bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes of obese low socioeconomic status women diagnosed with invasive breast cancer.
Authors: Quispe DR , Quispe ME , Runhua S , Amanda SW , Gary BV 
Published: December 2010

Abstract
Abstract #6092
Background: Obesity a possible risk factor for breast cancer development, may along with low socioeconomic status (LSES) influence breast cancer outcomes. Louisiana a state with the second highest level of poverty has an obesity prevalence above 25%. The Feist-Weiller Cancer Center (FWCC) provides oncology care to the majority of LSES patients (pts) in the nothern half of the state. This study examines if there is a difference in clinical outcomes in obese patients with invasive breast cancer treated at FWCC.&#x2028; Methods: The electronic medical records of pts with histologically proven invasive breast cancer diagnosed between 1981-2006 at FWCC were reviewed. Pts with Stage IV breast cancer at diagnosis were excluded. Data on insurance, race, body mass index at diagnosis (BMI), stage, disease free interval (DFI) and survival time was analyzed. National Institutes of Health criteria was used to stratify pts into normal weight (NW)[ BMI &lt;25 kg/m2], overweight (OW) [BMI 25-30 kg/m2], and obese (OB)[BMI &gt;30 kg/m2]. LSES was defined as pts who were either uninsured or received Medicaid assistance. Differences in DFI and Overall survival (OS) were analyzed by BMI.&#x2028; Results: 647 pts were analyzed, 49% were obese and 29% were overweight. 47% were African Americans and 53% were Caucasians. 49% had LSES (22% uninsured and 27% received Medicaid). Obese pts were more likely to be African American (58%; p&lt;0.001), LSES (57%; p=0.003), with Stage III breast cancer at diagnosis (23%; p=0.003) and to develop contralateral breast cancer after the initial diagnosis (10%; p=0.003). One hundred seventy three (27%) pts relapsed (90 obese and 82 non obese) and 74 (11%) deaths occurred (37 obese and 40 non obese). Obese pts had a shorter median DFI (56 months) in comparison with NW and OW pts (67 months and 70 months, respectively) however this difference was not statistically significant (p=0.43). Regarding OS, there were no statistically significant differences between BMI groups. In multivariate analysis using Cox regression model, after adjusting for race, SES, stage at diagnosis, menopausal status, age at diagnosis, smoker status, obesity remains as a none significant predictor of time to relapse. (HR=1.3; p=0.12)&#x2028; Conclusion: Our results suggest that African American race, low socioeconomic status, stage III at diagnosis and contralateral breast cancer occurrence are associated with obesity at diagnosis of invasive breast cancer. In our patient population, obesity did not appear to contribute to increase risk of relapse or shorter OS.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6092.
Who calls the breast care nurses – the rich, the poor or the poorly?.
Authors: Chaudhry A , Massey E , Roe T , Price R , Scarrott S , Chan C 
Published: December 2010

Abstract
Abstract #6094
Introduction: Breast care nurses (BCNs) are valuable members of the team; they provide advice, counselling and act as patients' advocates. We have previously demonstrated the worth of BCNs in our UK centre1 and the high number of calls they receive from patients and family. In this study, we investigate factors that might influence call rates from individual patients. We have examined the effect of patient age, prognosis and social deprivation on demand for this service.&#x2028; Methods: Our BCNs collect prospectively daily call sheets. These sheets include hospital number, age, type of call (phone or face to face), duration of call, purpose of call and outcome. We have examined breast nurse call sheets over a six-month period. The patients' home zip codes were also collected and allocated to the correct electoral ward (small geographical areas with average population of 5500). Using data from the UK National Census in 2000, information on social status was derived from the patients' zip codes and given as the Index of Multiple Deprivation (ID2000). The ID2000 has both an ID2000 score and ID2000 ranking for different electoral wards across England. Low ID2000 scores and high ID2000 rankings correspond to areas of affluence. Prognostic information was derived using the Nottingham Prognostic Index (NPI). The data were analysed by Spearman rank correlation using Statview 5.0 (SAS Inc) software comparing call rate to age, NPI and ID2000 scores & rankings.&#x2028; Results: During a six-month period, 1188 patients contacted the breast cancer nurse specialists in the NHS and private setting. 204 (17.1%) patients contacted their BCN once; 228 (19.1%) twice; 264 (22.2%) three times and 492 (41.4%) of patients called four times or more.&#x2028; Analysis by Spearman rank correlation of number of calls against age (Rho = -0.009, p=0.90), NPI (Rho = 0.068, p=0.40), ID2000 scores (Rho = 0.058, p=0.41) & ID20000 rank (Rho = -0.060, p=0.40) show no evidence of a relationship between age, prognosis or deprivation and the need to access BCNs.&#x2028; Conclusions: The BCNs provide a valuable service to patients with breast cancer. This support continues throughout the individual patient's cancer journey. In Gloucestershire, the need for support appears to be independent of age, prognosis and social status.&#x2028; 1 Counselling women with breast cancer - whose line is it anyway?&#x2028; F G Court, S Scarrott, M Cassidy-Gray, A Thomas, S Vestey, J Bristol, M Ghilchik, H Y Chan&#x2028; Abstract 6045 - SABCS 2007.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6094.
Obesity a significant risk factor for contralateral breast cancer ocurrence.
Authors: Quispe ME , Quispe DR , Shi R , Sun AW , Burton GV 
Published: December 2010

Abstract
Abstract #6097
Background: The health consequences of obesity are significant and it's effect on breast cancer outcomes are now being recognized. Several risk factors for contralateral breast cancer recurrence included age, lobular histology, genetic abnormalities and no prior adjuvant systemic therapy. This study's objective was to define the risk of contralateral breast cancer in obese patients following treatment for primary breast cancer.&#x2028; Methods: The electronic medical records of pts with histologically proven invasive breast cancer diagnosed between 1981 from 2006 were reviewed. Patients with Stage IV at diagnosis were excluded. Intrammamary breast cancer recurrence was defined as a new diagnosis of invasive or in-situ breast cancer at least 6 months after the diagnosis of primary invasive breast cancer, and it was classified as ipsilateral or contralateral breast cancer. Data on insurance, race, body mass index at diagnosis (BMI) and disease free interval (DFI) was analyzed. National Institutes of Health criteria was used to stratify pts as obese (BMI &gt;30 kg/m2). Differences in DFI were analyzed by BMI.&#x2028; Results: Of the 647 pts who were diagnosed with invasive breast cancer, 72 pts (11%) had intrammamary breast cancer recurrence, (28 ipsilateral and 44 contralateral). Pts with contralateral breast cancer in comparison with pts with ipsilateral breast cancer were more likely to be obese at diagnosis (64% vs 25%; p=0.001), to have a higher mean age at diagnosis (51 years vs 46 years; p=0.04) and to have primary breast cancer with ER positive status (67% vs 39%; p=0.05). In univariate analysis, obesity is a significant predictor of contralateral breast cancer. (HR =1.97; p=0.04). In multivariate analysis using Cox regression model, after adjusting for race, menopausal status, stage and SES, age at diagnosis and BMI remain statistically significant predictors for contralateral breast cancer (age at diagnosis: HR=1.09; p=0.006; BMI: HR=4.9; p=0.004).&#x2028; Conclusions: In this relatively small patient group, obesity represent a significant risk factor for contralateral breast cancer occurrence. Additional studies are needed to further define the impact of obesity in breast cancer outcomes.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6097.
Triple-negative breast cancer and obesity in a rural Appalachian population.
Authors: Vona-Davis L , Rose DP , Hazard H , Partin J , Adkins F , Hobbs G 
Published: December 2010

Abstract
Abstract #6099
Background: Our objective was to determine the clinico-pathological features of triple-negative (estrogen, progesterone and HER-2 receptor negative) breast cancer and their relationship to obesity in women drawn from a population with one of the highest obesity rates in the United States.&#x2028; Methods: This retrospective study involved 620 white patients with invasive breast cancer in West Virginia. Hospital tumor registry, charts, and pathology records provided age at diagnosis, tumor histologic type, size, and nodal status, and receptor status. Body mass index (BMI) was calculated and a value of ≥30 considered indicative of obesity.&#x2028; Results: Triple-negative tumors occurred in 117 (18.9%) of the 620 patients, most often in association with invasive ductal carcinomas. Patients with triple-negative tumors were younger than those with other receptor types, 44.5% and 26.7%, respectively, being diagnosed before age 50 years (P = 0.0004). The triple-negative tumors were larger (P = 0.0003), most notably in the younger women, but small tumors (&lt;2.0 cm) were more often accompanied by lymph node metastases. Obesity was present in 49.6% of those with triple-negative tumors, but only 35.8% of those with non-triple-negative tumors (P = 0.0098). Lymph node metastases were more frequently associated with T2 tumors in obese patients (P = 0.032) regardless of their receptor status.&#x2028; Conclusions: Triple-negative breast cancers within a white, socioeconomically-deprived, population occurred in younger women, with later stage at diagnosis, and in association with obesity. The elevated adipokine production which is present in obesity may exert tumor proliferative and angiogenic effects that contribute to an aggressive phenotype.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6099.
Modelling the cost-effectiveness of first, second and third generation polychemotherapy regimens in women with early breast cancer who have differing prognoses.
Authors: Campbell H , Epstein D , Griffin S , Sculpher M , Manca A , Bloomfield D , Yarnold J , Bliss J , Johnson L , Earl H , Poole C , Hiller L , Dunn J , Rea D , Hopwood P , Barrett-Lee P , Ellis P 
Published: December 2010

Abstract
Abstract #6106
Purpose: To use individual patient data from three sequential large UK randomised trials to facilitate an integrated comparison of the cost-effectiveness of three generations of chemotherapy plus a no treatment option. The ABC trial compared CMF versus no chemo (1991 patients), NEAT trial Epirubicin-CMF versus CMF (2391 patients) and TACT FEC-Docetaxel vs FEC or epi-CMF (4162 patients)&#x2028; Methods: The model estimates lifetime costs and Quality-Adjusted Life Years (QALYs). Model inputs include transition probabilities which are estimated from a longitudinal observational study using parametric survival models incorporating characteristics such as number of positive lymph nodes, ER status, grade and tumour size that allow analyses to be conducted for women with differing baseline prognoses. The effects of each chemotherapy regimen on preventing recurrence are taken from the above UK trials and are assumed to be additive on the log scale to facilitate previously untested comparisons. Costs and utility decrements associated with chemotherapy, its toxicity, and type of recurrent disease, are informed from the trial data and published literature. A secondary analysis is performed by basing the effects of each chemotherapy regimen on published meta-analyses based on individual level data that include RCTs conducted in a range of multi-national settings.&#x2028; Results: For a woman aged 50 years with 1 positive node, grade 2 tumour size 2cm, ECMF is expected to be the most cost-effective regimen. However, the cost-effectiveness of the chemotherapy options varies between women with different risk factors. On the basis of the results of the TACT trial, 3rd generation chemotherapy is not cost-effective, but including evidence of the relative risk of recurrence from non-UK trials, particularly those with ER- and HER2+ phenotype, may alter this conclusion.&#x2028; Indicative lifetime costs and QALYs for a woman aged 50 years, with 1 positive node, grade 2 tumor size 2cm, with and without ER+ are shown:&#x2028; &#x2028; &#x2028; &#x2028; Conclusions: Evaluating the cost-effectiveness of chemotherapy regimens in women with early breast cancer who have differing prognoses is feasible using an integrative synthesis and model. Thought does, however, need to be given to how best present cost-effectiveness results when there are differing levels of baseline risk.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6106.
Cost-effectiveness of anastrozole versus tamoxifen as adjuvant therapy in early breast cancer (EBC) – a German health economic analysis.
Authors: Lux MP , Benedict A , Buchholz S , Woeckel A , Harbeck N , Kreienberg R , Kaufmann M , Beckmann MW , Jonat W , Hadji P , Distler W , Raab G , Tesch H , Weyers G , Schneeweiss A , Possinger K 
Published: December 2010

Abstract
Abstract #6109
Background: The non-steroidal aromatase inhibitor (AI) anastrozole is superior to tamoxifen in terms of efficacy and safety in the adjuvant treatment of postmenopausal patients with hormone receptor-positive (HR+) early breast cancer (EBC). The aim of the current study was to evaluate the cost-effectiveness of anastrozole versus tamoxifen from the German health care perspective.&#x2028; Methods: A probabilistic Markov model was developed using data from the published literature and expert opinion to project trial outcomes to 25 years based on a cohort of 1000 postmenopausal women with HR+ EBC. Resource use data and costs were obtained from standard sources and expert opinion. Utility scores for the different heath states were obtained from a patient-based utility study using the standard gamble technique. Results were expressed as incremental cost-effectiveness ratios (ICERs) per quality adjusted life-years (QALYs) gained. Costs and benefits were discounted at 5% annually.&#x2028; Results: Total costs over the 25 year period for anastrozole and tamoxifen were €12,422 and €6,757, respectively. The cost per life year (LY) for anastrozole compared to tamoxifen was €24,822/LY gained. The ICER of anastrozole compared to tamoxifen was €21,050/QALY gained (95% CI €9,841 - €62,344). The result remained robust to all parameters tested in the sensitivity analysis. Cost-effectiveness probability curves indicated a &gt;90% probability that the cost per QALY gained with anastrozole would be &lt;€42,000.&#x2028; Conclusions: In this model, five years of adjuvant anastrozole is a cost-effective treatment alternative to tamoxifen in postmenopausal women with HR+ EBC from the German health care perspective.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6109.
High-dose chemotherapy with autologous stem-cell support versus standard-dose chemotherapy: meta-analysis of individual patient data from 6 randomized metastatic breast cancer trials.
Authors: Berry DA , Ueno NT , Johnson MM , Lei X , Smith DA , Caputo J , Yancey LJ , Bregni M , Demirer T 
Published: December 2010

Abstract
Abstract #6113
Background: The role of high-dose chemotherapy (HDC) with autologous hematopoietic stem-cell transplantation for metastatic breast cancer has not been well defined. The statistical power of the available trials has limited precision for determining whether HDC has any benefit for this indication, or for any subset of patients.&#x2028; Methods: Individual patient data from the 6 known randomized trials were merged into a single database. The primary endpoint was overall survival (OS): time from randomization to death. The secondary endpoint was progression-free survival (PFS). Cox proportional hazards regression compared the effect of HDC vs standard-dose chemotherapy (SDC) on PFS and OS adjusted for age, trial and hormone receptor (HmR) status (positive if either estrogen (ER) or progesterone (PgR) receptor positive), and other variables. Among the subset analyses considered were by age, HmR status, number metastatic sites, and soft tissue metastases.&#x2028; Results: A total of 846 patients (433 HDC, 413 SDC) had median follow-up of 1.9 years. Median age was 47 years (range 23 to 65). Preliminary analyses show that after adjusting for age and trial, HDC significantly prolonged OS (hazard ratio (HR) 0.86; 95%CI 0.73-1.00; p=0.05) and PFS (HR 0.73; 95%CI 0.63-0.84; p&lt;0.0001). Mean improvement (out to 8 yrs) was 4 months for both OS and PFS. Both age (p=0.023) and soft tissue disease (p=0.0025) had statistically significant interactions with treatment for OS, but neither remain significant after adjusting for multiple comparisons.&#x2028; Conclusions: HDC may have a modest benefit on OS that may be greater in patients younger than 50 years. However, we were not able to draw firm conclusions about age or other subset analyses.&#x2028; &#x2028;
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6113.
Ixabepilone plus capecitabine improves overall survival in symptomatic patients with metastatic breast cancer previously treated with anthracycline and taxane in 2 large phase III studies.
Authors: Conte P , Roche H , Perez E , Sparano J , Xu B , Jassem J , Peck R , Mukhopadhyay P , Hortobagyi G 
Published: December 2010

Abstract
Abstract #6114
Introduction:&#x2028; Symptomatic patients (pts) with performance status (KPS) 70-80 with locally advanced or metastatic breast cancer (MBC) have worse prognosis than pts with good performance status and are often excluded from clinical trials. Ixabepilone (ixa), the first in a new class of antineoplastic agents, showed clinical benefit in 2 large clinical trials in combination with capecitabine (C) in MBC pts with tumors resistant to (study 046; JCO; 2007) or pretreated with anthracycline (A) and taxane (T) (study 048). In 048, ixa + C, compared to C alone, showed significant increases in PFS (HR 0.79 [0.69-0.90] and ORR (43% vs 29%). A trend toward increased OS was seen in 048 (HR 0.90 [0.78-1.03]) and 046 (HR 0.90 [0.77-1.05]) which did not reach statistical significance. In 046 and 048 trials, a survival benefit was seen with ixa + C in a predefined analysis in a subset of symptomatic KPS 70-80 pts (HR: 0.75 [0.58-0.98], 0.76 [0.60-0.96], respectively). We present a predefined pooled analysis of clinical outcomes in symptomatic pts from both studies to better evaluate the treatment effect in this subset.&#x2028; Methods:&#x2028; 1973 pts with MBC previously treated with an A and T were randomized in phase III trials 046 and 048 to receive ixa (40mg/m2 IV over 3h Q3w) + C (1000mg/m2 PO BID x14d Q3w) or C alone (1250mg/m2 PO BID x14d Q3w). 606 pts from the 2 studies were KPS 70-80. Study outcomes included ORR, PFS and OS.&#x2028; Results:&#x2028; ORR, PFS and OS favored ixa + C in this pt population.&#x2028; &#x2028; In asymptomatic pts (KPS 90-100), similar improvement was observed in PFS and ORR; no benefit in OS was seen. Incidence of key treatment related grade 3/4 AEs for ixa + C in this subset of pts was similar to the overall population.&#x2028; Conclusions:&#x2028; In the pooled analysis, ixa + C demonstrates a survival benefit (2.8 mo) for symptomatic pts (KPS 70-80) failing A and T, which was consistently seen in this pt population in the individual studies as well, indicating that symptomatic pts can benefit from management of their disease and achieve overall clinical benefit with ixa combination.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6114.
A novel capecitabine dosing schedule combined with bevacizumab is safe and active in patients with metastatic breast cancer: a phase II study.
Authors: Traina TA , Theodoulou M , Dugan U , Feigin K , Patil S , Geneus S , Godfrey L , Norton L , Hudis C 
Published: December 2010

Abstract
Abstract #6121
Background&#x2028; Capecitabine (Xeloda®,C) has activity in breast cancer when dosed for 14 days (d) followed by a 7d rest (14 - 7). Using mathematical methods, we predict the optimal dosing schedule of C to be 7d followed by a 7d rest (7 - 7) (Norton et al, AACR 2005). Xenograft studies show this schedule improves tolerability and survival. The MTD of C(7 - 7) is higher than that for conventional dosing (Traina et al, JCO 2008). Bevacizumab (B), an anti-VEGF antibody, improves response when added to capecitabine in pts previously treated for metastatic disease (Miller et al, JCO) and improves PFS when added to taxanes in the 1st-line treatment of advanced disease (Miller et al, NEJM 2007; Miles ASCO 2008). B + conventionally-dosed capecitabine modestly increased TTP when used as 1st-line therapy (Sledge, ASCO 2007). This study tests C(7 - 7) with bevacizumab (B) in a Phase II trial.&#x2028; Methods&#x2028; Eligible patients (pts) have measurable, metastatic breast cancer (MBC), ECOG performance status (PS) ≤2 and normal organ function. Any number of prior chemotherapy (CRx) regimens is permitted. Pts with prior fluoropyrimidine or bevacizumab are excluded. Therapy (tx) consists of C (2,000mg BID, 7 - 7) and B (10mg/kg IV q2 weeks(wk)). Pts are evaluated for toxicity q2wk and for response q12wk. Cycle length: 4 wks. Primary endpoint: response rate (RR). Secondary endpoints: clinical benefit, TTP, PFS, toxicity. Using a mini-max, two-stage design, up to 40 patients will be enrolled. If &gt;6/40 pts respond, then C(7 - 7) + B will be considered worthy of further study. If &gt;11 pts experience Grade 3/4 capecitabine-related toxicity the trial will be stopped.&#x2028; Results&#x2028; Twenty-seven pts are enrolled. Median (med) age 57 yrs (29-71), med ECOG performance status 0 (0-2), ER/PR(+) 13, HER2(+) 1, sites of MBC: bone(13), liver/lung(13), soft tissue(12). Prior tx: Adjuvant: CRx (20), hormone tx (14); MBC: CRx (2), hormone tx (16). 27 pts are evaluable for toxicity. After a med of 6 (1-12) cycles: Twenty-three pts evaluable for response: PR=7 (confirmed=5), stable disease (SD) &gt;6 mo =6, SD&lt;6 mo=7, PD=3.Tx-related toxicity (# Gr 3/Gr 2): hand foot syndrome (HFS) (6/9); diarrhea (0/1); hypertension (2/1), proteinuria (0/0). 1 pt had grade 4 pulmonary embolism requiring discontinuation of B. Conclusions&#x2028; Combination capecitabine (7 - 7) and bevacizumab appears well tolerated and active. Additional safety and efficacy data is anticipated prior to this meeting. Supported in part by Roche and Genentech.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6121.