bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract PS4-32: Tim3 expression on tumor infiltrating lymphocytes is associated with poor response to neoadjuvan chemotherapy in patients with locally advanced triple negative breast cancer
Authors: Cabioglu Neslihan , Onder Semen , Oner Gizem , Karatay Hüseyin , Tukenmez Mustafa , Muslumanoglu Mahmut , Igci Abdullah , Eralp Yesim , Aydiner Adnan , Saip Pinar , Yavuz Ekrem , Ozmen Vahit 
Published: February 2021

Abstract
Background: Expression of immune checkpoint receptors (ICR) on tumor infiltrating lymphocytes (TILSs) is associated with better response to immunotherapies via immune checkpoint inhibitors. Therefore, we investigated various ICR expressions on TILs in patients with locally advanced triple negative breast cancer (TNBC) after neoadjuvant chemotherapy (NAC). Methods: Expressions of ICRs were examined immunohistochemically by staining surgical specimen (n=61) using specific monoclonal antibodies for PDL-1, PD-1, TIM-3, LAG-3, CTLA-4. Positivity was defined staining &gt;1% on TILs. Results: Median age was 49 (24-76) years. The majority patients were clinically T3-4 (n=31, 50.8%), and clinically N1-3 (n=58, 95.1%) before NAC. Of those, 82% were found to have CTLA-4 positivity, whereas TILs associated positivites for PD1, PDL-1, LAG3 and TIM-3 were 62.3%, 50.9%, 26.2%, 68.9%. High expression of CTLA-4 was found to be associated with a better chemotherapy response (OR=7.94, 95%CI: 0.9-70.12, p=0.06), whereas TIM-3 positivity was contrarly associated with a worse chemotherapy response (OR=0.253, 95%CI: 0.066-0.974, p=0.047) as measured by MDACC Residual Cancer Burden Index. At a 47-month follow-up, patients with ypN0 disease (DFS; HR=0.31, 95% CI: 0.12-0.83, p=0.02 and DSS; HR=0.21, 95% CI:0.07-0.62, p=0.005) and CTLA-4 high expression on TILs (DFS; HR=0.38, 95% CI=0.17-0.85, p=0.019 and DSS; HR=0.34, 95% CI:0.15-0.78, p=0.01) were found to have improved survival. Conclusions: These findings demonstrate that CTLA-4, PD-1, PDL-1 and TIM-3 were highly expressed in TNBC after NAC. Our results more favor an immuncheckpoint inhibitor therapy via CTLA-4 alone or in combination with other immune check point inhibitors against PDL-1 and/or TIM-3 in addition to NAC in advanced TNBC.
Citation Format: Neslihan Cabioglu, Semen Onder, Gizem Oner, Hüseyin Karatay, Mustafa Tukenmez, Mahmut Muslumanoglu, Abdullah Igci, Yesim Eralp, Adnan Aydiner, Pinar Saip, Ekrem Yavuz, Vahit Ozmen. Tim3 expression on tumor infiltrating lymphocytes is associated with poor response to neoadjuvan chemotherapy in patients with locally advanced triple negative breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS4-32.
Abstract PS4-46: Homologous recombination deficiency score predicts patient characteristics and outcomes of triple negative breast cancer in China
Authors: Wang Xue , Du Feng , Yue Jian , Si Yiran , Cui Lina , Yuan Peng 
Published: February 2021

Abstract
BackgroundPrevious studies found homologous recombination deficiency (HRD) score could predict response to platinum-containing neoadjuvant chemotherapy in patients with triple negative breast cancer (TNBC), but its predictive effects of adjuvant chemotherapy is unexplored.
Methods We developed the 3DMed-HRD algorithm, which combines loss of heterozygosity score (LOH), telomeric allelic imbalance score (TAI) and large-scale state transition score (LST) to characterize genomic instability using over 10000 SNPs, adjusted by tumor ploidy and purity. HRD positive is defined by deleterious mutation in BRCA1/2 or HRD score above the threshold (cut-off ≥30). Tumor samples were retrospectively obtained from 149 TNBC patients who received platinum-based (paclitaxel and cisplatin, TP) or platinum-free (cyclophosphamide and adriamycin, EC) adjuvant chemotherapy after surgery. All patients underwent the 3DMed-HRD testing.
ResultsIn 25.5% (38/149) of TNBC patients deleterious germline or somatic mutation in BRCA 1/2 was detected. HRD results were available for all patients and 81of the 149 patients (54.4%) were defined as HRD positive. HRD-positive patients had younger age at diagnosis (median 46.7 years vs 51.5 years, P=0.002), higher differentiated (59.8% vs 39.5%; p=0.037), lower N-stage (55.7% vs 33.3%; p=0.006) and more common at high expression of Ki67 (64.7% vs 39.0%; p=0.015). In TP treatment group, patients with HRD positive tumors had a lower 5-year recurrence rate although the difference was not statistically significant (8.82% vs 16.1%; p=0.463). Patients in EC treatment cohort, 5-year recurrence rate was comparable between HRD positive and negative subgroups (15.4% vs 13.3%; p=1.0). In the 81 patients in HRD-positive cohort, patients in TP treatment group showed a numerical lower 5-year recurrence rates compared with patients in EC treatment group (8.82% vs 15.4%; p=0.489).
Conclusions54.5% patients were characterized as HRD positive in TNBC patients in our cohort. HRD was associated with clinicopathologic characteristics. Our results suggested that HRD status mightguide chemotherapy treatment decisions. Prospective validation with larger sample size is needed.
Citation Format: Xue Wang, Feng Du, Jian Yue, Yiran Si, Lina Cui, Peng Yuan. Homologous recombination deficiency score predicts patient characteristics and outcomes of triple negative breast cancer in China [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS4-46.
Abstract PS6-26: Recurindex® predicts local regional recurrence for n1 breast cancer after mastectomy
Authors: Zhang Li-Na , Liu Yue-Ping , Li Chun-Xiao , Song Chao , Wang Ning , Tang Ji-Yu , Zhou Meng-Li , Chen Ting-Hao , Chen Ming-Shuo , Cheng Skye Hung-Chun , Geng Cui-Zhi 
Published: February 2021

Abstract
Background: Post-mastectomy radiation therapy (PMRT) is part of standard regimen in the management of breast cancer. It has been shown to decrease the incidence of local regional recurrence (LRR) and improve breast cancer survival. Yet, its role in patients with 1-3 positive lymph nodes (N1) remains unclear. The lack of biological markers to evaluate the efficacy of PMRT for N1 patients leads to excessive treatment of low-risk patients and ignore of those at high risk. A clinical-genomic model RecurIndex® (RI-LR), based on a genomic database from mRNA expression as well as clinical factors (lymph node involvement, ER status,age at diagnosis, and lymphovascular invasion), is mainly developed for predicting the LRR in early stage breast cancer patients.
Method: The preliminary result enrolled 107 breast cancer patients with N1 involvement in a retrospective study atthe fourth hospital of Hebei Medical University. Kaplan Meier method is used to calculate the survival rates in terms of LRR-free interval (LRFI). The log rank test and cox regression model are applied for the survival difference between two independent groups, and for investigating prognostic factors related to high-risk patients. The primary endpoint is LRFI.
Results: With a median follow-up of 84 [IQR 64-84] months, RI-LR partitioned these N1 patients into 70% high-risk group and 30% low-risk group. LRR rate was 14.7% in the high-risk group whereas only 3.1% in the low-risk group. The survival curve clearly showed a partitioned trend of two groups (5-year LRFI 87.5%vs 100%, p = 0.085). Patients identified in the RI-LR high-risk group showed significantly higher LRFI if they had PMRT compared to those without PMRT (5-year LRFI 94% vs 70%, p =0.043), suggesting that higher radiosensitive patients could be identified by RI-LR. Multivariate analysis revealed that high-risk patients treated with PMRT has a 71 % reduction of LRR compared to those without PMRT (HR 0.29, 95%CI: 0.08-1.00, p = 0.051).
Conclusions:The present study provided robust evidence that RI-LR could partition N1 breast cancer patients into good and poor prognosis of LRR. RI-LR is capable of identifying high-risk patients who would benefit from PMRT. This observation warrants to validate in a larger cohort.
Key words: Early breast cancer, genomic assay, recurrence index (RI), local-regional recurrence (LRR), post mastectomy radiotherapy (PMRT)
Citation Format: Li-Na Zhang, Yue-Ping Liu, Chun-Xiao Li, Chao Song, Ning Wang, Ji-Yu Tang, Meng-Li Zhou, Ting-Hao Chen, Ming-Shuo Chen, Skye Hung-Chun Cheng, Cui-Zhi Geng. Recurindex® predicts local regional recurrence for n1 breast cancer after mastectomy [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-26.
Abstract PS6-37: Clinical stage is the only predictor of survival in breast cancer patients with a complete pathological response
Authors: Acevedo Francisco , Walbaum Benjamin , Merino Tomas , Petric Militza , Sanchez Cesar 
Published: February 2021

Abstract
INTRODUCTION In breast cancer (BC) patients, achieving a complete pathological response (pCR) after neoadjuvant chemotherapy (NCT) is associated with better prognosis. Despite this, some of these patients will experience recurrences of the disease and will eventually die of BC. We identified clinical factors that can affect recurrence and survival in BC patients who achieve pCR.METHODSRetrospective analysis of a Chilean BC database including patients treated in public and private hospitals in Santiago, Chile from 2010 to 2019. pCR was defined as the absence of residual invasive disease in the breast and in the axillary lymph nodes (ypT0/is N0) at the completion of the NCT. Invasive Disease-Free Survival (IDFS), Distant Disease-Free Survival (DDFS) and BC-specific survival (BCS) was measured from the time of diagnosis to the event or lost to follow-up. We performed Cox regression analysis to identify factors associated with prognosis.RESULTSFrom 855 patients who received NCT, 195 (22.8%) achieved pCR and were included in this study. Clinical characteristics are shown in table 1. 76 (37.9%) patients had hormone receptor positive (HR+) and 113 (57.4%) had Human epidermal growth factor 2 (HER2) positive tumors. 88.7% were treated with a regimen that included anthracyclines and taxanes. With a median follow-up of 36 months, three-year IDFS, DDFS and BCS and their 95% confidence intervals were 90.9% (84.7 - 94.6), 91.8% (86.0 - 95.3) and 93.8% (87.8 - 97.5); respectively. The stage at diagnosis was the only predictor associated with IDFS (Hazard ratio (HR) = 5.6; p = 0.02), DDFS (HR = 4.1, p = 0.07), and BCS (HR = 8.3, p = 0.04). Body mass index (BMI), age, hospital, HR or HER2 status, lymph node involvement, or the presence of an in-situ component, were not associated with prognosis in the multivariate analysis.CONCLUSIONThe clinical stage at diagnosis was the only predictor of survival in patients who achieved pCR after NCT. Short follow-up and few events may have affected these results. This data is consistent with previously published work.
Table 1. Tumor and patient characteristicsMedian age49 (24 – 78)HospitalPublic57.4%Private43.6%BMIMedian27.2 (18.5 – 44.7)Overweight38.0%Obese31.9%Receptor StatusRH+/HER2-16.4%RH+/HER2+21.5%RH-/HER2+35.9%RH-/HER2-26.2%Clinical StageI2.1%II47.4%III50.5%Lymph Node +69.7%ypT0/N078.1%ChemotherapyAnthracycline5.1%Taxane6.2%Anthracycline-Taxane88.7%
Citation Format: Francisco Acevedo, Benjamin Walbaum, Tomas Merino, Militza Petric, Cesar Sanchez. Clinical stage is the only predictor of survival in breast cancer patients with a complete pathological response [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-37.
Abstract PS6-39: A novel prognostic nomogram for 2-year survival in HER2-positive patients
Authors: Zhu Li , Chen Mengdi , Wu Jiayi 
Published: February 2021

Abstract
Background: Targeted therapies have largely improved prognosis of human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Yet, disease can still progress rapidly for some patients in the first two years after diagnosis. Our study aimed to establish a nomogram model to predict 2-year breast cancer-specific survival (BCSS) in early HER2-positive breast cancer patients. Patients and Methods: A total of 32,481 HER2-positive patients derived from Surveillance, Epidemiology, and End Results (SEER) database were included in the construction of nomogram. Concordance index (C-index) and calibration curve were used to evaluate the discrimination ability and predictive accuracy. We also tested the model in 804 patients from Shanghai Jiao Tong University Breast Cancer Data Base (SJTU-BCDB).Results: Age, estrogen receptor (ER) status, progesterone receptor (PR) status, histologic type, T stage and N stage were selected to construct the nomogram according to multivariable analysis. The 2-year BCSS rate was 95% and 60% for patients at low risk (&lt;8 points) and high risk (&gt;13 scores) respectively. The C-index of model derived from SEER database is 0.81 (95%CI 0.79-0.83). Sensitivity analysis was performed in patients undergoing breast surgeries with the C-index of 0.81 (95%CI 0.79-0.83). Validation in 804 patients from SJTU-BCDB showed respective C-index of 0.77 (95%CI, 0.62-0.92) in total population, 0.67 (95%CI 0.44-0.90) in patients receiving anti-HER2 therapy and 0.90 (95%CI 0.81-0.90) in those without targeted therapy.Conclusions: The novel nomogram can predict 2-year survival outcome in HER2-positive patients independent of receiving anti-HER2 therapy or not and help clinicians to adjust therapeutic strategies for those patients with higher risk.
Citation Format: Li Zhu, Mengdi Chen, Jiayi Wu. A novel prognostic nomogram for 2-year survival in HER2-positive patients [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-39.
Abstract PS6-47: Breast cancer and COVID-19: Impact of active treatment on severe outcomes
Authors: Tawagi Karine , Burton Jeff , Lunski Michael , Maslov Diana , Cole John 
Published: February 2021

Abstract
Background: Several reports have observed that cancer patients who recently underwent chemotherapy or surgery had a higher risk of severe events compared with patients without cancer. Limited data is available on outcomes in specific cancer types, as well as the impact of non-cytotoxic systemic treatment, such as targeted therapy and hormonal therapy on severe outcomes. We aim to identify whether active treatment impacts severe outcomes (rate of hospitalization, ICU admission, intubation, and death) in breast cancer patients. Methods: We conducted a multicenter study in the state of Louisiana, throughout the Ochsner Health System, in both tertiary and non-tertiary centers. Patients must carry a diagnosis of breast cancer, and have a completed SARS-CoV-2 test between March 1st and April 30th, 2020. Chi-squared and Fisher’s exact tests were performed to compare the proportion of patients experiencing severe outcomes between treatment groups. Results: As of April 30, 2020, a total of 70 patients with breast cancer who had a positive SARS-COV-2 test were identified. Median age 64.5, median BMI 30.8, 62.9% (n=44) black, 27.1% (n=19) current/former smokers, HTN (n=52) and DM2 (n=22) were the most common comorbidities, and 12.9% (n=9) of patients had stage IV disease. Of these patients, 58.6% (n=41) were on hormonal treatment, and another 12.9% (n=9) were receiving other forms of systemic therapy (cytotoxic chemotherapy or targeted therapy). In terms of severe outcomes, 32.9% (n=23) of patients required hospitalization, 8.6% (n=6) required ICU admission with 7.1% (n=5) patients requiring intubation, 11.4% (n=8) of patients died. There was not a statistical difference in rate of severe outcomes (rate of hospitalization, ICU admission, intubation, and death) among breast cancer patients receiving active treatment (chemotherapy, targeted therapy, or hormonal therapy) vs those receiving no active treatment. There was also no difference in terms of severe outcomes by race. Conclusion: With an ongoing global COVID-19 pandemic, it is important to identify how the treatment and management of cancer impacts COVID-19 outcomes. This small cohort does not identify active treatment as a risk factor for increased rate of severe outcomes in patients with breast cancer. Further analyses describing impact of specific hormonal and chemotherapy regimens on risk of hospitalization and death will be completed by time of presentation.
Citation Format: Karine Tawagi, Jeff Burton, Michael Lunski, Diana Maslov, John Cole. Breast cancer and COVID-19: Impact of active treatment on severe outcomes [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-47.
Abstract PS7-13: Associations between frailty and cancer-specific mortality among older women with breast cancer
Authors: Yan Connie H , Coleman Chandler , Nabulsi Nadia A , Chiu Brian , Ko Naomi Y , Hoskins Kent , Calip Gregory S 
Published: February 2021

Abstract
PURPOSE Frailty is assessed when making treatment decisions among older women with breast cancer (BC), which in turn impacts survival. We evaluated associations between frailty and risks of BC-specific and all-cause mortality in older women.
METHODS We conducted a retrospective cohort study of Medicare beneficiaries ages ≥65 years with stage I-III BC using the Surveillance, Epidemiology and End Results Medicare Health Outcome Survey Data Resource. Frailty was measured using the deficit-accumulation frailty index, categorized as robust, pre-frail or frail, at baseline and during follow-up. Fine and Gray competing risk and Cox proportional hazards models were used to estimate sub-distribution hazard ratios (SHR) and hazard ratios (HR) with 95% confidence intervals (CI) for BC-specific and all-cause mortality, respectively.
RESULTS Among 2,411 women with a median age of 75 years at BC diagnosis, 50% were categorized as robust, 29% were pre-frail and 21% were frail. Compared to robust women, fewer frail women received breast-conserving surgery (52% vs. 63%) and radiation (44% vs. 52%). In multivariable analyses, frail women had higher risks of all-cause mortality compared to robust women (HR 2.16, 95% CI 1.80-2.60).
CONCLUSION Frail women in our study had a higher cumulative hazard of BC-specific death, but this observed higher risk was not significant after accounting for differences in treatment and competing risks of other-cause death. Measuring frailty may help determine overall life expectancy but not BC-specific death.
Table. Risk of Breast Cancer-Specific and All-cause Mortality, using time-varying DAFI measureEventsCrude SHRRobust 95%CIP-valueMinimally Adjusted SHRaRobust 95%CIP-valueFully Adjusted SHRbRobust 95%CIP-valueBreast Cancer-Specific MortalityDAFI CategoriesRobust891.001.001.00Pre-frail691.250.91 – 1.700.161.150.84 – 1.590.381.060.77 – 1.480.72Frail621.531.11 – 2.110.011.371.00 – 1.900.051.190.85 – 1.660.31All-Cause MortalityDAFI CategoriesRobust2721.001.001.00Pre-frail2241.551.30 – 1.84&lt;0.00011.411.19 – 1.68&lt;0.00011.371.15 – 1.63&lt;0.0001Frail2362.32.12 – 3.02&lt;0.00012.331.96 – 2.78&lt;0.00012.161.80 – 2.60&lt;0.0001DAFI = deficit-accumulation frailty index; HR = hazard ratio; SHR = subdistribution hazard ratios; CI = confidence intervalsa adjusted for age categories and breast cancer staging b adjusted for age categories, breast cancer staging, surgery type, radiation, Estrogen/Progestin Receptor, race/ethnicity, marital status, and education
Citation Format: Connie H Yan, Chandler Coleman, Nadia A Nabulsi, Brian Chiu, Naomi Y Ko, Kent Hoskins, Gregory S Calip. Associations between frailty and cancer-specific mortality among older women with breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-13.
Abstract PS7-64: Breast cancer in young women in a tertiary-level hospital in Guatemala
Authors: Alvarado-Muñoz Juan F , Reyes-Morales Agatha , Kihn-Alarcón Alba J , Chivalan Marco , Torselli Silvana , Puac-Polanco Victor 
Published: February 2021

Abstract
Background: Breast cancer is the frequent neoplasia in young women, which in developing countries is associated with more adverse outcomes. In Latin America, reports have shown an increased incidence of breast cancer in young women. No information exist regarding breast cancer characteristics in young Guatemalan women. We aimed to describe the clinical-pathological features among women aged 45 years or less treated in a tertiary-level hospital in Guatemala. Methods: We examined data from 119 women aged 45 years or less diagnosed with primary invasive breast cancer at the Oncology Unit Roosevelt Hospital in Guatemala between 2016 and 2020. Data were drawn from medical files on sociodemographic characteristics, histology, clinical stage, and breast cancer subtypes.Results: Of the total sample, breast cancer in women aged 45 years or less represented 31.2% of the cases. Of these, 24.36% is before 35 years, 28.57% between 35 to 39 years, and 47.05% between 39 to 45 years. Advanced clinical stages affected 66.6% of young women (48.33% for stages III and 18.33% stage IV). Data from specific breast cancer molecular subtype showed that 72.35% of cases in young women expressed an aggressive molecular subtype (Her-2 positive 27.06%, triple-negative 21.76%, and luminal/Her-2 positive 23.53%). Regarding treatment, most young patients received surgical treatment, as well as neoadjuvant or adjuvant chemotherapy. Only 24.37% received hormonal and 26.89% radiation therapy. Conclusions: Our finding suggested that young women treated for breast cancer at a tertiary-level hospital in Guatemala had a high proportion of aggressive molecular subtypes and a high rate of locally advanced disease. This aggressive cancer behavior among young women is consistent with findings in other Latin American countries. Evidence examining risk factors for aggressive cancer in young women, such as delay in diagnosis and treatment timing, is warranted.
Table 1. Distributions of socio-demographic and cancer-related characteristics variables% (SE)n = 119ETHNIC GROUPMayan Indigenous12.61 (3.05)No-Mayan Indigenous87.39 (3.05)HISTOLOGYDuctal96.64 (1.66)Lobular1.68 (1.18)Other1.68 (1.18)CLINICAL STAGE*I1.67 (1.17)II31.67 (4.26)III48.33 (4.58)IV18.33 (3.54)BREAST CANCER SUBTYPELuminal27.65 (4.76)Her2 positive27.06 (5.11)Triple-negative21.76 (5.05)Luminal/Her223.53 (6.61)TREATMENTSurgery55.46 (4.58)Neoadjuvant Chemotherapy82.35 (3.51)Adjuvant Chemotherapy47.06 (4.59)Radiotherapy26.89 (4.08)Hormonotherapy24.37 (3.95)
Citation Format: Juan F Alvarado-Muñoz, Agatha Reyes-Morales, Alba J Kihn-Alarcón, Marco Chivalan, Silvana Torselli, Victor Puac-Polanco. Breast cancer in young women in a tertiary-level hospital in Guatemala [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-64.