bluuebunny/crossref_metadata_2025_split huggingface dataset:
P5-14-10: Ethnic Differences in the Association between Tumor Size and Lymph Node Status among Breast Cancer Patients in South East Asia.
Authors: Saxena N , Verkooijen HM , Bhoo Pathy N , Siew EL , Iau P , Lee SC , Yip CH , Hartman M 
Published: June 2012

Abstract
Background: South East Asia consists of three major ethnic groups, i.e. Chinese, Malays and Indians. Previous work from our breast cancer research group showed that Malay ethnicity is an independent predictor of poor survival. In this study we evaluate whether (part of) these ethnic survival disparities may be due to ethnic differences in the association of tumor size and lymph node involvement.
Methods: We included all patients diagnosed with breast cancer at the National University Hospital (Singapore) and University of Malaya Medical Center (Kuala Lumpur) between 1990 and 2007, for whom information on tumor size and axillary lymph node status was available (n = 3805). Ethnic differences in the association between tumor size and lymph node involvement were studied and logistic regression analysis was performed to determine the independent effect of ethnicity on the association of tumor size and lymph node involvement.
Results: 1474 patients were categorized as T1 (&gt;0 to 2 cm), 1777 as T2 (2.1 to 5 cm) and 554 as T3 (&gt;5 cm). Within the small tumor size range (&gt;0 to 2 cm) the Malays were significantly more likely to present with node positive disease as compared to the other ethnic groups (36.9% as compared to 24.5% for Chinese and 25.9% for Indians, p value &lt;0.001). Similarly, for tumors measuring 2.1-5 cm, Malays were more likely than Chinese and Indians to have lymph node involvement (59.5%, 50.2% and 52.1%, respectively p value 0.016). After adjustment for age, Progesterone Receptor (PR) status, grade and treatment received, Malay ethnicity was an independent predictor of lymph node involvement, with adjusted Odds Ratio's of 1.4 (95% CI 1.0 to 2.1) for T1 tumors and 1.4 (95% CI 1.1 to 1.9) for T2 tumors compared to Chinese women.
Conclusion: Malay patients are more likely to present with lymph node metastasis especially for the small and midsized tumors as compared to the Chinese and Indians. This could reflect differences in tumor biology between the three ethnic groups with the Malays possibly having more aggressive disease than the others.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-14-10.
P5-14-17: Stage IV at Presentation – Are HER2 Positive Tumors Overrepresented?
Authors: Woods R , Yerushalmi R , Speers C , Tydesley S , Gelmon K 
Published: June 2012

Abstract
Background: A minority of patients are diagnosed with Stage IV breast cancer at presentation. Recent studies (Dawood 2010) have suggested a better outcome for de novo vs. recurrent Stage IV but they did not account for the variation of molecular subtype. We questioned whether HER2 overexpressing tumors were over-represented in de novo Stage IV disease, and whether this impacted on survival compared to other subtypes. Further, if different subtypes are more likely to present with metastatic disease, then this factor may need to be considered when developing guidelines for staging. With such considerations in mind, the purpose of this study was to determine the breast cancer subtypes according to stage. The main hypothesis was that HER2 positive tumors would be more prevalent in stage IV presentations. Methods: Using the Breast Cancer Outcomes Unit database from the BC Cancer Agency (BCCA), patients referred to the BCCA with a new diagnosis of breast cancer between 2005 and 2010 were selected. Patients with a previous or synchronous contralateral breast cancer, male cases, and patients with referrals for reasons other than new disease were excluded. Four subtypes according to available markers were defined: ER+/HER2−, ER+/HER2+, ER-/HER2+, and ER-/HER2−.
Results: Using these criteria, 485 cases of de novo stage IV disease and 10,723 stages I — III cases were extracted. After excluding cases with missing data, our final cohort consisted of 10,186 stage I-III cases and 425 stage IV cases. Distribution by subtype is presented in the Table below.

Assessment of other patient characteristics for the group of Stage IV de novo patients revealed that age (younger for HER+ subgroups), site of metastases (more visceral vs. non- visceral for ER-/HER2+ and ER-/HER2−) and type of systemic therapy (chemotherapy (CT), hormone therapy (HT), trastuzumab (T) or not) were significant. Surgery rates for both mastectomy and breast-conserving surgery were similar for all subtypes. The ER-/HER2− subtype had the worst overall survival (p &lt; 0.001).

Conclusion: Young age and HER2 overexpression is more common in stage IV de novo presentations (26.6% of stage IV tumors were HER2+ vs. only 16% of stage I-III tumors). This data may be important in considering routine staging guidelines at diagnosis to ensure correct diagnosis and treatment recommendations.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-14-17.
P5-14-26: Results from a Prospective Clinical Study on the Impact of Oncotype DX on Adjuvant Treatment Decision Making in a Cohort of 142 UK Patients.
Authors: Holt S , Bertelli G , Brinkworth E , Durrani S , Jones S , Khawaja S , Laggner U , Moe M , Pudney D , Pitcher S , Rolles M , Sharaiha Y , Whelan S 
Published: June 2012

Abstract
Objectives: International guidelines support the use of the Oncotype DX derived Recurrence Score (RS) to provide additional prognostic and predictive information in early breast cancer but experience in the UK is limited. In our prospective study we evaluate this test for the NHS and its impact on costs (subject of a separate abstract) and treatment recommendations by UK oncologists.
Methods: 150 tests were made available to consecutive patients with ER+, pN0, pN1itc or pN1mic early breast cancer who had no contraindication to adjuvant chemotherapy (CT) and who would accept CT + hormone therapy (HT) if recommended. CT recommendations of oncologists based on Adjuvant! Online figures were recorded at an initial consultation. Eligible patients were consented to Oncotype DX testing and review arranged once the result was available. After a second consultation a final decision on adjuvant therapy was recorded.
Results: Analysis is based on 142 patients. (150 tests performed, 3 failed to give a result, 3 repeated tests giving a result on the second block, one bilateral and one test stopped because the patient withdrew from the study). Initial treatment recommendations changed in 38 (26.8%) cases. Of the patients initially recommended CT + HT (total 57 patients), 26 (45.6%) patients were spared chemotherapy after review with the RS. Of the 85 patients initially recommended HT only 12 (14.1%) were changed to HT + CT.

Further analysis shows that Grade, estrogen receptor status by immunohistochemistry (ER by IHC) and progesterone receptor by immunohistochemistry (PR by IHC) are correlated to RS but in our cohort age, size and node status were not. (Spearman rank correlation for grade is 0.05, 95%, Cl 0.36 to 0.61; for ER by IHC is −0.36, Cl −0.49 to −0.20; and for PR by IHC is −0.49, 95%, Cl −0.60 to −0.35). Apart from HER2 positive patients who are already recognized to return a high RS, further analysis of our series shows no clear combination of currently available prognostic factors that would predict RS and therefore reliably avoid testing of any subset of patients.
Conclusion: The results of our study suggest that Oncotype DX is applicable and feasible to perform in UK patients with a reduction in the use of adjuvant chemotherapy consistent with findings of reported studies. RS added prognostic information beyond information provided by Adjuvant!
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-14-26.
P5-17-02: Associations between Breast Cancer Patients' Satisfaction with Nursing Staff and Hospital Characteristics, Results of a German Multicenter Study.
Authors: Wuerstlein R , Kowalski C , Diener S , Krebs S , Pfaff H , Harbeck N 
Published: June 2012

Abstract
Background
Only few studies have investigated the association between breast center characteristics such as teaching status, number of patients, whether clinical trials are conducted, or whether breast care nurses are employed and patients’ perceptions of care.
Objective: The aim of the study was to determine whether or not the satisfaction of newly-diagnosed breast cancer patients with nursing staff correlates with hospital characteristics after adjusting for relevant patient characteristics. The study is part of a national process-identifying project focusing on breast cancer of the MAGS NRW (Ministry of work, health and social affairs, North Rhine Westfalia, Germany).
Methods: Multilevel regression analysis was applied combining data from newly-diagnosed breast cancer patients (n= 3733) on patient characteristics and satisfaction with nursing staff and data on characteristics of the hospitals (n= 93 breast centers in Germany) in which patients were treated. Patients’ perspectives were measured for six month using the Cologne Patient Questionnaire for Breast Cancer (CPQ-BC), the other informations and hospital characteristics were collected by medical personnel.
Results: Full data of 2945 patients from 81 hospitals were analysed in the multilevel logistic regression model. The odds for patients being satisfied with nursing staff were significantly higher in hospitals which employed breast care nurses at the time of the survey. At the patient level, patients were significantly more likely to be satisfied with nursing staff if they were native speakers, and with higher self-rated health. Cross-level interaction analysis suggested that higher patient satisfaction resulting from employing breast care nurses was largely limited to native speaking patients. Other hospital characteristics were not significantly associated with the perception of nursing staff (teaching hospital, required number of surgeries, clinical trial participation).
Conclusions: The results demonstrate that patient satisfaction with nursing staff is higher if breast care nurses are employed in the treating hospital. Further work will focus on the description of the breast care nurses work as it is interpreted individually in every breast center. However, only the satisfaction of native speakers was significantly higher when breast care nurses were employed.
Implications for Practice: Findings suggest that hospitals should invest in employing specialist nurses. Special attention should be paid to the care of non-native speaking patients.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-17-02.
P5-18-02: A Population Level Assessment of Emergency Room Visits and Hospitalizations for Women Undergoing Adjuvant Chemotherapy for Early Breast Cancer.
Authors: Enright KA , Trudeau M , Yun L , Grunfeld E , Krzyzanowska M 
Published: June 2012

Abstract
Background: Adjuvant chemotherapy is considered the standard of care for women with lymph node positive and high risk lymph node negative breast cancer. While the acute toxicities of chemotherapy are well documented in clinical trials, the frequency of serious treatment related toxicities of adjuvant chemotherapy in the general population is not well described. We undertook a population based assessment of the frequency of serious treatment related toxicity in women undergoing adjuvant chemotherapy for early breast cancer (EBC). Methods: All incident EBC patients diagnosed between January 2007 and December 2008 in Ontario, Canada were identified from the Ontario Cancer Registry. Patient records were linked deterministically to multiple provincial administrative health care databases to provide comprehensive medical follow-up. Exclusion criteria were set to exclude patients on chemotherapy for advanced breast cancer. Any patient with who received at least 1 cycle of adjuvant chemotherapy was included in the analysis. Serious toxicities resulting in emergency room (ER) visits or hospitalizations occurring between the start date of chemotherapy and 30 days after the last dose of chemotherapy were identified. Logistic regression models were used to identify the impact of chemotherapy regimen, age, comorbidity and duration on therapy on the likelihood of experiencing serious toxicity.
Results: Of the 3090 women identified in our cohort, 1440 (46.6%) experienced at least 1 serious toxicity resulting in an ER visit during their adjuvant treatment. Of the ER visits, the majority (1107, 87%) were attributable to treatment related toxicities. Febrile neutropenia (FN) was the most common treatment related toxicity occurring in 27.1% of patients in the cohort. Docetaxel containing regimens were associated with a significantly higher rate of ER visits and FN (54.6%, 34.6%) compared with paclitaxel (38.0%, 17.9%), or anthracycline alone (epirubicin 45.8%, 23.8%; doxorubicin 32.8%, 15.4%). Table 1 displays the impact of clinical and patient factors on multivariable analysis.

Conclusion: Serious toxicities are a common in women undergoing adjuvant chemotherapy for EBC and result in significant acute health care utilization.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-18-02.
P5-18-11: Incidence of Chemotherapy Dose Reductions and Dose Delays, and Reduced Chemotherapy Dose Intensity in Early Stage Breast Cancer.
Authors: Weycker D , Edelsberg J , Kartashov A , Barron R , Lyman G 
Published: June 2012

Abstract
Background: Chemotherapy is widely used to treat early stage breast cancer (ESBC). Dose reductions and dose delays–e.g., due to advanced age or severe/febrile neutropenia–are generally believed to increase risk of disease progression and reduce survival. Little is known about incidence of chemotherapy dose reductions and dose delays among women with ESBC in clinical practice.
Methods: This study employed a retrospective cohort design and electronic medical records from over 60 community oncology clinics in more than 20 states (2004-2010). Study population included adult women who received myelosuppressive chemotherapy for ESBC (stages I-IIIA). For each such woman, each unique cycle of chemotherapy within their first observed course was identified. Incidences of chemotherapy dose delays (≥7 days for any drug in ≥1 cycles), chemotherapy dose reductions (≥15% for any drug in ≥1 cycles), and low relative chemotherapy dose intensity (&lt;85% over the course) – relative to physician-reported planned chemotherapy administration – were descriptively analyzed for the seven most frequently observed regimens among subjects.
Results: 2,350 women received seven most frequently observed regimens (80% of study population); mean age – across regimens – ranged from 51–56 years, and 31–94% received primary prophylaxis against severe/febrile neutropenia with a colony-stimulating factor. Incidence of dose reductions ranged from 17–48%, and dose delays, from 24–45%. Overall mean relative dose intensity (RDI) ranged from 80%-99%, and 17–50% of subjects received RDI &lt;85%; mean RDI among those with low RDI ranged from 40%-67%.

Discussion: Chemotherapy dose delays and dose reductions are common in ESBC, among those receiving dose-dense as well as conventional regimens.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-18-11.
P5-19-03: Albumin-Bound Paclitaxel (ab-pac) Versus Docetaxel for First-Line Treatment of Metastatic Breast Cancer (MBC): Overall Survival and Safety Analysis of a Randomized Phase II Trial.
Authors: Gradishar WJ , Krasnojon D , Cheporov S , Makhson AN , Manikhas GM , Clawson A , Bhar P 
Published: June 2012

Abstract
Background
We previously reported the results of a phase II study evaluating the efficacy and safety of 3 different dosing regimens of ab-pac and docetaxel for the first-line treatment (Tx) of MBC (Gradishar et al. J Clin Oncol. 2009;27:3611–3619). Here, we report final overall survival (OS) and an analysis of safety and associated dose reductions (DRs).
Methods: Patients (pts; N = 300) with previously untreated MBC were randomized to 1 of 4 Tx arms (table). A step-down statistical approach was used for pairwise comparisons of Tx arms. The trial was powered for antitumor activity and safety.
Results: Tx arm C produced the longest OS (33.8 months) with an 11.6-month longer median OS vs arm B (HR 0.575; P = .008) and a 7.2-month longer median OS vs arm D (HR 0.688; P not statistically significant). OS data were consistent with previously reported investigator assessment of overall response rates and progression-free survival. Grade (gr) 4 neutropenia (np) was significantly less frequent in the ab-pac arms vs. the docetaxel arm (5-9% vs. 75%; P &lt; .001). Febrile np occurred in 1% of each ab-pac arm vs 8% in the docetaxel arm. Rates of gr 3 sensory neuropathy (SN) were 21%, 9%, 22% and 12%, respectively, in arms A-D (P = .083). No gr 4 SN occurred. Median time to improvement to ≤ gr 2 SN was 20–22 days in the ab-pac arms vs 41 days in the docetaxel arm. Gr 3 fatigue occurred in 5, 0, 4, and 19% of pts in arms A-D, respectively. In arm C, best response was observed at cycle 2, whereas DRs due to toxicity occurred later, at cycle 4 (table). The percentage of pts dose reduced due to ≥ 1 Tx-related toxicity were 18%, 17%, 47%, and 28% in arms A-D. The median cycles at which DRs occurred were 7, 5, 4, and 3, respectively. Np and SN were the most common toxicities leading to DRs.

Conclusion: Ab-Pac 150 mg/m2 qw3/4 resulted in a 33.8-month OS, a longer OS than historically achieved with taxane monotherapy in MBC. Within the 150 mg/m2 ab-pac arm, best response occurred at cycle 2, whereas DRs due to toxicities occurred at later cycles. These data indicate that dosing ab-pac at 150 mg/m2 on a qw3/4 schedule may allow pts to achieve a clinical response before emergence of dose-limiting adverse events.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-19-03.
P5-19-07: The Effects of ABCC2 and SLCO1B3 Single Nucleotide Polymorphisms on Docetaxel-Induced Leukopenia in Breast Cancer Patients.
Authors: Chen J , Wu LJ , Shen P , Yu LF , Huang S 
Published: June 2012

Abstract
Purpose Docetaxel-based combination treatment has known to be effective for breast cancer. Genotyping of ABCC2 and SLCO1B3 were demonstrated determining the risk of docetaxel-induced leucopenia in other ethnic. We designed this phase II trial to evaluate single nucleotide polymorphisms (SNPs) of the two genes association with docetaxel haematological toxicity in chemonaive breast cancer patients of chinese population.
Patients and Methods We selected 45 breast cancer patients who received docetaxel combination chemotherapy, Genomic DNA was isolated from peripheral blood and detected polymorphisms in ABCC2 and SLCO1B3.
Results All patients were evaluated for toxicity. 28 patients developed with grade 3 or 4 leukopenia, and 17 with grade 1 or 2 in nadir leukocyte from cycle 1 baseline. The combined analysis indicated a significant association of 9383C/G in ABCC2 (P = 0.002) and 5676A/G in SLCO1B3 (P = 0.005) with docetaxel induced ***leukopenia. Patients homozygous for the variant allele (GG) of SLCO1B3 5676A/G had significantly higher leukopenia compared to patients with AA/AG ***genotypes(P &lt;0.05). Similar trend was observed for ABCC2 (9383C/G) with heterozygotes (CG) having the highest percentage decrease compared to those with CC/GG genotypes(P = 0.06).
Conclusion The study indicating that SNPs in ABCC2 and SLCO1B3 may predict the risk of leukopenia induced by docetaxel chemotherapy in china breast cancer patients.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-19-07.
P5-19-14: Platinum-Based Chemotherapy in Triple-Negative Breast Cancer.
Authors: Villarreal-Garza C , Bouganim N , Khalaf D , Clemons M , Kassam F , Enright K , Verma S , Myers J , Dent R 
Published: June 2012

Abstract
Background: There is increasing evidence that DNA repair defects characteristic of BRCA1-related cancers and triple negative breast cancer (TNBC) confer sensitivity to certain chemotherapeutic agents, such as platinums. However, prospective and retrospective studies comparing the efficacy of these agents versus conventional treatment in TNBC are lacking. The aim of this study was to evaluate the efficacy of platinum-based chemotherapy (PBC) in metastatic TNBC in terms of median duration of treatment and overall-survival (OS) and compare it to patients treated with conventional chemotherapy. Methods: We performed a retrospective chart review of patients with metastatic TNBC who received PBC from January 2007 to June 2010 treated at the Sunnybrook Odette Cancer Center and the Ottawa Hospital Cancer Centre. This cohort was compared to a control group that included metastatic TNBC treated with conventional agents that included anthracyclines, taxanes, capecitabine, and vinorelbine.
Results: A total of 166 metastatic TNBC patients were analyzed: 60 treated with PBC and 106 managed with conventional treatment. Median age at diagnosis was 48 years and distant disease-free interval was 26 months (m) for both groups. Patients on both groups had multiple sites of metastases at diagnosis of recurrence than a single site of metastasis (69% for both groups). Of the 60 patients treated with PBC, 90% received a combination regimen, most commonly weekly cisplatin plus gemcitabine in 37% of patients and cisplatin plus vinorelbine in 17% of patients. The median number of cycles delivered was 4 (1-24). 33% received the PBC as first-line treatment, 38% as second-line, 18% as third-line, 7% as fourth line, and 3% as fifth-line. Only 8 patients (5%) discontinued PBC secondary to toxicity. The median time on treatment in first, second and third-line therapy was longer for the PBC group compared to the conventional group (5 vs. 2 m, p=0.108; 5 vs. 2 m, p=0.01; and 4 vs. 1 m, p=0.026). Patients treated with PBC had a longer OS compared to those managed conventionally (16 vs. 10 m, p=0.039).
Conclusions: PBC appears to improve clinical outcomes in patients with metastatic TNBC compared to those treated with conventional chemotherapy regimens. Although this is a retrospective study with its obvious limitations, it adds to the growing body of literature, suggesting the benefit of PBC in TNBC. Prospective trials are needed to confirm its benefit in order to integrate it as part of the routine management of these patients.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-19-14.