥ 50, and HER2 positivity was defined as 3+. Results: A total of 86 such patients were treated over a two-year period and the biological characteristics of their tumours were as follows (see Table ). Conclusions: Within the group of ER positive patients, approximately half of the tumours also expressed PgR. The total number of HER2 positive tumours was small although the majority of these were PgR negative. Clinical follow-up is ongoing to elucidate the relationship between endocrine sensitivity and these biological characteristics. [Table: see text] [Table: see text]
Cowden Syndrome as an indication for bilateral prophyllactic mastectomy: A series of two cases
Authors: Loewen M. , Ashikari A. , Kelemen P. , Salzberg A. , Savino J. , Ashikari R. 
Published: March 2020

10761 Background: Multiple hamartoma syndrome, or Cowden Syndrome, is an autosomal dominant disorder which predisposes toward neoplasms in the thyroid, colon, and breast. Chemoprevention in women with a genetic predisposition toward breast cancer has not yet been shown to be beneficial in prospective data. Bilateral prophylactic mastectomy (BMP) has emerged as a viable option for women with suspected genetic predispositions toward breast cancer, with an estimated risk reduction of around 90 percent. Our search of the literature has not detected any case series of BMP in the Cowden Syndrome patients. Methods: We present two women presenting with historical and physical evidence for this Cowden Syndrome with desire to undergoing PBM. Results: Both women successfully underwent subcutaneous bilateral mastectomy with immediate reconstruction. (See table ) They are both alive without evidence of breast cancer to date. Conclusions: Cowden Syndrome can be added to other genetic syndromes with clear predispositions toward breast cancer, and presents an option for prophylactic bilateral mastectomy in women who desire a risk reduction for breast cancer. [Table: see text] No significant financial relationships to disclose.
Transplantation for breast cancer: Oncologists beware—a multicenter phase I-II study open to enrollment
Authors: Van Hoef M. E. 
Published: March 2020

10763 Introduction: After a surge of autologous transplantation (auto-tx) for breast cancer (brca) in the 90s numbers decreased; however, early results of auto-tx in brca were promising; moreover, a graft versus tumor effect was reported for metastatic brca following ablative allogeneic transplant (allo-tx) (Blood 96;88:15011; JCO 98;16:9862). First results of non-myeloablative allo-tx (NMT) in other diseases suggested reduction of adverse effects. Methods: In 2000 a by donor availability controlled multicenter study of dose dense chemotherapy (ChT) (500/100/500) FEC + G-CSF (×4) at 2 wk intervals, semi-high-dose (3000/250/800) auto-tx (×2) at 4 wk intervals to consolidate or enhance complete response rates and a non-myeloablative (8/120/1050–Bu/Flu/Cy) allo-tx for newly diagnosed metastatic breast cancer was designed; all ChT scheduled within 7 mth; GVHD prophylaxis and treatment; supportive care recommendationw. Feasibility, treatment related mortality, DFS and OS major endpoints. The study was promoted. Results: In 2000 and 2001 no papers on allo-tx for brca were published. Since 2002 there are a hand full of case reports or pilot studies about NMT for advanced brca; ample commentaries emphasize clinical response in advanced disease and recent reports also eradication of micrometastatic bone marrow disease. HD-auto-tx/NMT-allo tx was recently reported for advanced disease. No multicenter studies have been reported. The above study remains open to enrollment. Discussion: The treatment method and timing of treatment does hypothetically reduce health care costs. In order to assess the value compared to standard therapy (6 cycles ChT), treatment and outcome utilities can be assigned and a standard cohort be added. Normal life expectance when alive without disease at five years is used for computation of incremental cost beyond five years. In addition, utilities are assigned for activity in good health during the remaining productive years of life. The economic and societal value will be discussed. No significant financial relationships to disclose.
Providing information and support on all aspects of breast health and breast cancer in Ireland
Authors: Fitzgibbon N. , Langtry A. 
Published: March 2020

10766 In 2001 the Irish Cancer Society launched Action Breast Cancer (ABC) to provide breast cancer information and support. ABC’s services are free, confidential and accessible and include a national helpline, patient education, one-to-one support, health promotion, research, advocacy, and professional support. Over the last five years, we have been continually developing our services to the public, at the heart of which is the Freefone Helpline (1800 30 90 40). The Helpline is staffed by specialist cancer nurses who offer information, support, and appropriate referral for women who are concerned about breast health, women who have been diagnosed with breast cancer, their families and carers, and healthcare professionals. In order to meet the need for clear, concise information, we are continually producing and updating literature and supporting materials. This includes a series of factsheets on all aspect of a breast cancer diagnosis including the different aspects of living with the disease. In January 2005, we launched a programme to address the unique needs of younger women with breast cancer. Services include conferences for younger women, a specialist nurse, and the selection and training of younger Reach to Recovery volunteers. Professional support is also a key element of ABC’s service. Most recently we have developed a workshop for nurses working in oncology to improve communication with breast cancer patients around sexuality. ABC’s annual Breast Cancer Awareness Month campaign takes place in October. A high profile advertising campaign and a nationwide roadshow are just two of the many mediums used to target Irish women in order to make them breast aware for life. Throughout the year, ABC is constantly seeking to raise awareness in communities and workplaces across the country by organising presentations about breast awareness, screening and early detection. Now that we have firmly established ourselves as the leading provider of breast cancer information and support, we have started to significantly develop our advocacy programme, and we are currently working on ensuring that the national breast screening programme will be fully rolled out by the end of 2007. We are also undertaking major nationwide research into the provision, supply and fitting of breast prostheses. No significant financial relationships to disclose.
Capecitabine (Xeloda) and quality of life (QoL) in patients (pts) with metastatic breast cancer (MBC) relapsing after treatment with anthracycline and taxane containing–therapy
Authors: Grecea Sr. D. , Neamtiu L. , Vasiliniuc C. , Tanasescu R. , Rancea A. , Resiga L. , Galatar M. , Popita V. , Daicoviciu D. , Postescu D. , Ghilezan N. 
Published: March 2020

10774 Background: The study was designed to evaluate further the efficacy and safety of capecitabine in patients with MBC previously treated with antracycline and taxane. In addition to response rates and survival times, pts preference for oral therapy and QoL are increasingly important considerations in MBC. Methods: All MBC patients had to have documented progression after antracycline and taxane- containing chemotherapy in neoadjuvant or adjuvant setting, no more than one line for MBC. Treatement comprised 3-week cycles of oral capecitabine 1250 mg/m2 twice- daily for 14 days followed by a 7-day rest period. Results: From December 2002 to November 2005, 35 pts were enrolled. Baseline characteristics of the pts. were: median age 51 years (range 33–73), median ECOG PS 1 (range 0–2) and adequate bone marrow, renal and hepatic functions. Median number of metastatic sites was 2 (range 1–5). The pts were evaluable for response and toxicity and received a total of 162 cycles of chemotherapy. Disease stabilization occurred in 11 pts (31.4%), the overall response was 34.2%, ten pts (28.5%) achieved a partial response, two patients (5.7%) achieved a complete response. Median duration of response was 5 months and median overall survival was 8 months with significant advantage for responding patients. For pts achieving a CR or PR, median survival was 13 months, for SD 10 months and for pts with PD as best response 5 months. The most treatment-related adverse events were grade 1/2 in intensity: grade 3 treatment-related adverse events were hand-foot syndrome (11%), diarrhea (7%), vomiting (5%), and nausea (6%). Pts had a significant, sustained improvement in the following: global health status, role and emotional functioning, social functioning, breast symptoms, arm symptoms and hair loss. Conclusions: This study confirms that capecitabine achieves a high tumor control rate in heavily pretreated MBC pts. Pts had a significant improvement in global health status, with substantial improvements in almost all functional and symptomatic QoL domains. Capecitabine should be considered the reference treatment in this setting based on consistently high efficacy and good tolerability. No significant financial relationships to disclose.
Primary chemotherapy in breast cancer shows excellent clinical and pathological response with docetaxel and epirubicin
Authors: Marana H. R. , Andrade J. M. , Tiezzi D. G. , Zola F. E. , Carrara H. H. , Reis F. C. , Bighetti S. 
Published: March 2020

10779 Background: Primary chemotherapy is becoming the standard of care for locally advanced breast cancer. Recently tested regimens using new drugs have been showing better results than usual anthracycline based treatments. Methods: From April 1998 through April 2004, 104 patients (18 stage IIA; 36 stage IIB; 13 stage IIIA; 33 stage IIIB; 4 stage IV) were included in the trial and received three cycles of docetaxel 75 mg/m2 and epirubicin 50 mg/m2 (q3w). Patients with stable or progressive disease were excluded from the trial, receiving alternative treatment. Those with partial response after three cycles but still not suitable for conservative surgery received up to 3 additional cycles. Following completion of the chemotherapy regimen, tumour response was assessed and appropriate surgery performed. Pathological response was evaluated in excised specimens. Results: According to the UICC criteria for clinical evaluation, 79 pts (76%) had objective regression (14 CR and 65 PR); 21 resulted in stabilised disease and 4 showed progression (24%). There was no toxicity in 62 patients, grade I/II in 4 and grade III/IV in seven patient. Ninity-nine patients became eligible for surgery (95%); 60 underwent conservative surgical treatment (60.6%) and in 39 patients a modified radical surgery was done (39.4%). No axyllary involvement were detected in 22 patients, other 23 had 1–3 positive nodes and 54 had 3 or more positives node in axillary dissection. 338 chemotherapy cycles were given, with an average of previously expected 3.25 cycles per patient. Conclusions: Our study demonstrates a high response rate with primary docetaxel and epirubicin chemotherapy in locally advanced breast cancer and high axillary envolvement group, enabling conservative surgery to take place and carrying no significant toxicity. Survival rate was directly linked to pathological response and complete response was associated to highest rate of survival in the group. No significant financial relationships to disclose.
Neoplastic meningitis in unknown primary neoplasms
Authors: Loghin M. E. , Groves M. D. 
Published: March 2020

11517 Background: Neoplastic meningitis (NM) is diagnosed in 5–8% of patients with solid tumors. Unknown primary cancers (UPC) constitute 1% to 7% of NM cases. There is scattered data addressing NM in the context of UPC. Here we characterize the clinical manifestations, prognostic factors and survival outcomes in patients with NM from UPC. Methods: Through an IRB-approved, retrospective chart-review, spanning 1944–2002, we identified 38 patients with UPC, with NM either the presenting feature or a later manifestation of their systemic cancer. Imaging studies were also reviewed. Results: Median age at UPC diagnosis was 44 (13–72 years); for those patients not presenting with NM, time from UPC diagnosis to NM diagnosis was 10 weeks (range 3–60 weeks). Five patients presented with NM as the first and only manifestation of cancer, 1 presented with NM simultaneously with UPC, and 32 patients presented with UPC, followed by NM. Sixteen of those 32 patients presented with central nervous system (CNS) metastases concomitantly with their UPC diagnosis. The final cancer diagnoses were: melanoma (n=21), adenocarcinoma (n=12), small cell undifferentiated carcinoma (n=2), undifferentiated malignant tumor (n=1), Ewing sarcoma (n=1) and sarcomatoid carcinoma (n=1). The median overall survival after the initial diagnosis of UPC was 54 weeks (range: 6–344 weeks), and the median survival after the diagnosis of NM was 10.7 weeks (range: 2–132 weeks). Thirteen patients had a prolonged survival after the diagnosis of NM (24–132 weeks), 8 with melanoma, 3 with adenocarcinoma, 2 with small cell cancer. Six of the 8 melanoma patients with prolonged survival presented with only CNS disease, and none developed other metastatic sites during the course of their disease. Conclusions: Patients with NM and UPC have a poor prognosis. The most commonly identified primary tumors in patients with NM and UPC are melanoma and adenocarcinoma. UPC presenting as NM, and found to be melanoma limited to the CNS and or meninges, carries a better prognosis than other UPCs with NM where systemic tumor burden is identified. This may aid in the systemic diagnostic evaluation and treatment of such patients. No significant financial relationships to disclose.
Frameless Cyberknife radiosurgery for metastatic and primary brain tumors
Authors: Wong E. T. , Lu X. , Devulapalli J. , Mahadevan A. 
Published: March 2020

11527 Background: Cyberknife delivers image-guided stereotactic radiation to intracranial and extracranial skull base tumors without a frame. This frameless feature makes Cyberknife a completely non-invasive procedure and allows non-surgical neuro-oncology personnel to treat patients with tumors in the neuraxis. Methods: Patients with intracranial tumors were selected from our Brain Tumor Clinic if they were not surgical candidates or had residual tumors after neurosurgery. The decision for Cyberknife radiosurgery was made after careful review of all available treatment options in our multidisciplinary brain tumor conference based on patients’ history and neurologic findings, neuroimaging data, and pathology. All patients signed informed consent prior to fusion head MRI and CT scanning. They were pre-medicated with 4 mg of dexamethasone and 500 mg of levetiracetam twice daily. All dose plans were calculated based on CT images acquired from 1.25-mm slices with an inverse planning technique. Dynamic tracking software monitored patient movements and adjusted the robotic arm accordingly, compensating for patient motion up to 10 mm in translation and 5 degree in rotation. Results: Nine subjects with 15 treatment targets, including 4 meningiomas, 1 high-grade glioma, 1 plasmacytoma, and 3 melanomas, were treated with single-fraction or 5 fractions of Cyberknife radiosurgery. No acute toxicity was seen during or within 24 hours of treatment. One subject developed subacute onset of cerebral edema 2 weeks after the procedure but his symptoms were quickly reversed with dexamethasone. Conclusions: Cyberknife radiosurgery is a well-tolerated procedure for intracranial and extracranial tumors in the skull base. Neuro-oncologist, with the appropriate training, could perform Cyberknife radiation planning with radiation oncologists and physicists. No significant financial relationships to disclose.
Phase I, pharmacokinetic (PK), pharmacodynamic study of paricalcitol [19-nor-1 alpha, 25-(OH)2 D2] in combination with gemcitabine [2’,2’ difluorodeoxycytidine] in patients with advanced malignancies
Authors: Trump D. , Javle M. , Muindi J. , Pendyala L. , Yu W. , Ramnath N. , Ross M. , Fakih M. , Iyer R. , Johnson C. 
Published: March 2020

12010 Background: Calcitriol+ gemcitabine (gem) combination results in synergistic anti-tumor effect in preclinical models. Cytidine deaminase (CDD) inactivates gem into 2’,2’-difluorodeoxyuridine (dFdU) and its overexpression may lead to gem resistance. Calcitriol decreases CDD activity in peripheral blood mononuclear cells (PBM). Paricalcitol is cytotoxic in vitro and synergistic with several chemotherapeutic agents, including gem. We are conducting a phase I study of paricalcitol + fixed-dose gem. Objectives: The primary aim is to determine maximum tolerated dose (MTD) of the combination in patients (pts) with advanced cancer. Secondary aims are to evaluate toxicity, the effect of paricalcitol on gem PK, CDD activity in PBM and clinical outcome. Methods: Each cycle is 4 weeks: Gem 800 mg/m2 (over 80 min) weekly × 3, starting day 1; paricalcitol weekly, 24 h prior to gem, starting day 7. Standard 3+3 dose-escalation schema is used. Planned paricalcitol doses are 0.24, 0.72, 1.20, 1.8, 2.4 μg/kg, and 25% increments till MTD. Gem PK and CDD activity (PBM) are studied on days 1 and 8. Paricalcitol PK studies are obtained on day 7. Results: Fourteen pts with the following cancers: pancreatic (n=3), colon (n=3), lung (n=5), esophageal (n=1), bladder (n=1) and unknown primary (n=1) have been enrolled. No dose limiting toxicities have occurred. Median of 2 cycles were delivered (range 1–9). Grade 3 toxicities: anemia (n=3 pts), neutropenia (n=5), thrombocytopenia (n=3), thrombosis (n=2), anorexia (n=1), hypophosphatemia (n=1), dehydration (n=1), syncope (n=1), pneumonia (n=1) and chills (n=1). Grade 4 toxicities: anemia (n=1) and neutropenia (n=1). Hypercalcemia (> grade 1) did not occur. Stable disease occurred in 2 and progressive disease in 3. Conclusions: MTD was not reached at 1.8 μg/kg of paricalcitol with gem 800 mg/m2/week. Dose escalation is ongoing. PK data will be presented at meeting. Supported by NIH grants CA67267 and CA85142. [Table: see text]