bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract S4-7: Compliance with Mammographic Screening Guidelines from an Administrative Claims Database
Authors: Subar M , Lust SA , Lin W 
Published: April 2011

Abstract
BACKGROUND: Guidelines for breast cancer screening using mammography vary in terms of monitoring frequency and age at which screening should be performed. In November 2009, the US Preventive Services Task Force (USPSTF) modified their recommendations for women at average risk for breast cancer, now supporting first mammographic screening at age 50, with repeat mammograms every two years. The American Cancer Society and the Mayo Clinic continue to support yearly mammograms beginning at age 40. In two separate surveys performed after the USPSTF recommendations became public, 71% and 84% of women indicated an intention to undergo or continue mammographic testing during their 40's (Annals of Internal Medicine 2010; 152:531-532; USA Today 11/24/2009), but few studies have looked at actual screening frequency among women of different age groups. This study was performed to determine current pattern of testing as derived from an administrative medical claims database. METHOD: De-identified medical claims were reviewed from a 12-million member medical claims database at Medco Health Solutions, Inc. Claims for mammography for women 40 years of age and older eligible from January 2006 through December 2009 were reviewed. All women through age 64 had employer or health-plan based insurance coverage. Those 65 and older were covered through either an employer based retiree plan, or Medicare. Testing within each calendar year is reported. Annual testing was determined for women continuously eligible over the 4-year period. RESULTS: Among women 40-85 years old in any given year, 41-50% had a medical claim for a mammogram. Over the 4-year study (2006-2009), mean annual mammography rates were 41% (40-49 years old), 50.0% (50-64 years old), and 44% (65-85 years old). The percentage of women who were continuously eligible over the 4-year study period with any mammogram and with 1, 2, 3, or 4 or more mammograms over the 4-year study period are shown in the table below.
CONCLUSIONS: Although surveys indicate that over 70% of women support mammographic screening between ages 40-49, these data suggest that even among an insured population, many women do not have claims evidence of even one mammogram in 4 years and almost half of women do not receive biannual or more frequent mammography. These data also indicate that additional efforts are needed to reach the HealthyPeople 2010 goal of at least 70% of women aged 40 years or older having a mammogram in the past two years.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S4-7.
Abstract S4-9: Comparing the Prediction of Chemotherapy Benefit in Patients with Node-Negative, ER-Positive Breast Cancer Using the Recurrence Score and a New Measure That Integrates Clinical and Pathologic Factors with the Recurrence Score
Authors: Tang G , Costantino JP , Crager M , Shak S , Wolmark N. 
Published: April 2011

Abstract
Background: The 21-gene Oncotype DX® Recurrence Score® (RS) is widely used for assessment of recurrence risk and prediction of chemotherapy benefit in patients with early stage ER-positive breast cancer. Through a meta-analysis on the NSABP B-14 study and the ATAC study, the Recurrence Score-Pathology-Clinical (RSPC) risk assessment has been developed as an integration of RS and clinico-pathologic factors (including tumor size, tumor grade and age) for assessment of recurrence risk in early stage ER-positive, node-negative breast cancer. The value of RSPC in prediction of chemotherapy benefit needs to be evaluated. Methods: In the NSABP trial B-20, patients were node-negative and ERpositive by the ligand binding assay, and were randomized to tamoxifen with or without adjuvant chemotherapy (MF or CMF). B-20 patients who had successful Oncotype DX RS assay and ER score ≥6.5 were included in this study. Cox proportional hazards models with interaction terms were used to evaluate RS and RSPC in prediction of chemotherapy benefit in reducing risk of distant recurrence.
Results: The analysis included 625 patients among whom 60 distant recurrence events occurred. RS showed a significant interaction with chemotherapy treatment (p=0.037), as found previously, with a standardized hazard ratio (HR) of 0.836. The interaction of RSPC with treatment was not significant (p=0.10), although the trend was in the same direction as RS (standardized HR 0.833).
Conclusions: RS used alone remains the best predictor of chemotherapy benefit in ER-positive, node-negative breast cancer.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S4-9.
Abstract S5-1: Prospective Outcomes for Patients with Micro-Metastases and Macro-Metastases In Sentinel Nodes: NSABP B-32 Sentinel Node Trial
Authors: Julian TB , Anderson SJ , Golesorkhi N , Fourchotte V , Mamounas EP , Wolmark N. 
Published: April 2011

Abstract
Background: Sentinel node biopsy (SNB) allows for a more detailed analysis of axillary nodes, increasing the detection of nodal metastatic disease. Prospective outcome results related to patients with micro-and macro-metastases in sentinel nodes from the NSABP B-32 trial are presented here.
Methods: After stratification, women with operable invasive breast cancer and clinically negative nodes were randomly assigned to sentinel node resection (SNR) with immediate conventional axillary dissection (AD) [Group 1] or to SNR without AD [Group 2]. Group 2 patients with positive SNs underwent AD. Sentinel nodes underwent analysis by hematoxylin and eosin. Systemic therapy was at the discretion of the physician. Regional nodal irradiation for node positive lumpectomy patients and chest wall/regional node irradiation for node positive mastectomy patients was permitted. Univariate and multivariate analyses were carried out via Cox PH models to identify predictors of overall survival (OS) and disease-free survival (DFS).
Results: From May 1999 through February 2004, 5,611 patients were entered into NSABP B-32. A total 1,390 patients with positive SN were identified; 1,389 of these patients had follow-up data. There were 422 patients with macro-metastases (&gt;2mm), 312 with micro-metastases (&gt;0.2, ≥2.0mm), and 626 with unknown status. Median time in study was 94 months. 97% of SN-positive patients received systemic adjuvant therapy. Significant univariate predictors of OS and DFS were age, receptor status, clinical tumor size, histologic grade, number of positive SNs, SN metastasis size, number of positive nodes, lymphovascular invasion, and systemic therapy. Multivariate analysis identified histologic grade (HR: 2.30, P&lt;0.0001), SN macrometastasis (HR: 2.44, p=0.0003), systemic therapy (HR: 0.22, P&lt;0.0001), age, and clinical tumor size (CTS) as significant predictors of OS (Table 1) with similar predictors for DFS. For DFS, a significant quadratic effect due to age (p=0.015) was observed where younger and older women had higher risk of having an event than did middle aged women.
Conclusion: The most striking factors associated with poor OS and DFS were poor histologic tumor grade and macro-versus micro-SN metastases. Patients with micro-or macro-SN metastases who received systemic therapy had a 78% reduction in mortality and a 76% improvement of DFS.
Supported by: NCI U10-CA-69651, -12027, -37377, -69974.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S5-1.
Abstract S5-5: Identification of a Clinically Relevant Gene Signature in Triple Negative and Basal-Like Breast Cancer
Authors: Rody A , Karn T , Liedtke C , Pusztai L , Ruckhäberle E , Hanker L , Gaetje R , Solbach C , Ahr A , Metzler D , Schmidt M , Müller V , Holtrich U , Kaufmann M. 
Published: April 2011

Abstract
Background: Gene expression profiles in breast cancer mainly reflect ER, PgR, HER2 status, and proliferation. Triple negative breast cancers (TNBC) seem to constitute a heterogenous entity and their relationship to basal-like breast cancers (BLBC) is not fully clear. Further understanding of TNBC is important since new treatments are needed.
Materials and Methods: We assembled an Affymetrix dataset of n=579 TNBC (finding cohort n=394, validation cohort n=185). Unsupervised methods identified principal metagenes differing among TNBC in this clean cohort. Clinical data were correlated to these metagenes for the basal-like and apocrine phenotypes, different types of immune cells, the claudin-CD24 signature, markers of blood and adipocytes, as well as signatures for stroma, angiogenesis, and inflammation.
Results: 73% of TNBC displayed a basal-like phenotype correlating with poor histological grading and younger age. However, no effect of basal-like phenotype on survival was observed. A good prognosis was obtained for expression of immune cell metagenes and a poor prognosis was associated with metagenes for inflammation, angiogenesis and stromal cells. A combination of high B-cell metagene and low IL-8 metagene expression identified 27% of TNBC with a favourable prognosis (HR 0.25, 95% CI 0.12-0.48; P&lt;0.001) and remained the only significant factor in multivariate analysis with standard parameters.
Conclusion: All published prognostic signatures assign TNBC to a poor prognosis group. Use of a subtype-specific dataset not confounded by the main variables of breast cancer allowed the identification of a novel prognostic signature for TNBC. Targeting the IL-8 pathway could be a valuable therapeutic opportunity in TNBC.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S5-5.
Abstract S6-3: Four vs 6 Cycles of Doxorubicin and Cyclophosphamide (AC) or Paclitaxel (T) as Adjuvant Therapy for Breast Cancer in Women with 0-3 Positive Axillary Nodes: CALGB 40101 — A 2x2 Factorial Phase III Trial: First Results Comparing 4 vs 6 Cycles of Therapy
Authors: Shulman LN , Cirrincione C , Berry DA , Becker HP , Perez E , O'Regan R , Martino S , Atkins JN , Hudis C , Winer E 
Published: April 2011

Abstract
Background: Four cycles of chemotherapy are frequently used as standard adjuvant chemotherapy for patients with low-risk primary breast cancer, though other regimens such as CAF, CMF, and TAC frequently are given for 6 cycles. Using a phase 3 factorial design we attempted to define whether 6 cycles of one chemotherapy regimen are superior to 4 cycles in patients with low-risk primary breast cancer. We also sought to determine if T would be equally efficacious as compared to AC, with reduced toxicity. Methods: The study enrolled women with operable breast cancer and 0-3 positive nodes. Study stratifiers were ER/PgR, HER2, and menopausal status. When the study was activated in May 2002, AC (60 and 600 mg/m2) was administered every 3 wks for 4 or 6 cycles, and T (80mg/m2) weekly for 12 or 18 wks. In 2003 (after 570 enrolled patients) treatment schedule was changed to every 2 wks for both AC and T (175 mg/m2), each given for 4 or 6 cycles. In 2008 accrual to the 6-cycle regimens was permanently closed due to slow accrual, with 3173 patients enrolled. The primary endpoint for this comparison was the superiority of 6 vs 4 cycles in relapse-free survival (RFS). The study was powered to have 567 RFS events. Data comparing AC with T are not yet available. Results: This report describes the impact of treatment duration and includes the 3173 patients randomized to 6- versus 4-cycles of chemotherapy, 93% of whom had node-negative disease. At a median follow-up of 4.6 years (2.5 - 8 yrs), the number of RFS events is 288 (with 138 on 4 cycles vs 150 on 6 cycles). The 4-yr RFS was 91.6% and 91.8% for 6 and 4 cycles, respectively. The Hazard Ratio of 6 to 4 cycles was 1.10 (95% CI = 0.87-1.39, p=0.42). Four-year OS was 95.3% and 96.4% for 6 and 4 cycles, respectively, with a HR of 6 to 4 cycles of 1.31 (95% CI = 0.95-1.82, p=0.097). Based on the present data the Bayesian predictive probability of concluding superiority of 6 cycles [a primary goal of the study] with 567 RFS events is only 0.001. There was no interaction between the number of cycles and type of chemotherapy, ER/PgR status, or HER2 status. In particular, the effect of number of cycles on RFS and OS was similar for both AC and T.
Conclusions: For women with primary breast cancer and 0-3 positive nodes, we found no evidence that extending chemotherapy from 4 to 6 cycles improves clinical outcome.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S6-3.
Genomic Profiles Specific to Patient Ethnicity in Lung Adenocarcinoma
Authors: Broët Philippe , Dalmasso Cyril , Tan Eng Huat , Alifano Marco , Zhang Shenli , Wu Jeanie , Lee Ming Hui , Régnard Jean-François , Lim Darren , Koong Heng Nung , Agasthian Thirugnanam , Miller Lance D. , Lim Elaine , Camilleri-Broët Sophie , Tan Patrick 
Published: April 2011

AbstractPurpose: East-Asian (EA) patients with non–small-cell lung cancer (NSCLC) are associated with a high proportion of nonsmoking women, epidermal growth factor receptor (EGFR)-activating somatic mutations, and clinical responses to tyrosine kinase inhibitors. We sought to identify novel molecular differences between NSCLCs from EA and Western European (WE) patients.Experimental Design: A total of 226 lung adenocarcinoma samples from EA (n = 90) and WE (n = 136) patients were analyzed for copy number aberrations (CNA) by using a common high-resolution SNP (single nucleotide polymorphism) microarray platform. Univariate and multivariate analyses were carried out to identify CNAs specifically related to smoking history, EGFR mutation status, and ethnicity.Results: The overall genomic profiles of adenocarcinomas from EA and WE patients were highly similar. Univariate analyses revealed several CNAs significantly associated with ethnicity, EGFR mutation, and smoking, but not to gender, and KRAS or p53 mutations. A multivariate model identified four ethnic-specific recurrent CNAs—significantly higher rates of copy number gain were observed on 16p13.13 and 16p13.11 in EA tumors, whereas higher rates of genomic loss on 19p13.3 and 19p13.11 were observed in tumors from WE patients. We identified several potential driver genes in these regions, showing a positive correlation between cis-localized copy number changes and transcriptomic changes.Conclusion: 16p copy number gains (EA) and 19p losses (WE) are ethnic-specific chromosomal aberrations in lung adenocarcinoma. Patient ethnicity should be considered when evaluating future NSCLC therapies targeting genes located on these areas. Clin Cancer Res; 17(11); 3542–50. ©2011 AACR.
Pentostatin Plus Cyclophosphamide Safely and Effectively Prevents Immunotoxin Immunogenicity in Murine Hosts
Authors: Mossoba Miriam E. , Onda Masanori , Taylor Justin , Massey Paul R. , Treadwell Shirin , Sharon Elad , Hassan Raffit , Pastan Ira , Fowler Daniel H. 
Published: April 2011

Abstract
Purpose: The success of immunotoxin therapy of cancer is limited by host production of neutralizing antibodies, which are directed toward the Pseudomonas exotoxin A (PE) component. In this proof-of-principle study using a well-established murine model, we hypothesized that a newly developed immune depletion regimen consisting of pentostatin plus cyclophosphamide would abrogate anti-immunotoxin reactivity.
Experimental Design: BALB/c hosts were injected weekly with recombinant immunotoxin (RIT) SS1P, which is an antimesothelin Fv antibody fragment genetically fused to a 38 kDa portion of PE, and has been evaluated in clinical trials. Experimental cohorts received induction chemotherapy consisting of pentostatin (P) plus cyclophosphamide (C) prior to initial RIT exposure; some cohorts received further maintenance PC therapy of varying intensity just prior to each weekly RIT challenge. Cohorts were monitored for T, B, myeloid cell depletion, and for total anti-SS1P antibody (Ab) formation.
Results: Controls uniformly developed anti-SS1P Ab after the third RIT exposure. Induction PC therapy reduced the frequency of hosts with anti-SS1P Ab. Abrogation of antibody generation was improved by maintenance PC therapy: nearly 100% of recipients of intensive PC maintenance were free of anti-SS1P Ab after 9 weekly RIT doses. The most effective PC regimen yielded the greatest degree of host B-cell depletion, moderate T-cell depletion, and minimal myeloid cell depletion.
Conclusions: Induction and maintenance PC chemotherapy safely prevented anti-immunotoxin antibody formation with uniform efficacy. These data suggest that immunotoxin therapy might be used in combination with pentostatin plus cyclophosphamide chemotherapy to improve the targeted therapy of cancer. Clin Cancer Res; 17(11); 3697–705. ©2011 AACR.
Pharmacologic Inhibition of ALK5 Causes Selective Induction of Terminal Differentiation in Mouse Keratinocytes Expressing Oncogenic HRAS
Authors: Markell Lauren Mordasky , Masiuk Katelyn E. , Blazanin Nicholas , Glick Adam B. 
Published: April 2011

Abstract
TGFβ has both tumor suppressive and oncogenic roles in cancer development. We previously showed that SB431542 (SB), a small molecule inhibitor of the TGFβ type I receptor (ALK5) kinase, suppressed benign epidermal tumor formation but enhanced malignant conversion. Here, we show that SB treatment of primary K5rTA/tetORASV12G bitransgenic keratinocytes did not alter HRASV12G-induced keratinocyte hyperproliferation. However, continuous SB treatment significantly enhanced HRASV12G-induced cornified envelope formation and cell death linked to increased expression of enzymes transglutaminase (TGM) 1 and TGM3 and constituents of the cornified envelope small proline-rich protein (SPR) 1A and SPR2H. In contrast, TGFβ1 suppressed cornified envelope formation in HRASV12G keratinocytes. Similar results were obtained in HRASV12G transgenic mice treated topically with SB or by coexpressing TGFβ1 and HRASV12G in the epidermis. Despite significant cell death, SB-resistant HRASV12G keratinocytes repopulated the primary culture that had overcome HRas-induced senescence. These cells expressed reduced levels of p16ink4a and were growth stimulated by SB but remained sensitive to a calcium-induced growth arrest. Together these results suggest that differential responsiveness to cornification may represent a mechanism by which pharmacologic blockade of TGFβ signaling can inhibit the outgrowth of preneoplastic lesions but may cause a more progressed phenotype in a separate keratinocyte population. Mol Cancer Res; 9(6); 746–56. ©2011 AACR.
Balloon Angioplasty and Stenting of Branch Pulmonary Arteries
Authors: Holzer Ralf J. , Gauvreau Kimberlee , Kreutzer Jacqueline , Leahy Ryan , Murphy Joshua , Lock James E. , Cheatham John P. , Bergersen Lisa 
Published: April 2011

Background—
Pulmonary artery (PA) balloon angioplasty and/or stenting (PA rehabilitation) is one of the most common procedures performed in the cardiac catheterization laboratory, but comprehensive and consistently reported data on procedure-related adverse events (AE) are scarce.

Methods and Results—
Data were prospectively collected using a multicenter registry (Congenital Cardiac Catheterization Project on Outcomes). All cases that included balloon angioplasty and/or stent implantation in a proximal or lobar PA position were included. Multivariate analysis was used to evaluate for independent predictors of AE and need for early reintervention. Between February 2007 and December 2009, 8 institutions submitted details on 1315 procedures with a PA intervention. An AE was documented in 22% with a high severity (level 3 to 5) AE in 10% of cases. Types of AE included vascular/cardiac trauma (19%), technical AE (15%), arrhythmias (15%), hemodynamic AE (14%), bleeding via endotracheal tube/reperfusion injury (12%), and other AE (24%). AE were classified as not preventable in 50%, possibly preventable in 41%, and preventable in 9%. By multivariate analysis, independent risk factors for level 3 to 5 AE were presence of ≥2 indicators of hemodynamic vulnerability, age below 1 month, use of cutting balloons, and operator experience of <10 years. Reintervention during the study period occurred in 22% of patients undergoing PA rehabilitation.

Conclusions—
PA rehabilitation is associated with a 10% incidence of high-level severity AE. Hemodynamic vulnerability, young age, use of cutting balloons, and lower operator experience were significant independent risk factors for procedure-related AE.
One-Year Clinical Outcome of Interventionalist- Versus Patient-Transfer Strategies for Primary Percutaneous Coronary Intervention in Patients With Acute ST-Segment Elevation Myocardial Infarction
Authors: Zhang Qi , Zhang Rui Yan , Qiu Jian Ping , Zhang Jun Feng , Wang Xiao Long , Jiang Li , Liao Min Lei , Zhang Jian Sheng , Hu Jian , Yang Zheng Kun , Shen Wei Feng 
Published: April 2011

Background—
Traditional reperfusion options for patients with acute ST-segment elevation myocardial infarction (STEMI) presenting to non-primary percutaneous coronary intervention (PPCI)-capable hospitals generally include onsite fibrinolytics or emergency transfer for PPCI. A third option, involving interventionalist transfer, was examined in the REVERSE-STEMI study.

Methods and Results—

A total of 334 patients with acute STEMI who presented to 5 referral hospitals with angiographic facilities but without interventionalists qualified for PPCI were randomized to receive PPCI with either an interventionalist- (n=165) or a patient-transfer (n=169) strategy. The primary end point of door-to-balloon (D2B) time and secondary end points of left ventricular ejection fraction and major adverse cardiac events (MACE) at 1-year clinical follow-up were compared between the 2 groups. Compared with the patient-transfer strategy, the interventionalist-transfer strategy resulted in a significantly shortened D2B time (median, 92 minutes versus 141 minutes;
P
<0.0001), with more patients having first balloon angioplasty within 90 minutes (21.2% versus 7.7%,
P
<0.001). This treatment strategy also was associated with higher left ventricular ejection fraction (0.60±0.07 versus 0.57±0.09,
P
<0.001) and improved 1-year MACE-free survival (84.8% versus 74.6%,
P
=0.019). Multivariate Cox proportional hazards modeling revealed that the interventionalist-transfer strategy was an independent factor for reduced risk of composite MACE (hazard ratio, 0.63; 95% CI, 0.45 to 0.88;
P
=0.003).

Conclusions—
The interventionalist-transfer strategy for PPCI may be effective in improving the care of patients with STEMI presenting to a non-PPCI-capable hospital, particularly in a congested cosmopolitan region where patient transfers could be prolonged.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00713557.