bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract PS1-20: Pathologic lymph lode status of patients with T1 HER2-positive breast cancer who did not receive neoadjuvant chemotherapy using the national cancer database
Authors: DeCesare Laura , Perez Claudia , Nimmagadda Neha , Zhang Yanyu , Terranella Samantha , Skertich Nicholas , Wiegmann Aaron , Madrigrano Andrea , Alvarado Rosalinda , O'Donoghue Cristina 
Published: February 2021

Abstract
Purpose: HER2 directed neoadjuvant therapies for locally advanced HER2-positive breast cancer have improved complete pathologic response and event-free survival. For T1 breast cancer, lymph node status often determines whether neoadjuvant treatment is indicated. The aim of this study was to identify patient and tumor characteristics using the National Cancer Database.Methods: A retrospective review of patents diagnosed with T1 clinically node negative (cT1N0) HER2-positive breast cancers was performed using the American College of Surgeons National Cancer Database (ACS NCDB) from 2004-2016. Exclusion criteria included age &lt;18 years and neoadjuvant treatment. Primary outcome was lymph node status. Additional variables included: age, tumor size, tumor location, histology, grade, lymphovascular invasion (LVI), grade, and estrogen receptor (ER) and progesterone receptor (PR) status. Chi-Square tests were performed to evaluate the relationship between these variables and lymph node positive disease.
Results: A total of 57,366 T1 HER2-positive patients were identified with 8,994 patients (15.68%) having positive lymph nodes. Characteristics associated with lymph node involvement included age (p&lt;0.001), tumor location (p&lt;0.001), lymphovascular involvement (p&lt;0.001), ER positivity (p=0.021), and PR positivity (p&lt;0.001). There was a significant difference in tumor size when comparing lymph node positive and negative disease (19.06 mm vs. 13.11 mm, p&lt;0.001). Conclusion: Age, tumor location, LVI, ER positivity, PR positivity, and larger tumor size are associated with lymph node involvement in cT1N0 HER2-positive breast cancers. Future research includes determining best practices to identify which patients in this population would benefit from neoadjuvant chemotherapy.
Citation Format: Laura DeCesare, Claudia Perez, Neha Nimmagadda, Yanyu Zhang, Samantha Terranella, Nicholas Skertich, Aaron Wiegmann, Andrea Madrigrano, Rosalinda Alvarado, Cristina O'Donoghue. Pathologic lymph lode status of patients with T1 HER2-positive breast cancer who did not receive neoadjuvant chemotherapy using the national cancer database [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 PS1-20.
Abstract PS1-25: Axillary management after neoadjuvant chemotherapy in initially node positive early breast cancer
Authors: Murillo Serafin Morales , Cudós Ariadna Gasol , Subirats Ona Pallisé , Olivé Jordi Melé , Morales Carles Canosa , Villellas Felip Vilardell , Guzman Douglas René Sanchez , Rodriguez Joel Veas , Galindo Alvaro Rodriguez 
Published: February 2021

Abstract
Response to neoadjuvant treatment could modify axillary management of those with node involvement at diagnosis. We investigated whether histological response correlates with node response and could avoid axillary dissection. A series of 339 patients with node positive early breast cancer who received neoadjuvant chemotherapy was analysed. We reported the axillary conversion (ypN0) rate and its association between clinical/pathological parameters. Median age was of 52 (24-89), median tumor size of 38mm; 120 (35%) patients were HER2 positive, 132 (39%) were luminal, and 87 (26%) were triple negative breast cancer. 113 (33%) patients obtained breast pathological complete response (breastpCR): 53/120 (44%) in HER2 positive, 21/132 (16%) in luminal and 39/87 (45%) in triple negative breast cancer. Axillary conversion to ypN0 rate was of 157/339 (46%): 71/120 (59%) in HER2 positive, 40/132 (30%) in luminal and 46/87 (53%) in triple negative breast cancer. It was found a 105/339 (31%) of relapse, and mean survival was of 147 months (CI 95% 134-159). Of 113 patients with breastpCR, 94 achieved axillary ypN0 (83%) (OD=12.8, p=0.000): 45/53 of breastpCR in HER2 positive (85%) (OD=8.8; p=0.069); 16/21 of breastpCR in luminal (76%) (OD=11.6; p=0.000); 33/39 (85%) of breastpCR in triple negative breast cancer (OD=14.8; p=0.002). Residual axillary involvement in breastpCR is reported in the table.Conclusion: Global axillary conversion in patients with breastpCR was of 83%; being HER2 and triple negative those with major association. BreastpCR could predict axillary conversion in triple negative breast cancer (OD=14.8; p=0.002) and the residual node involvement never was more than 3 positive nodes. These patients could avoid axillary dissection if an adequate sentinel node biopsy is performed.
Axillary conversion in breastpCRGlobal (113)HER2 (53)Luminal (21)TN (39)ypN094 (83%)45 (85%)16 (76%)33 (85%)1 node8 (7%)3 (5%)1 (5%)4 (10%)2 nodes1 (0.8%)001 (2.5%)3 nodes1 (0.8%)001 (2.5%)&gt;3nodes9 (7.9%)5 (10%)4 (19%)0
Citation Format: Serafin Morales Murillo, Ariadna Gasol Cudós, Ona Pallisé Subirats, Jordi Melé Olivé, Carles Canosa Morales, Felip Vilardell Villellas, Douglas René Sanchez Guzman, Joel Veas Rodriguez, Alvaro Rodriguez Galindo. Axillary management after neoadjuvant chemotherapy in initially node positive early 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 PS1-25.
Abstract PS1-32: A multicentre prospective feasibility study of carbon dye tattooing of biopsied axillary node and surgical localisation in breast cancer patients
Authors: Goyal Amit , Puri Shama , Marshall Andrea , Valassiadou Kalliope , Hoosein Moin , Carmichael Amtul R , Erdelyi Gabriella , Sharma Nisha , Dunn Janet , York Joanne 
Published: February 2021

Abstract
Background: The primary aim of this prospective, multicentre feasibility study was to determine whether the biopsied axillary node in patients with breast cancer can be marked using black carbon dye and successfully identified at the time of surgery. Methods: We included patients undergoing needle biopsy of the axillary lymph gland. The biopsied node was tattooed at the time of needle biopsy (fine needle aspiration or core biopsy) or at a separate visit with black carbon dye (Spot™ or Black Eye™). Participants underwent primary surgery or neoadjuvant chemotherapy and axillary surgery (SNB or ALND) as per routine care. Results: 110 patients were included. Median age of the women was 59 (range 31 to 88) years. 48 of 110 (44%) underwent SNB and 62 (56%) ALND. The median volume of dye injected was 2.0 ml (range 0.2-4.2).Tattooed node was identified in 90 of 110 (82%) patients. The identification rate was higher (86%) in the primary surgery group compared with NACT (64%). Of those undergoing NACT, the identification rate was better in the patients undergoing SNB (3 of 4, 75%) compared with ALND (11 of 18, 61%). The tattooed node was the sentinel node in 78% (28 of 36) patients in the primary surgery group and 100% (3 of 3) in the NACT group. For surgeons who had performed ≥5 operations, there was no learning curve. The identification rate did not vary with body mass index or volume of dye injected. There was no correlation between volume of dye and number of tattooed nodes removed. Conclusion: It is feasible to mark the axillary node with carbon dye and identify it intraoperatively. Modifications of the technique, such as injecting the dye in the cortex alone, restricting the volume to 0.2 to 0.4 ml and combining with clip, will improve the technical ability to identify the marked node.
Citation Format: Amit Goyal, Shama Puri, Andrea Marshall, Kalliope Valassiadou, Moin Hoosein, Amtul R Carmichael, Gabriella Erdelyi, Nisha Sharma, Janet Dunn, Joanne York. A multicentre prospective feasibility study of carbon dye tattooing of biopsied axillary node and surgical localisation in breast cancer 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 PS1-32.
Abstract PS10-13: Impact of trastuzumab on Ipsilateral breast tumor recurrence after breast conserving surgery
Authors: Cheun Jong Ho , Lee Han-Byoel , Moon Hyeong-Gon , Noh Dong-Young , Han Wonshink 
Published: February 2021

Abstract
Background: Trastuzumab is well known to be effective to control locoregional recurrence and distant metastasis of human epidermal growth factor receptor 2 (HER2)-overexpressing breast tumor. However, few studies have reported the effect of ipsilateral breast tumor recurrence (IBTR) in spite of higher incidence of IBTR for HER2 overexpressing subtype than other subtypes. The purpose of this study is to investigate the difference in the incidence of IBTR of HER2-overexpressing breast tumor according to adjuvant trastuzumab.
Methods: We retrospectively reviewed 996 patients who had done surgery for HER2-overexpressing breast cancer between January 2000 and December 2017 in our institution. Patients with tumors smaller than 0.5cm without axillar node metastasis were excluded. As regarding IBTR as recurrence “in” the ipsilateral breast, only patients who had done breast conserving surgery were included.
Results: There were 735 patients who had finished adjuvant trastuzumab as first planned and 555 patients with hormone receptor positive. Median follow-up period for all patients was 70.7 months (range 12.7-239.6 months). The 10-year IBTR-free survival rate showed a significant benefit for the group treatment with trastuzumab than the group without trastuzumab (97.0% versus 91.9%; p=0.007). In a multivariate analysis, presence of lymphovascular invasion (Hazard ratio [HR], 2.53; 95% Confidence interval [CI], 1.19 - 5.41), closed or involved resection margin (HR, 2.62; 95% CI, 1.20 - 5.74), positive hormone receptor (HR, 3.70; 95% CI, 1.69 - 8.08), positive axillar lymph node (HR, 5.21; 95% CI, 1.75 - 15.57), and omitted or uncompleted adjuvant trastuzumab (HR, 2.72; 95% CI, 1.11 - 6.67) were independent predictors of IBTR. However, subgroup analysis of the patients with hormone receptor negative tumor showed no benefit of adjuvant trastuzumab (98.1% versus 96.6%, p=0.669) while it controlled IBTR for hormone receptor positive tumor (95.7% versus 86.2%; p=0.002). When additionally analzyed, trastuzumab showed benefit for 10-year locoregional recurrence-free survival (95.5% versus 89.7%, p=0.012) and distant metastasis-free survival (93.5% versus 77.8%, p&lt;0.001).
Conclusions: Trastuzumab has a clinical benefit in not only locoregional recurrence but also IBTR among HER2-overexpression breast cancer, especially with negative hormone receptor.
Citation Format: Jong Ho Cheun, Han-Byoel Lee, Hyeong-Gon Moon, Dong-Young Noh, Wonshink Han. Impact of trastuzumab on Ipsilateral breast tumor recurrence after breast conserving surgery [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 PS10-13.
Abstract PS10-58: Cost effectiveness of routine cardiac imaging during adjuvant trastuzumab in HER2-positive breast cancer
Authors: Tatineni Vineeth , Redle Daniel , Singh Daljeet , Abid Arifa , Mahesh Sameer 
Published: February 2021

Abstract
Background: Guidelines recommend patients treated with trastuzumab (TRA) undergo a multiple gated-acquisition (MUGA) scan or echocardiogram (ECHO) at baseline and every 3 months thereafter. In this retrospective study, we evaluated the incidence of clinically significant cardiotoxicity and analyzed cost effectiveness of routine cardiac imaging during adjuvant TRA.
Methods: HER2-positive breast cancer patients treated with adjuvant TRA between 2015 and 2019 were investigated. Information regarding comorbidities, clinical diagnosis of cardiotoxicity, and alterations in therapy were collected. ECHO and MUGA scans were reviewed to monitor trends in ejection fractions (EF). Data was analyzed via the FREQ procedure. We defined clinically significant cardiotoxicity as holding or discontinuing TRA regimen.
Results: We found 108 patients. Median age was 57 years (interquartile range (IQR) of 47-68 years); 86% Caucasian and 12% African American. 3% had preexisting heart failure, 43% hypertension, 14% diabetes, 4% coronary artery diseases, 32% hyperlipidemia, 2% chronic kidney disease, 6% stroke, and 38% were smokers. No patients received anthracycline containing regimens. 30 patients (27.7%) had EF drop &gt;10% from baseline. Six patients (5.5%) were identified with clinically significant cardiotoxicity; 4 (3.7%) had EF &lt; 50% and 3 of those 4 were symptomatic (2.7% of total). Median time from initiation to decline in EF &gt; 10% was 6 months (IQR of 4.5-7.5 months).
Conclusions: Current practice for TRA cardiotoxicity monitoring consists of cardiac imaging every 3 months. The average cost for a MUGA scan and ECHO is approximately $3700 and $2500, respectively. We determined that clinically significant cardiotoxicity, occurred in 5.5% of the patients approximately 6 months into treatment. With TRA causing reversible cardiotoxicity and 2.7% of the patients being symptomatic, cardiac imaging every 3 months appears excessive, especially in patients without comorbidities. Baseline cardiac imaging with repeat assessment in 6 months appears sufficient in non-anthracycline containing regimen. This strategy allows cost savings of approximately $6000 per patient.
Characteristics of patients with clinical cardiotoxicityClinically Significant Cardiotoxicity (N=6)StageChemotherapy RegimenHeart Failure SymptomsEF drop below 50%Initiation to Drop in EF &gt;10% (months)Discontinuation to Recovery in EF (months)1IIBTCHPNoNo3.21.12IATCHPYesYes6.12.83IIATCHNoNo9.31.34IBTCHYesYes6.54.85IIATHYesYes6.12.66IIATCHPNoYes6.31.2
Citation Format: Vineeth Tatineni, Daniel Redle, Daljeet Singh, Arifa Abid, Sameer Mahesh. Cost effectiveness of routine cardiac imaging during adjuvant trastuzumab in 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 PS10-58.
Abstract PS11-34: Time to completion of breast cancer treatment and survival
Authors: Pratt Debra Ann , Burneikis Talia , Tu Chao , Grobmyer Stephen R. 
Published: February 2021

Abstract
Background:Modern breast cancer (BC) treatment involves the use of multimodality therapy. Treatment delays are common and can be multifactorial. There are few studies examining the association between the duration of the time from diagnosis to completion of all acute BC treatment modalities and survival. This study is designed to determine if there is an association between time to complete treatment and survival. Study Design:A retrospective analysis was performed using data from The National Cancer Database (NCDB) to determine whether an association exists between the duration of time from diagnosis to completing all acute BC treatment (surgery, chemotherapy and radiation therapy) and survival. A second analysis was performed to determine if the association between treatment duration and survival varies by receptor status. Results:The NCDB data from BC patients diagnosed in 2010 was analyzed. The inclusion criteria included less than 80 years of age with a single cancer diagnosis, Stage I through III invasive breast cancer who required treatment with surgery, chemotherapy and radiation therapy. A total of 28,284 patients were included in the analysis. Median follow-up was 5.8 years. The order of treatment included 20,772 patients had treatment in the order of surgery, chemotherapy and radiation therapy and 7,512 patients had treatment order chemotherapy, surgery and radiation therapy. A Cox proportional hazards model was developed and identified a cut off showing the risk of delaying completion of all treatment beyond 38 weeks was associated with decrease in overall survival. This was statistically significant with an adjusted hazard Ratio of 1.21. This cut off of 38 weeks was found to be significant regardless of receptors type. The statistically significant Hazard ratios for receptor subtypes include: Triple negative (HR: 1.188, 95%CI: 1.06-1.34), ER+PR+Her2- (HR: 1.22, 95%CI: 1.09-1.36), ER-PR-Her2+ (HR: 1.29, 95%CI: 1.004-1.67) and ER+PR+Her2+ (HR: 1.32, 95%CI: 1.01-1.72). The patients with treatment duration greater than 38 weeks were comprised of 4768(63.47%) neo-adjuvant chemotherapy patients and 8191 (39.43%) of the surgery first group. Conclusion: Efforts to improve the efficiency of multimodality BC treatment and reduce treatment delays should be a priority to optimize BC patient outcomes.
Citation Format: Debra Ann Pratt, Talia Burneikis, Chao Tu, Stephen R. Grobmyer. Time to completion of breast cancer treatment and survival [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 PS11-34.
Abstract PS11-40: A novel and highly selective CDK9 inhibitor (D11) suppresses proliferation of triple negative breast cancer cells
Authors: Mustafa Ebtihal 
Published: February 2021

Abstract
Targeted treatment for triple-negative breast cancer (TNBC) remains an elusive clinical challenge. Cyclin-dependent kinase 9 (CDK9) is a transcriptional regulator shown to promote growth of multiple cancers, including TNBC, and represents a potential new therapeutic target. CDK9 increases RNA Polymerase II (RNAPII) activity, which facilitates sustained expression of normally short-lived oncogenic and anti-apoptotic proteins. However, preclinical evaluation of CDK9 as a therapeutic target has been hampered by the poor selectivity of existing CDK9 inhibitors (CDK9i). Herein, we evaluated the preclinical efficacy of a newly developed, highly selective CDK9i (D-11) across a panel of TNBC cell lines: MDA-MB-453, MDA-MB-468, MDA-MB-231 and MFM-223. Cells were treated with increasing concentrations of D-11 and effects on proliferation, apoptosis, cell cycle and expression of known CDK9 substrates were examined. Treatment with D-11 significantly reduced cell proliferation, induced G2/M cell cycle arrest and increased apoptosis in MDA-MB-453 and MDA-MB-468 cell lines (IC50s of 160 and 258 nM, respectively). Cell proliferation was also inhibited by D-11 in MDA-MB-231 and MFM-223 cells, but with IC50s of 400 and 468 nM, respectively, but without inducing apoptosis. Protein expression of known CDK9 targets, including phosphorylated-RNAPII, the proto-oncogene C-MYC, and the anti-apoptotic marker MCL-1, were examined by Western blot using the optimal D-11 dose determined for each cell line. As expected, D-11 suppressed phosphorylation of RNAPII (Ser2) without affecting total RNAPII expression in all cell lines, indicative of targeted CDK9 inhibition. C-MYC and MCL-1, which highly expressed in the TNBC models, were significantly decreased by treatment with D-11. To determine whether D-11 influenced normal breast epithelial cells, breast tissues were collected from women undergoing reduction mammoplasty and cultured ex vivo as explants treated with or without different doses of D-11 for 48h. A high dose of D-11 (2.7µM) elicited a 20% decrease in the proliferative index (Ki67 positivity) of epithelial cells within normal tissue explants but had no effect on their histology. Collectively, these data demonstrate that D-11 effectively inhibits CDK9 in TNBC cell lines, resulting in growth inhibition with non-toxic effects on histologically normal breast tissues.
Citation Format: Ebtihal Mustafa. A novel and highly selective CDK9 inhibitor (D11) suppresses proliferation of triple negative breast cancer cells [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 PS11-40.
Abstract PS13-05: A phase 2 study of oral paclitaxel and encequidar (oPac+E) in the treatment of cutnaeous angiosarcoma: The breast angiosarcoma subgroup
Authors: Ravi Vinod , Wagner Michael , Chen Tom Wei-Wu , Loong Herbert H , Mennel Robert , Yen Cheuh-Chuan , Clack Glen , Cutler David , Kwan Rudolf , CHan Wing=Kai 
Published: February 2021

Abstract
Background Cutaneous angiosarcomas are highly aggressive malignant tumors with poor prognosis. Currently there is no FDA-approved treatment. oPac+E is a combination of oral paclitaxel and a novel oral P-glycoprotein inhibitor, Encequidar. Materials and Methods: This is a phase-2 study evaluating the activity, safety and tolerability of oPac 205mg/m2 + E 12.9 mg once daily for 3 consecutive days weekly for patients with unresectable cutaneous angiosarcoma. Tumour response was evaluated every 6 weeks using RECIST and photography. Results: From Aug-2018 to May-2020, 7 of 26 enrolled patients (pts) had breast cutaneous angiosarcoma. All had previous breast cancer, mastectomy and radiotherapy and/or adjuvant chemotherapy, no prior taxane for angiosacoma and no metastatic disease. Median age was 66 yrs (range 49-76). Best objective response rates were: complete response (CR) 43% (3/7 pts), partial response (PR) 14% (1/7 pts), stable disease (SD) 43% (3/7 pts), progressive disease (PD) 0%. Furthermore, 3 pts (43%) who had inoperable lesions were deemed operable after Oraxol treatment and received curative intent surgical resection. Median progression free survival (PFS) was 17 weeks. oPac+E was generally well tolerated. Grade-3 treatment related adverse events (AEs) occurred in 5 pts: diarrhea=1, fatigue=2, neutropenia =1, dyspnea=1, dehydration=1, pneumonitis=1. Grade-4 AE were neutropenia in 2 pts. Grade-2 paraesthesia=1. All pts fully recovered. Dose reductions were needed in 3 subjects. No patients discontinued treatment due to AEs. To date no patients died. Conclusions: oPac+E may provide an effective oral treatment for radiation-associated breast angiosarcoma, with a high clinical benefit rate (CR + PR+ SD=100%), durable response and enabled resection of unresectable tumors. It is generally well tolerated even in elderly patients; with low incidence of neuropathy. It may allow patients to avoid hospital IV chemotherapy visits and the option of home treatment.
Citation Format: Vinod Ravi, Michael Wagner, Tom Wei-Wu Chen, Herbert H Loong, Robert Mennel, Cheuh-Chuan Yen, Glen Clack, David Cutler, Rudolf Kwan, Wing=Kai CHan. A phase 2 study of oral paclitaxel and encequidar (oPac+E) in the treatment of cutnaeous angiosarcoma: The breast angiosarcoma subgroup [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 PS13-05.