bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract PS7-27: Trends in breast cancer mortality in Brazil - a 14-year registry-based study
Authors: Marta Guilherme Nader , Testa Laura , Guindalini Rodrigo Santa Cruz , Marta Gustavo Nader , Del Pilar Estevez Diz Maria , Hoff Paulo M. 
Published: February 2021

Abstract
Background: Breast cancer (BC) is the leading cause of cancer-related deaths among women worldwide. BC mortality rates have been decreasing over the past decades in the developed countries. In the United States, BC mortality declined on average 1.5% each year over 2008-2017. Given the paucity of BC mortality data in Brazil, we sought to characterize BC mortality trends in southeastern Brazil and its relationship with demographic variables.
Methods: A cross-sectional registry-based analysis was conducted to describe BC mortality trends in the State of Sao Paulo (Brazil) from 2004 to 2017. Sao Paulo is the most populous state in Brazil, with 45.5 million inhabitants, corresponding to 21.8% of the country's total population. BC-related death records, including gender and age were collected from SEADE Foundation’s database, an official entity charged with generating statistical data for the State of Sao Paulo. Mortality rates are expressed in units of deaths per 100,000 individuals per year. The annual percentage change (APC) was calculated to identify mortality trends over the period. Trend analysis was carried out by linear regression and an increase or decrease in trend was considered statistically significant when p-value &lt; 0.05.
Results: From 2004 to 2017, 52,005 deaths from BC were recorded in the State of São Paulo, Brazil. Average annual mortality was 8.96/100,000 (17.38/100,000 for females and 0.11/100,000 for males). Average mortality rates were higher in the age group over 65 years-old (46.47/100,000). BC mortality rates remained stable during the period analyzed (APC 0, 95%CI -0.2% to +0.3%, P = 0.9) for both females (APC 0, 95%CI -0.3% to +0.2%, P = 0.7) and males (APC +2.4%, 95%CI -1.7% to +6.6%, P = 0.2). Among females, an increasing BC mortality trend was detected for patients under 40 years-old (APC +2.4%, 95%CI +1.6% to +3.2%, P &lt; 0.0001) and remained stable for the age groups between 40 - 65 years-old (APC -0.3%, 95%CI -0.7% to +0.1%, P = 0.1) and over 65 years-old (APC -0.1%, 95%CI -0.4% to +0.2%, P 0.5).
Conclusion: In contrast with data from other developing countries, a stable BC mortality has been demonstrated in southeastern Brazil over a 14-year period for the general population. However, a significant increase in BC mortality rates has been demonstrated among patients under 40 years-old.
Citation Format: Guilherme Nader Marta, Laura Testa, Rodrigo Santa Cruz Guindalini, Gustavo Nader Marta, Maria Del Pilar Estevez Diz, Paulo M. Hoff. Trends in breast cancer mortality in Brazil - a 14-year registry-based study [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 PS7-27.
Abstract PS7-78: Trends in BRCA testing among patients diagnosed with breast cancer -a retrospective analysis of a United States commercial claims database from the PRIOR-1 study
Authors: Corman Shelby , Kale Hrishikesh , Shah Pooja , Adeboyeje Gboyega 
Published: February 2021

Abstract
Background The use of BRCA testing to guide the course of breast cancer treatment has evolved in the last 5 years; however, little is known about the use of BRCA testing in a real-world setting. This study assessed the trend in prevalence of BRCA testing and sociodemographic and clinical predictors of receiving a BRCA test among newly diagnosed patients with breast cancer. Methods This was a retrospective study conducted using the Optum Clinformatics Datamart database. Patients newly diagnosed with breast cancer, continuously enrolled in a health plan for ≥6 months before and after diagnosis were included in the study. Claims for BRCA testing were identified after diagnosis using HCPCS, ICD-9/10 procedure, and LOINC codes. The prevalence of BRCA testing was calculated for patients diagnosed in each year from 2012-2017. Multivariable logistic regression was used to assess predictors of BRCA testing controlling for sociodemographic and clinical factors. Results From a total of 81,774 breast cancer patients included, 13,529 (16.5%) received a BRCA test after diagnosis. The prevalence of BRCA testing increased from 1,721 (11.5%) in 2012 to 2,384 (17.1%) in 2013 and remained stable over time until 2017 [2,191, (18.5%)]. Of patients receiving a BRCA test, 11,688 (86%) were tested within 1 year of diagnosis. The median time to receive a BRCA test from diagnosis was 29 days (mean: 172.7 days). Results from logistic regression indicated that diagnosis at a younger age (e.g., 18-44 years versus ≥75 years, odds ratio [OR] = 25.3), diagnosis in recent years (e.g., 2017 versus 2012, OR =1.94), having a point of service versus health maintenance organization plan type (OR = 1.10), presence of metastasis (OR = 1.62), and family history of cancer (OR = 4.98) significantly (P&lt;0.05) increased odds for receiving a BRCA test. Female gender (OR = 0.28), living in regions other than West (e.g. South, OR = 0.86), having commercial insurance versus Medicare Advantage (OR = 0.96), Charlson comorbidity index score of ≥3 vs 0 (OR= 0.83) were significantly (P&lt;0.05) associated with lower odds of receiving a BRCA test. Conclusions Prevalence of BRCA testing among breast cancer patients increased initially in 2013 and remained stable over time until 2017. Several demographic and clinical factors were associated with the use of BRCA testing among breast cancer patients.
Citation Format: Shelby Corman, Hrishikesh Kale, Pooja Shah, Gboyega Adeboyeje. Trends in BRCA testing among patients diagnosed with breast cancer -a retrospective analysis of a United States commercial claims database from the PRIOR-1 study [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 PS7-78.
Abstract PS8-18: Describing the cancer spectrum in families with CHEK2 pathogenic and likely pathogenic variants by mutation type
Authors: Moroney Julia G , Basiliere Michele S 
Published: February 2021

Abstract
Background: Deleterious CHEK2 variants have well-defined risks for breast and colorectal cancers. Some studies have also suggested association with a variety of other cancers, including leukemia, kidney, prostate, thyroid and gastric cancers. However, most CHEK2 studies are based on European founder mutations, and there is a lack of data on non-founder mutations. Here, we describe the cancer family histories of patients with both founder and non-founder CHEK2 mutations. Methods: This is a retrospective review of patients who underwent germline testing of 31 cancer risk genes. All pathogenic (P) and likely pathogenic (LP) variants in CHEK2 were selected from our database and categorized as founder or non-founder mutations. Personal and family histories of cancer reported by the ordering provider were recorded for each case. Cancer rates were calculated as the number of patients with a personal and/or family history of each cancer divided by the total number of patients. Ethnicities in our CHEK2+ cohort and our overall database were calculated as a percentage. Results: A total of 132 patients were found to have P/LP variants in CHEK2. This CHEK2+ cohort was largely Caucasian (79.5%), despite our overall database being ethnically diverse (56% Caucasian). Nineteen different mutations were identified, 75% of which were founder and 25% were non-founder mutations. Personal histories of cancer were identified in 7% of patients. Twenty-eight different cancers were reported in patients’ personal/family histories. The rates of select cancers in the total cohort, founder mutation group and non-founder mutation group are reported in Table 1. Discussion: These findings support previous reports that prostate, gastric and kidney cancers may be part of the CHEK2 cancer spectrum, which has typically only included breast and colorectal cancer. We also identify ovarian and pancreatic cancer as potential CHEK2-associated cancers. Cancer rates are similar between CHEK2 patients with founder and non-founder mutations. Differences in cancer rates were observed between these two groups, but this cohort was too small to determine significance. Additional studies are needed to understand the overlap of cancer risk with non-founder mutations and those well-described for founder mutations.
Table 1: Select cancer rates by CHEK2 mutation typeBreast FemaleOvarianProstateColorectalPancreaticUterineGastricKidneyAll80.3%39.4%25%23.5%13.6%8.3%8.3%6.1%Founder81.8%40.4%30.3%23.2%18.2%9.1%9.1%8.1%Non-founder75.8%36.3%9.1%24.2%0%6%6%0%
Citation Format: Julia G Moroney, Michele S Basiliere. Describing the cancer spectrum in families with CHEK2 pathogenic and likely pathogenic variants by mutation type [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 PS8-18.
Abstract PS9-22: Supportive care needs and patient experience of women with metastatic breast cancer in a safety-net system
Authors: Buchanan Ashley , El-Mubasher Ola , Sarfo Astrid , Badr Hoda 
Published: February 2021

Abstract
Background: Metastatic breast cancer (MBC) is an incurable, albeit treatable cancer affecting over 150,000 women in the US. Addressing supportive care needs has become increasingly important as women are living longer with MBC due to advances in treatment. However, most supportive care programs were developed for women with early stage breast cancer. The existing literature also offers limited understanding of the needs of patients receiving care in safety net settings, which are often under-resourced and treat medically underserved populations, who are more likely to be diagnosed with MBC.
Methods: This study sought to understand the supportive care needs and experience of MBC patients receiving care in a safety net system. Semi-structured interviews were conducted with 11 patients (average age = 42.8 years, SD = 19.5) who were undergoing treatment for MBC. Questions centered on the diagnosis and treatment experience, patient-provider communication, and perceived barriers to care. Interviews were digitally audio-recorded, transcribed and coded using a Grounded Theory approach. Results: Patients noted that a lack of familiarity with medical terminology and insufficient medical knowledge made it difficult for them to evaluate treatment options, make treatment decisions, and communicate their supportive care needs. Half (n=5) did not feel their healthcare concerns were validated when expressed and some even went so far as to exaggerate reports of physical symptom severity in order to receive more timely and attentive care. Patients were dissatisfied with the timeliness of information delivery, scheduling delays, and long wait times. Some also felt that seeing different providers (e.g., residents, fellows) each time they came into the clinic interfered with the doctor-patient bond and continuity of care.
Conclusion: This study identified patient, provider, and system-level factors affecting MBC patients’ experience of care in a safety-net system. Our findings indicate a strong need for support services including outreach to address health literacy issues, treatment decision making, and symptom management concerns. They also indicate a need for improved disease and treatment information exchange between patients and healthcare providers.
Citation Format: Ashley Buchanan, Ola El-Mubasher, Astrid Sarfo, Hoda Badr. Supportive care needs and patient experience of women with metastatic breast cancer in a safety-net system [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 PS9-22.
Abstract PS9-35: Volumetric assessment of lymphedema with 3D sensor
Authors: Maciel-Miranda Alejandro , Otero-Hernández Miriam I , Martínez-Silva Darinka , Escrivá-Machado Jesus F 
Published: February 2021

Abstract
Volumetric assessment of lymphedema with 3D sensor: A new practical method Secondary lymphedema of the upper extremities is an important quality-of-life issue for around 40% of patients who were treated for breast cancer and required axillary nodal dissection and radiotherapy. Volume measurement is an important aspect of diagnosis, follow up, and evaluation after conservative or surgical treatment for lymphedema. Until now, there have been complex techniques to assess volume of affected limbs: bioimpedance, liquid-displacement volumetry, CT, MRI. There is a need for a practical method of volumen assessment in lymphedema patients. The objective of the present study is to confirm whether or not 3D scanning for volumetric assessment is useful and correlates with direct perimeter measurement and indirect volume calculation. Methods: A 3D sensor (Structure Sensor, Occipital Inc) mounted on an Ipad (Apple, Inc.) was used to make a 3D model file of the affected limb, that was later analyzed by 3DsizeME software (TechMed 3D, Inc.) in a desktop computer. 3D model analysis allows to measure perimeters and volumes. Fifteen patients were measured, lymphedema and normal limbs (30 extremities) by this technique and were also measured with tape, as traditional method; results were compared to assess correlation. Results: There were not statistical difference between the two techniques (p 0.05). Table attached. Discussion: volumetric assessment by 3D sensor allows consistent and reproducible measurements. It is practical as we only need the space of an ipad, it can be performed in the clinic visit, by any doctor, nurse or physical therapist. It is not expensive, as the software charges US$10 by each analysis. It do not expose the patient to any harmful radiation, as is obtained by and infrared camera. Allows electronic records of all measurements. Average time to capture 3D model is 5 minutes. We think this new method is a valuable tool for any lymphedema clinic as volume measurement is important for disease evaluation and now, more important, with a growing field of surgical treatment for this disease.
Citation Format: Alejandro Maciel-Miranda, Miriam I Otero-Hernández, Darinka Martínez-Silva, Jesus F Escrivá-Machado. Volumetric assessment of lymphedema with 3D sensor [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 PS9-35.
Abstract PS9-63: Real world data on the adoption of trastuzumab biosimilars in the treatment of HER2-positive breast cancer
Authors: Flood William A , Avery Tiffany , Kozlovsky Vlad , Margolis Neil , Reddy Sandeep 
Published: February 2021

Abstract
Background: Biosimilars for trastuzumab were introduced into the US market for the treatment of HER2-positive breast cancer in 2019, with the goal of providing the clinical benefit of the brand product at a lower price (increased value). Adoption of trastuzumab biosimilars may be affected by multiple factors, including physician confidence in biosimilar efficacy and efficacy across stages, practice reimbursement, payer medical policy/redirection. To look at the adoption of trastuzumab biosimilars in the US medical oncology community, we queried a database of submitted treatment plans for patients with breast cancer. Methods: Data from a pre-authorization platform used by multiple commercial insurance companies in the US (NantHealth Eviti) was analyzed. Cases were identified from approved treatment plans for patients with breast cancer by inclusion of brand trastuzumab or trastuzumab + hyaluronidase-oysk, or trastuzumab biosimilars. Results: As of July 1, 2020, 10,557 treatment plans trastuzumab-based therapy were submitted, 1740 (16.5%) of which used a trastuzumab biosimilar. Adoption of trastuzumab biosimilars increased over time, from 1.6% (27/1676) treatment plans in Q3-2109 to 43.3% (753/1736) in Q2-2020. No clear differences were observed between use in stage 0-IIIc disease (17.4%) vs stage IV/recurrent disease (14.5%). Using the July 1, 2020 CMS pricing for these drugs at normalized dose of 440 mg for trastuzumab/trastuzumab biosimilars or 600 mg of trastuzumab + hyaluronidase, the average cost/cycle/patient for brand therapy and biosimilar therapy is $4502 and $3618, respectfully, representing a savings of $1,374,620/cycle across the biosimilar-treated population. Additional analyses to be presented will include Q3 2020 utilization and patterns of utilization across payers with/without medical policy favoring biosimilars. Conclusions: Adoption of trastuzumab biosimilars in this commercial population has been rapid since their introduction. Use of these drugs provides a substantial opportunity for societal savings in the treatment of HER2-positive breast cancer.
Citation Format: William A Flood, Tiffany Avery, Vlad Kozlovsky, Neil Margolis, Sandeep Reddy. Real world data on the adoption of trastuzumab biosimilars in the treatment of HER2-positive 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 PS9-63.
Abstract SP113: The making of an ADC
Authors: Parren PWHI 
Published: February 2021

Abstract
Targeted treatment using antibody therapeutics has proved successful for the development of meaningful treatments in diverse therapeutic areas. However, despite strong advances, many patients still fail to respond or become resistant to targeted treatment and novel innovative approaches to improve therapy are therefore required. Genetic and chemical engineering of antibodies, fueled by recent molecular insights, is providing important opportunities for the development of more potent antibody therapeutics.
Antibody-drug conjugates (ADC), which combine the tumor-targeting capacity of monoclonal antibodies with the antitumor activity of cytotoxic agents, received much attention. In the road-map to developing an ADC, understanding target biology and selecting the most optimal antibody, linker and toxic payload represent critical parameters. This talk will provide an overview of this thought process in the context of the development of two ADCs currently in the clinic, tisotumab vedotin and enapotamab vedotin.
Citation Format: PWHI Parren. The making of an ADC [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 SP113.
Abstract SP012: Convergent evolution of resistance pathways during early stage breast cancer treatment with combination cell cycle (CDK) and endocrine signaling inhibitors
Authors: Griffiths JI , Chen J , Cosgrove PA , O'Dea A , Sharma P , Ma CX , Trivedi M , Kalinsky K , Wisinski KB , O'Reagan R , Makhoul I , Spring LM , Bardia A , Adler FR , Cohen AL , Chang JT , Khan QJ , Bild AH 
Published: February 2021

Abstract
Combining cyclin-dependent kinase (CDK) inhibitors with endocrine therapy improves outcomes for metastatic estrogen receptor positive (ER+), HER2 negative, breast cancer patients. However, the value of this combination in potentially curable earlier stage patients is not clear. Using single cell transcriptomic profiling, we examined the evolutionary trajectories of early stage breast cancer tumors using serial tumor biopsies from a clinical trial of preoperative endocrine therapy alone (letrozole) or in combination with the cell cycle inhibitor ribociclib. Applying hierarchical regression and Gaussian process mathematical modelling, we classified each tumor by whether it shrinks or persists with therapy and determined cancer phenotypes related to evolution of resistance and cell cycle transcriptional rewiring. We found that all patients’ tumors undergo subclonal evolution during therapy, irrespective of the clinical response. However, tumors subjected to endocrine therapy alone showed reduced diversity over time, those facing combination therapy exhibited increased diversity. Despite different diversity, single nuclei RNA sequencing uncovered common phenotypic changes in tumor cells that persist following treatment. In these tumors, accelerated loss of estrogen signaling is convergent with up-regulation of the JNK pathway, while persistent tumors that maintain estrogen signaling during therapy show potentiation of CDK4/6 activation consistent with ERBB4 and ERK signaling up-regulation. Cell cycle reconstruction identified that these tumors can rebound during combination therapy treatment, indicating stronger selection and promotion of a proliferative state. These results indicate that combination therapy in early stage ER+ breast cancers with ER and CDK inhibition drives rapid evolution of resistance via a shift from estrogen signaling to alternative growth factor receptor mediated proliferation and JNK signaling activation, concordant with a bypass in the G1 checkpoint.
Citation Format: JI Griffiths, J Chen, PA Cosgrove, A O'Dea, P Sharma, CX Ma, M Trivedi, K Kalinsky, KB Wisinski, R O'Reagan, I Makhoul, LM Spring, A Bardia, FR Adler, AL Cohen, JT Chang, QJ Khan, AH Bild. Convergent evolution of resistance pathways during early stage breast cancer treatment with combination cell cycle (CDK) and endocrine signaling inhibitors [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 SP012.
Abstract SP121: Personalized treatment for early stage HER2-positive breast cancer
Authors: Prat A 
Published: February 2021

Abstract
In my presentation, I will review the main clinical questions to be addressed in early-stage HER2+ disease, including the latest results from clinical trials as well as biomarker studies. Overall, the objective of my presentation is to dissect how personalized treatment of HER2+ early breast cancer has evolved in the last decade, and how is becoming a reality in particular settings, such as residual disease following standard neoadjuvant anti-HER2 therapies or in stage 1 disease. Moreover, I will discuss how the field is evolving to improve personalization of therapies and/or approaches even more in the upcoming years.
Citation Format: A Prat. Personalized treatment for early stage HER2-positive 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 SP121.
Abstract SP143: Advancing Cancer Research During Challenging Times
Authors: Sharpless N 
Published: February 2021

Abstract
The impact of the COVID-19 pandemic on care for people with cancer and the conduct of cancer research have been significant and will be evident for many years to come. While the National Cancer Institute (NCI) has brought to bear considerable expertise and capabilities to respond to the pandemic, our top priority remains advancing cancer research. The NCI budget, activities in response to the pandemic, breast cancer research advances, and the vision for cancer clinical trials will be discussed.
Citation Format: N Sharpless. Advancing Cancer Research During Challenging Times [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 SP143.