bluuebunny/crossref_metadata_2025_split huggingface dataset:
Good news for a change: receipt of adjuvant chemotherapy in diverse populations.
Authors: Griggs JJ , Abrahamse PH , Hawley ST , Hamilton AS , Graff JJ , Katz SJ 
Published: December 2010

Abstract
Abstract #2092
Background: Racial, ethnic, and social disparities in the use of chemotherapy have been demonstrated in women with breast cancer in numerous clinical settings. The purpose of this study was to investigate patterns and correlates of chemotherapy use in a recently-treated population-based sample of black, Latina, and non-Hispanic white women with invasive breast cancer. Methods: A sample of women diagnosed with breast cancer between August 2005 and March 2007 and reported to the Los Angeles County and Detroit Metropolitan Surveillance Epidemiology and End Results (SEER) Registries was identified and invited to complete a survey about their breast cancer treatment. Patient responses were linked to SEER data. Black women and Latinas were oversampled. Bivariate and multivariate analyses examined the use of adjuvant chemotherapy according to clinical, disease, and sociodemographic characteristics, including self-reported height and weight, comorbidity, educational attainment, income, insurance, marital status, and employment factors. Results: Of the 1655 respondents, 1041 (60.8%) received chemotherapy. Black women (65.4%) and Latinas (69.5%) were more likely than non-Hispanic white women (57.1%) to receive adjuvant chemotherapy (p = 0.0001). In multivariate models, only younger age (p &lt; 0.0001), increasing tumor size (p &lt; 0.0001), increasing number of involved lymph nodes (p &lt; 0.0001), and negative hormone receptor status (p &lt; 0.0001) were significantly associated with receipt of chemotherapy. In addition, severely obese women were significantly more likely to receive adjuvant chemotherapy than healthy weight women (odds ratio 1.63, 95% confidence interval 1.04, 2.57). Comorbidity, education, income, insurance, marital status, and employment status were not associated with receipt of chemotherapy. Conclusion: Use of adjuvant chemotherapy in this population-based sample was higher among patients who were more likely to benefit from chemotherapy. In contrast to practice-based studies of chemotherapy use in cohorts treated in older time periods, this study using patient report of chemotherapy and of sociodemographic information demonstrates no evidence of racial, ethnic, or social disparities in chemotherapy use in this diverse population-based sample of recently-treated women.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2092.
Communication of treatment goals in breast cancer: a comparison of perceptions of physicians, nurses and patients.
Authors: West HF , Cohn WF , Guterbock TM , Gurka MJ , Back AL , Blackhall LJ 
Published: December 2010

Abstract
Abstract #2099
Background: Previous evidence suggests that 20-50% of patients do not have a clear understanding of the goal of their cancer treatment, using the provider's goal as the standard for comparison. This lack of alignment between patients and providers may undermine the concept of informed decision making. We aimed to determine the current level of understanding of the goal of chemotherapy in patients with breast cancer by comparing treatment goals of the patients with those of their providers.&#x2028; Patients and methods: Forty – three women undergoing chemotherapy for breast cancer and their providers (nine physicians and three nurses) were surveyed. The primary outcome was the level agreement between the patient and the physician regarding the goal of chemotherapy. Additionally, to examine the extent to which disagreement was recognized by the participants, physicians and nurses were asked to give their perception of the patient's goal, and patients and nurses were asked to give their perception of the physician's goal. Agreement was estimated using generalized estimating equations, which allowed for correlation among patients seen by the same physician.&#x2028; Results: Agreement between the physicians and the patients regarding goal of chemotherapy was 38% (95% CI: 22-57%). The patient's goal and the nurse's perception of the patient's goal agreed 36% of the time (95% CI: 35-37%), while the patient's goal and the physician's perception of the patient's goal agreed 33% of the time (95% CI: 21-49%). When response categories were collapsed into groups with similar broad treatment intent (palliative versus curative/adjuvant), then the level of agreement improved dramatically (91% -100%).&#x2028; Discussion: While broad agreement regarding treatment intent as curative or palliative was higher in this study than in previous research, agreement of the goal on a more detailed level was still poor across varying combinations of the triad of patient, physician and nurse. Future communication studies should focus on interventions to align patients and providers around a common understanding of the goal of chemotherapy, which will improve the quality of care through the provision of truly informed decision making.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2099.
Awareness of breast cancer among women in an urban region of China.
Authors: Wang G , Tian F , Wang L , Lian R , Zhao W , Liang X , Gao J 
Published: December 2010

Abstract
Abstract #2104
Introduction: Even though breast cancer can be cured if detected early and treated appropriately, it remains the most common cause of cancer mortality for women living in some major cities in China. Moreover, the incidence of this disease has increased steadily in China over the last two decades. The aim of this cross-sectional study was to investigate the knowledge about breast cancer concerning risk factors, signs and symptoms, effective screening methods, treatment choices and prognosis among native Chinese women.&#x2028; Method: Two hundred and seventy healthy women were invited to complete a self-administered questionnaire in Taiyuan city of China. Participants' characteristics, including age, education, occupation, and awareness of breast cancer diagnosis, treatment and prognosis were collected and analyzed.&#x2028; Results: Two hundred and thirty nine women had returned the questionnaire. The response rate was 88.5%. The median age of women in this study was 44 years old (range: 25 – 72). Among them, more than one third had received tertiary education, 6.7% had breast cancer family history, and one quarter ever had benign breast disease. Most of the participants (60.3%) did not know how to perform breast self-examination (BSE), whereas 61.5% never did BSE. Only 2.9% of those who had performed BSE did so regularly. As for effective screening methods, more than half of the participants chose clinical breast examination (CBE), and 21.8% regarded mammography as a reliable mean. Most of women considered breast cancer a curable disease and assumed that therapeutic approaches should include surgery, chemotherapy, endocrine therapy, radiotherapy, and in some cases, traditional Chinese medicine. Only 8.8% of the participants identified two or more of the eight breast cancer risk factors. The factors mostly identified included breast cancer family history (33.5%), late birth (10%), and early age at menarche (9.6%). The breast cancer signs and symptoms mostly indicated were breast lump (54.4%), breast pain (26.4%), and nipple discharge (23.9%). Women who received high level education appeared to be more likely to perform BSE and possessed more knowledge regarding to breast cancer risk factors and treatment.&#x2028; Conclusion: The study indicates that awareness of breast cancer among Chinese women needs to be improved, and that breast cancer early-detection measures needs to be enhanced in China.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2104.
The use of a mixed reality breast simulator with an innovative touch map feedback system to teach breast history-taking and examination skills.
Authors: Deladisma AM , Kotranza A , Shah H , Fox P , Rossen B , Imam T , Wang S , Gucwa A , Pugh C , Lok B , Lind DS 
Published: December 2010

Abstract
Abstract #2105
Introduction: Physical examination remains an important method of breast cancer detection. Unfortunately, many health care professionals express concerns about missing breast lesions and current methods of teaching this essential skill are limited. Through an interdisciplinary collaboration, we created an immersive virtual patient to teach health professions students history-taking and breast examination skills.&#x2028; Methods: Fifteen physician's assistant (PA) and 13 medical students (MS) interacted with a mixed reality human (MRH, a computer avatar with a mannequin-based breast simulator) with a breast complaint (Figure 1).&#x2028; &#x2028; Students spoke to and touched the MRH to take a history and examine a simulated breast with two masses of differing size and consistency. Subjects were surveyed regarding the usefulness of the virtual teaching tool and composed a patient note documenting pertinent history and physical examination findings. Students received feedback regarding the content of their patient note (number of 17 essential content items documented) and on the completeness of their breast examination (percentage area covered) using a color-coded touch map.&#x2028; Results: Student feedback related to the utility of this virtual educational tool was positive. Students only documented a mean of 7.8±2.7 (range=4-15) essential content items in the breast history. The completeness of the breast exam was a mean of 82% (range=62% to 97%) of total breast area examined (Figure 2, green=area examined, red=area missed).&#x2028; &#x2028; More clinically experienced students (MS 3 and 4, N=9) performed better than those with no clinical experience (MS 1 and PA 1, N=19) in both history-taking (58% vs. 40%, p&lt;0.05) and completeness of exam (90% vs. 84%, p&lt;0.05). Fifty percent of students were able to locate at least one mass but only 14% were able to correctly document the location of both lesions.&#x2028; Conclusions: The simulated experience differentiated performance among students with varying levels of clinical experience and identified a need for improved teaching and greater practice among all students. MRH scenarios provide a less anxious learning environment for students to practice breast history-taking and examination.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2105.
Canadian pattern of care for anemia: comparison of chemotherapies in adjuvant breast cancer setting.
Authors: Quinn A , Wong C , Younus J , Dranitsaris G , Goel R , Trudeau M 
Published: December 2010

Abstract
Abstract #2118
Background: Anemia is a common side effect of chemotherapy in adjuvant breast cancer patients (pts) but its treatment may be inconsistent. Erythropoiesis-stimulating agents (ESAs) are the only alternative to blood transfusion in the treatment of chemotherapy-induced anemia, yet their appropriate use continues to be defined. The purpose of this study was to determine the frequency of anemia associated with adjuvant chemotherapy in Canadian breast cancer pts and to explore the corrective interventions which were undertaken.&#x2028; Methods: A retrospective chart review was conducted at 11 cancer centres in Ontario, Canada. Beginning on September 1, 2004 data were collected for 60 consecutive cases of adjuvant breast cancer at each centre, giving a total of 620 patients. Chemotherapy consisted mainly of FEC100, AC-T, AC, CEF, FEC50, and AC-T Dose Dense. Overall, 8% of pts were enrolled in a clinical trial and 76% received adjuvant radiotherapy. Hemoglobin level (Hb), supportive therapy (antibiotics, GCSF, ESA, and transfusion) and type of chemotherapy were recorded at each cycle.&#x2028; Results: The median pt age was 53. The mean baseline Hb was 132.8 (92.0-163) g/L, 11.6% of pts had Hb&lt;120g/L. During the course of chemotherapy, the percentage of subjects with Hb&lt;120 at least once was 55.8%, Hb&lt;110 was 37.8%, Hb&lt;100 was 21.2 % and Hb&lt;90 was 11.5%, with a median of 36.0, 52.5, 71.0, and 75.0 days to develop anemia respectively. For pts whose Hb dropped below 100 g/L, 45.4% occurred after the 1st cycle, 68.8% after the 2nd, 83.7% after the 3rd, and 92.2% after the 4th chemotherapy cycle. Overall, 13.2% of subjects received prophylactic antibiotics, 26.3% were supported by G-CSF, 9.0% received an ESA (epoetin alfa) during their chemotherapy and 7.4% were transfused. The rates of anemia as well as means of intervention are summarized in Figure 1. ESAs were not used prophylactically in this setting.&#x2028; Conclusions: In Canada, breast cancer patients receiving adjuvant chemotherapy commonly become anemic during their course of treatment. This retrospective study demonstrated that ESAs play an important role in the management of anemia in the adjuvant setting. Canadian treatment guidelines recommend that ESA therapy be initiated when Hb &lt;100 g/L. Our finding shows that ∼42% of patients whose Hb dropped below 100g/L were treated with ESAs, suggesting that ESAs were not overused in Canadian practice.&#x2028; &#x2028;
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2118.
Targeting of breast cancer with non-oncology drugs – possible novel therapeutic option for triple-negative breast cancer.
Authors: Liedtke C , Yan K , Wu Y , Hortobagyi GN , Symmans WF , Valero V , Goette M , Kiesel L , Pusztai L 
Published: December 2010

Abstract
Abstract #2119
Introduction: Triple-negative breast cancer (TNBC) is defined by lack of ER, and PR expression and normal HER2 expression. It is characterized by aggressive biological presentation and unfavorable outcome. It is associated with frequent lack of response to current chemotherapy agents. Recently, 392 drugged genes that serve as targets for 1557 both oncologic and non-oncologic drugs were identified from the pharmacologic database DrugBank (Lauss et al. Pharmacogenomics 2007). In this study, we compared expression levels of these known drug targets between TNBC and receptor-positive cancers. Methods: Gene expression profiles were obtained from fine needle biopsies of newly diagnosed early stage breast cancer before any therapy (n=133, MDACC dataset). Differential expression of these genes was validated in a second independent data set (n=286, Rotterdam dataset) and in a panel of cell lines (n=19). In order to assess the functional relevance of known drug targets overexpressed in TNBC we performed in vitro experiments. Cell lines were treated with various concentrations of selected drugs alone or in combination with paclitaxel. Results: We mapped 675 U133A probe sets representing 347 unique drug targets to the Affymetrix U133A Genechip. 44 drug targets were overexpressed in TNBC compared to non-TNBC in the MDACC dataset. Thirty-three of these (75%) were also overexpressed among TNBC compared to non-TNBC in the Rotterdam dataset. Glutathione-S-transferase pi (GSTpi, target of clomipramine) was the most highly and consistently overexpressed target in human TNBC and in estrogen- and HER2-receptor-negative breast cancer cell lines. The GSTpi overexpressing (and triple negative) human mammary cell line HBL-100 showed dose-dependent inhibition of growth after 144 hrs of incubation with clomipramine, whereas growth of the GSTpi-low expressing (non-triple negative) breast cancer cell lines MCF-7 and SKBR3 was not inhibited by this drug. Treatment with clomipramine did not alter sensitivity to paclitaxel in either cell line in vitro. Conclusion: Gene expression analysis indicates that targets for several known drugs are over expressed in TNBC relative to other types of breast cancers. We hypothesize that some of these drugs may influence the behavior of TNBC and may represent future therapeutic options. Further experiments are needed to fully explore the functional implications of these findings; however, our preliminary results suggest that inhibition of GSTpi with clomipramine leads to inhibition of cell growth of TNBC cell lines in vitro.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2119.
Triple negative breast cancer: a phase 2, multi-center, open-label, randomized trial of gemcitabine/carboplatin (G/C), with or without BSI-201, a PARP inhibitor.
Authors: O'Shaughnessy J , Yoffe M , Osborne C , Blum J , Rocha C , Ossovskaya V , Sherman B , Bradley C 
Published: December 2010

Abstract
Abstract #2120
Background: PARP is a critical enzyme of cell proliferation and DNA repair and BSI-201 has been shown to be a potent inhibitor of PARP-1 in humans. Triple negative breast cancer (TNBC) shares important features with BRCA1-related breast cancer, a validated target for PARP inhibition. Our studies demonstrate that PARP-1 gene expression is statistically significantly upregulated in TNBC compared with normal breast tissue. The primary objective of this study is to assess the Clinical Benefit Rate (CBR=CR+PR+SD &gt; 6 months) of Gemcitabine/Carboplatin with or without BSI-201 in patients with TNBC.&#x2028; Methods: Eligible subjects are ≥ 18 years old who had received ≤ 2 prior chemotherapies for metastatic disease with histologically documented breast cancer that is ER-negative, PR-negative, and HER2-negative. Patients were randomized (1:1 ratio) to one of 2 study arms: a) arm 1: G/C alone; b) arm 2: BSI-201 + G/C. G/C was given on days 1 and 8; G = 1000 mg/m2, C at an AUC=2. In study arm 2, BSI-201 was administered I.V. twice weekly (days 1, 4, 8 and 11) at a dose of 5.6 mg/kg. Cycles were defined as being 21 days in duration. Modified RECIST criteria are used to assess tumor response every 6 weeks (every 2 cycles). Subjects who have progressive disease may crossover to receive BSI-201 and continue G/C. Archived tissue samples were retrieved for the assay of cancer related genes including PARP-1 by multiplex quantitative RT-PCR.&#x2028; Results: To date, 50 subjects have been enrolled and treated for up to 8 cycles of therapy. Overall 39 of 50 (78%) subjects experienced at least 1 adverse event. The frequency and nature of the AE's do not differ between the two treatment groups. Gene expression profiling results from the first 28 patients enrolled confirm that the cancers of patients enrolled have uniformly low hormone receptor expression, variable HER2 receptor expression and significant upregulation of PARP-1 compared with normal breast tissue.&#x2028; Conclusions: This is the first randomized study of a PARP inhibitor in cancer patients. BSI-201 is safe and well tolerated when given in combination with G/C and adverse events observed were consistent with the known safety profiles of G / C regimens. An updated evaluation of toxicity profile and PARP-1 expression analysis will be presented.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2120.
Combination or sequential single agent for the treatment of metastatic breast cancer (MBC) patients (pts). Impact of further chemotherapy (CT) in overall survival (OS) in the Alamo registry.
Authors: Lluch A , Ruiz A , Martín M , Alba E , Pastor M , de la Haba J , Llombart A , Ramos M , Martínez del Prado P , Escudero M 
Published: December 2010

Abstract
Abstract #2121
Introduction: Combinations can improve OS in MBC; however sequential single agent is sometimes preferred. In a recent report, pts receiving paclitaxel monotherapy in first line had a significantly worse OS if they were not receiving post study CT (PSC); no difference was seen in pts receiving paclitaxel+gemcitabine (Llombart, EBCC 2008). In this trial only 58% of pts received PSC.&#x2028; Purpose: To assess, outside the context of a clinical trial, the amount of MBC pts receiving CT beyond first line, as well as the impact of combination use and further CT lines in their OS.&#x2028; Methods: Alamo 1-2 is a breast cancer patient registry run by the GEICAM. 15482 pts diagnosed from 1990-1997 in 54 sites were included in the database. 4668 pts were stage IV; 778 (16.7%) metastatic at diagnosis and 3890 (83.3%) have had a recurrence.&#x2028; Results: 3045 (65%) pts received CT in first line, 83% were combinations (with anthracyclines 42%, CMF 16%, taxane+anthracyclines 9.4% or +other agents 8%) and 16% were monotherapy. Among other variables studied, only previous treatment (in early stage) was influencing the choice of a combination (pts without previous CT received more combinations than pts receiving CMF, than pts receiving anthracyclines). Median survival for pts receiving single agent was significantly shorter compared to pts receiving combination, 16.2 and 21.85 months (m) respectively, HR=1.37 (IC 95%: 1.21-1.55; p&lt;0.0001). Several covariates showed significant prognostic value in survival in the Cox multivariate model: monotherapy treatment in first line, anthracyclines pre-exposure, age &gt; 65, negative hormonal receptor status, hepatic disease, Grade 3 and ≥ 3 disease sites. Half of the pts never received further CT after first line treatment. Only age and number of disease sites were influencing this decision in the Cox multivariate model. Median survival was 24.9 m in pts receiving further CT and 14.5 m in the ones not receiving it. In pts not receiving further CT, median OS was significantly shorter if they were treated with single agent in first line in comparison to those receiving previous combination: HR= 1.59 (IC 95%: 1.33-1.89; p&lt; 0,00001). This difference was not significant in pts receiving further CT: HR= 1.15 (IC 95%: 0.97-1.37; p=0.101).&#x2028; Conclusion: Our data show that only half of the MBC pts receive further CT after first line; they have longer survival. We found significant evidence that further CT is impacting the OS in pts treated with single agent in first line, but not in those receiving previous combination. Those facts should be taken into consideration when selecting single agent or a combination in first line.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2121.