tbuckley/cabot-search huggingface dataset:
The effectiveness of darbepoetin alfa administered at 300 mcg every 3 weeks on clinical outcomes in elderly patients with chemotherapy-induced anemia
Authors: R. V. Boccia, P. Silberstein, S. Tchekmedyian, D. Tomita, T. Lillie, G. Otterson
Journal: Journal of Clinical Oncology (2006)

18511 Background: Chemotherapy-induced anemia (CIA) is common in patients (pts) receiving chemotherapy, and reduces health-related quality of life. The primary objective of this exploratory analysis was to describe the effectiveness of darbepoetin alfa administered at 300 mcg every 3 weeks (Q3W) in elderly (≥ 65 years old) and younger pts (&lt; 65 years old) with CIA. Methods: We analyzed data on 1493 pts, enrolled in a multicenter, open-label, 16-week study and who received ≥ 1 dose of darbepoetin alfa. Eligible pts were ≥ 18 years old, had a non-myeloid malignancy, and were anemic (hemoglobin [Hb] &lt; 11 g/dL). Pts were analyzed stratified by age (≥ 65 and &lt; 65 years old) and baseline (BL) Hb (&lt; 10 or ≥ 10 g/dL). Hb-based endpoints were analyzed using 2 approaches: the last value carried forward (LVCF) method, where missing Hb values or values within 28 days of a red blood cell (RBC) transfusion were imputed, or an available data approach, where missing Hb values were not imputed. Pt-reported outcomes were assessed using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F) scale. Results: Pt demographics and disease characteristics varied between the age strata: in the ≥ 65-stratum (mean age = 73.7, n = 724), 52% of pts were women and the most common cancer was gastrointestinal (27%); in the &lt; 65-stratum (mean age = 52.1, n = 769), 69% of pts were women and the most common cancer was breast (41%). Mean (SD) BL FACT-F scores for pts ≥ 65 and &lt; 65 were 27.5 (12.8) vs 27.2 (12.1) for the &lt; 10-g/dL strata and 29.0 (12.5) vs 27.5 (12.0) for the ≥ 10-g/dL strata. Study endpoints are shown in the table. The safety profile was as expected for each age group. Conclusions: Darbepoetin alfa 300 mcg Q3W appears to be as effective in achieving and maintaining Hb between 11 to 13 g/dL in elderly pts as in younger pts with CIA. Since chemotherapy is often administered Q3W, synchronizing darbepoetin alfa treatment with pts’ chemotherapy schedules may simplify the treatment of CIA in this pt population. [Table: see text] [Table: see text]
Gastrin-releasing peptide receptors in the tumor vascular bed of various human cancers: high incidence in urinary tract cancers
Authors: A. M. Fleischmann, B. Waser, J. C. Reubi
Journal: Journal of Clinical Oncology (2009)

e14575 Background: Tumoral Gastrin-releasing peptide (GRP) receptors are potential targets for diagnosis and therapy using radiolabeled or cytotoxic GRP analogs. GRP-receptor overexpression has been detected in cancer cells and, more recently, also in the vascular bed of selected tumors. More information on vascular GRP-receptors in cancer is required to asses their potential for vascular targeting applications. Methods: Frequent human cancers from the breast (n=134), lung (n=57), prostate (n=50), kidney (n=32), colon (n=46), urinary tract (n=26) and biliary tract (n=23) were analyzed using in vitro GRP-receptor autoradiography on tissue sections with the 125 I-[Tyr 4 ]-bombesin radioligand and/or the universal radioligand 125 I-[D-Tyr 6 , ß-Ala 11 , Phe 13 , Nle 14 ]-bombesin(6–14). GRP-receptor expressing tumoral vessels were evaluated in each tumor group for prevalence, quantity (vascular score) and GRP-receptor density. Results: Prevalence of vascular GRP-receptors is variable, ranging from 13% (prostate cancer) to 92% (urinary tract cancer). Different tumor-types within a given site may have divergent prevalence of vascular GRP-receptors (e.g. lung: small cell cancer: 0%; adenocarcinoma: 59%; squamous carcinoma: 83%). Also the vascular score varies widely, with highest score in urinary tract cancer (1.69), moderate scores in lung (0.91), colon (0.88), kidney (0.84) and biliary tract (0.69) cancers and low scores in breast (0.39) and prostate (0.14) cancers. Vascular GRP-receptors are expressed in the muscular vessel wall in moderate to high densities. Normal non- neoplastic control tissues from these organs lack vascular GRP-receptors. Conclusions: Tumoral vessels in all evaluated sites overexpress GRP-receptors, suggesting a major biological function of GRP-receptors in the tumor vascular bed. Vascular GRP-receptor expression varies between the tumor-types indicating tumor-specific mechanisms in their regulation. Urinary tract cancers express vascular GRP-receptors so abundantly, that they are promising candidates for vascular targeting applications. No significant financial relationships to disclose.
Antiproliferative effect of mTOR inhibitor everolimus (EV) alone or in combination with multikinase inhibitor (MK-I) sorafenib (SOR) in preclinical models of osteosarcoma (OS).
Authors: Y. Pignochino, G. Grignani, M. Basiricò, G. Cavalloni, M. Motta, S. Bruno, S. Aliberti, M. Alberghini, P. Picci, M. Aglietta
Journal: Journal of Clinical Oncology (2010)

10058 Background: Targeting pathways involved in progression and metastatization might be a suitable way to overcome chemoresistance in OS. Monoclonal antibodies (anti-IGF1R) andMK-I (SOR, dasatinib) are investigated in the clinical setting. Since mTOR is involved in OS progression [Zhou Q, 2009], the activity of EV, SOR and their combination was explored in vitro and in vivo. Methods: In vitro effects of EV (from 500 to 15.125 nM) and SOR (from 10 to 0.3125 μM) were assessed on 7 human OS cell lines evaluating cell proliferation (Cell Titre GLO assay), cell cycle (flow cytometry) and apoptosis (Annexin V/propidium iodide assay). Synergism (SOR+EV) was assessed through normalized isobologram and combination index (CI) by CalcuSyn software. For in vivo experiments 106 OS cells were injected in SCID mice. After tumor establishment (500 mm3), mice were treated by oral gavage for 3 wks with SOR (5 mg/kg/day) or EV (1 mg/kg/day) and their combination. Tumor volumes were compared between the 3 treatment groups and vehicle (DMSO) treatment control and p- values calculated. Results: SOR showed a dose-dependent inhibition effect. EV alone was able to affect around 40% of cell proliferation. The combination displayed synergism in the interval of 30-70% of fractions affected (CI<1) and antagonism at higher doses (CI>1). SOR IC50 was reduced from 2.7 to 1.3 mM in presence of EV, with a marked increase in apoptotic cells compared to both single agents. In vivo each treatment strikingly inhibited tumor growth with relative tumor proliferation rate (T/C) values of 0.34 (SOR) 0.46 (EV) 0.29 (combination). Survival was increased from 12 to 20 days, (p<0.05). Conclusions: This work shows the in vitro and in vivo antiproliferative effect of SOR, EV and their combination. Whilst molecular mechanisms are investigated, the combination of SOR and EV warrants to be tested in OS clinical setting. No significant financial relationships to disclose.
A phase II study of bortezomib in relapsed Hodgkin lymphoma: Preliminary results of CALGB 50206
Authors: K. A. Blum, J. L. Johnson, D. Niedzwiecki, G. P. Cannellos, B. D. Cheson, N. L. Bartlett
Journal: Journal of Clinical Oncology (2006)

7576 Background: Constitutive NF-κB activation has been described in both Hodgkin lymphoma (HL) cell lines and patient-derived Reed-Sternberg cells. In vitro, therapeutic targeting of NF-κB with proteasome inhibitors like bortezomib leads to apoptosis of HL cell lines, providing a rationale for clinical trials with this agent. Methods: From 3/15/2004 until 2/23/2005, the CALGB conducted a phase II trial of bortezomib in patients (pts) with relapsed and refractory classical HL to assess response rate and toxicity. Eligibility requirements included at least one prior systemic therapy, measurable disease, absolute neutrophil count ≥ 750/μL, platelets ≥ 75,000/μl, and creatinine ≤ 2.5 mg/dl. Pts able to undergo a stem cell transplant with curative intent or with pre-existing sensory neuropathy ≥ grade 2 were not eligible. Bortezomib was administered at 1.3 mg/m 2 days 1, 4, 8, and 11 every 21 days for 2–8 cycles, or until disease progression. Results: 30 pts received a median of 2 cycles (range, 1–8). For 25 pts with available data, 80% had stage IV disease with a median of 4 prior therapies (range 2–8, 92% with prior stem cell transplant). For 29 pts with complete response data, 2 pts were not evaluable due to adverse events (bleeding gastric ulcer and grade 4 dyspnea) during cycle 1 leading to a discontinuation of therapy prior to restaging. In the remaining 27, no responses were observed [95% CI (0.0, 0.13)]; 18 pts progressed, and 9 pts had stable disease. Median follow-up is 4.4 (range, 0.6 -16.4) months. The median progression-free and overall survival times are 1.4 [95% CI (1.3, 2.8)] and 11.6 months [95% CI (6.6, ongoing)], respectively. Toxicity data are available for 26 pts. Grade 3–4 events included thrombocytopenia (27%), lymphopenia (8%), dyspnea (8%), anemia (4%), diarrhea (4%), hypotension (4%), rash (4%), and hyperbilirubinemia (4%). Both instances of grade 3–4 dyspnea occurred in pts with disease progression in the lung. 27% developed grade 2 sensory or motor neuropathy. Conclusions: Although well-tolerated, bortezomib has no single agent efficacy in relapsed classical HL at the current dose and schedule. No significant financial relationships to disclose.
Medication use in multi-symptom asthma: Results from the West Sweden asthma study
Authors: Linda Ekerljung, Jan Lötvall, Bo Lundbäck
Journal: European Respiratory Journal (2011)

Background:  Multi-symptom asthma (MSA) can be defined in epidemiological studies and has been shown to reflect severity. It has been uncertain if the definition reflects a more severe disease or is a result of inadequate use of asthma medication. The prevalence of MSA in West Sweden is 2.0%, representing 24% of subjects with physician-diagnosed asthma. The current study aims to determine the use of asthma medication in a group with MSA.   Methods:  From a randomly selected population of 18 087 subjects aged 16-75, who participated in a postal survey on respiratory symptoms, a random sample of 2000 was selected for clinical examinations and interview, including questions on use of asthma medication. In addition all remaining subjects (n=1536) reporting asthma were invited. MSA was defined from the questionnaire as reporting physician-diagnosed asthma and reporting use of asthma medication, attacks of shortness of breath and recurrent wheeze and at least one additional respiratory symptom. Asthmatic subjects not having MSA are referred to as “other asthmatics”.   Results:  92% of MSA used asthma medication at the time of the clinical examination, compared with 61% among “other asthmatics”. 71% were on treatment with steroids and 47% used long-acting β2-agonists (either combined with ICS or separately) vs. 40% and 23%, respectively, for “other asthmatics”. Oral steroids were used by 14% and bronchodilators by nebuliser by 6%, 18% used one or both of these.   Conclusion:  Subjects with MSA are to a large extent treated with steroids. We conclude that a large majority of multi-symptom asthmatics defined by using a questionnaire have a more severe disease and only a minority does not use maintenance treatment.
Mortality and alcohol consumption
Authors: A G Shaper
Journal: BMJ (1995)

Mortality and alcohol consumptionNon-drinkers shouldn't be used as baseline EDITOR,-The interpretation of the finding that light or moderate drinkers have a lower mortality than non-drinkers remains controversial.'The original cohort of 34000 male doctors was recruited in 1951, and information on alcohol consumption was obtained from the surviving third of the men some 27 years later (1978) and from the surviving quarter 40 years later (1991).The authors make no comment on the possible implications of these large gaps in time or on the issue of survivorship.The British regional heart study has shown that middle aged male non-drinkers are likely to be ex- drinkers, are older, and have higher rates of a wide range of diseases and of drug treatment than light or moderate drinkers.'Non-drinkers should not be
Clinical characteristics and prognostic factors in diffuse large B-cell lymphoma with bone marrow involvement
Authors: K. Lee, J. Yi, I. Choi, J. Kim, D. Kim, J. Lee, D. Heo, Y. Bang, H. Cho, N. Kim
Journal: Journal of Clinical Oncology (2006)

7588 Background: Although several studies have been reported about non-Hodgkin’s lymphomas (NHL) with bone marrow (BM) involvement, most of them have not performed immunophenotypic studies and contained heterogeneous NHL histologies. Until now, only a few studies with small sample sizes have been reported about clinical characteristics and prognostic factors in diffuse large B-cell lymphoma (DLBCL) with BM involvement. Methods: Between January 1993 and March 2004, 486 patients were diagnosed with DLBCL. Among 84 DLBCL patients who had BM involvement at initial diagnosis, 9 were not ineligible because of the lack of clinical data or unavailability of BM specimen. So, clinical factors and patterns of BM involvement of 75 patients were analyzed in this study. Results: At initial diagnosis, the median age was 57 years (range: 25∼79). In addition to BM, lymph nodes (76%), spleen (23%), Waldeyer’s ring (19%), gastrointestinal tract (16%), lung/pleura (15%), bone (15%), central nervous system (9%), nasal cavity (8%) and liver (7%) were also involved. Among 75 patients, 67 patients received anthracycline-containing chemotherapy; 4 patients received non-anthracycline-containing chemotherapy and 4 could not receive systemic chemotherapy because of combined medical conditions. The median survival was 32.3 months (5-year overall survival [OS]: 38%). In univariate analysis for prognostic factors, high-intermediate or high international prognostic index (IPI), B-symptoms, leucopenia, anemia, thrombocytopenia, pattern of BM involvement (interstitial or diffuse pattern), &gt; 10% replacement of BM area by lymphoma cells, &gt; 10% of large cell infiltration in BM-involved area by lymphoma at initial diagnosis were associated with poor OS (p &lt; 0.05). Multivariate analysis indicated that &gt; 10% replacement of BM area by lymphoma cells (p &lt; 0.001), peripheral thrombocytopenia (p = 0.001) and high-intermediate or high IPI (p = 0.042) were independent predictors of poor OS. Conclusions: To our knowledge, this is the largest study about DLBCL patients with BM involvement. The BM areas involved by lymphoma cells, peripheral thrombocytopenia and IPI at initial diagnosis are independent prognostic factors in these patients. No significant financial relationships to disclose.
A Phase 3 Trial of RTS,S/AS01 Malaria Vaccine in African Infants
Authors: Selidji Todagbe Agnandji, Bertrand Lell, José Francisco Fernandes, Béatrice Peggy Abossolo, Barbara Gaelle Nfono Ondo Methogo, Anita Lumeka Kabwende, Ayola Akim Adegnika, Benjamin Mordmüller, Saadou Issifou, Peter Gottfried Kremsner, Jahit Sacarlal, Pedro Aide, Miguel Lanaspa, John J Aponte, Sonia Machevo, Sozinho Acacio, Helder Bulo, Betuel Sigauque, Eusébio Macete, Pedro Alonso, Salim Abdulla, Nahya Salim, Rose Minja, Maxmillian Mpina, Saumu Ahmed, Ali Mohammed Ali, Ali Takadir Mtoro, Ali Said Hamad, Paul Mutani, Marcel Tanner, Halidou Tinto, Umberto D'Alessandro, Hermann Sorgho, Innocent Valea, Biébo Bihoun, Issa Guiraud, Berenger Kaboré, Olivier Sombié, Robert Tinga Guiguemdé, Jean Bosco Ouédraogo, Mary J Hamel, Simon Kariuki, Martina Oneko, Chris Odero, Kephas Otieno, Norbert Awino, Meredith McMorrow, Vincent Muturi-Kioi, Kayla F Laserson, Laurence Slutsker, Walter Otieno, Lucas Otieno, Nekoye Otsyula, Stacey Gondi, Allan Otieno, Victorine Owira, Esther Oguk, George Odongo, Jon Ben Woods, Bernhards Ogutu, Patricia Njuguna, Roma Chilengi, Pauline Akoo, Christine Kerubo, Charity Maingi, Trudie Lang, Ally Olotu, Philip Bejon, Kevin Marsh, Gabriel Mwambingu, Seth Owusu-Agyei, Kwaku Poku Asante, Kingsley Osei-Kwakye, Owusu Boahen, David Dosoo, Isaac Asante, George Adjei, Evans Kwara, Daniel Chandramohan, Brian Greenwood, John Lusingu, Samwel Gesase, Anangisye Malabeja, Omari Abdul, Coline Mahende, Edwin Liheluka, Lincoln Malle, Martha Lemnge, Thor G Theander, Chris Drakeley, Daniel Ansong, Tsiri Agbenyega, Samuel Adjei, Harry Owusu Boateng, Theresa Rettig, John Bawa, Justice Sylverken, David Sambian, Anima Sarfo, Alex Agyekum, Francis Martinson, Irving Hoffman, Tisungane Mvalo, Portia Kamthunzi, Rutendo Nkomo, Tapiwa Tembo, Gerald Tegha, Mercy Tsidya, Jane Kilembe, Chimwemwe Chawinga, W Ripley Ballou, Joe Cohen, Yolanda Guerra, Erik Jongert, Didier Lapierre, Amanda Leach, Marc Lievens, Opokua Ofori-Anyinam, Aurélie Olivier, Johan Vekemans, Terrell Carter, David Kaslow, Didier Leboulleux, Christian Loucq, Afiya Radford, Barbara Savarese, David Schellenberg, Marla Sillman, Preeti Vansadia
Journal: New England Journal of Medicine (2012)

The candidate malaria vaccine RTS,S/AS01 reduced episodes of both clinical and severe malaria in children 5 to 17 months of age by approximately 50% in an ongoing phase 3 trial. We studied infants 6 to 12 weeks of age recruited for the same trial.
Phase 1–2a dose ranging study of TLK286 (a novel glutathione analog) in combination with liposomal doxorubicin in platinum refractory or resistant ovarian cancer
Authors: G. L. Brown, L. Lewis, H. Choi, R. Iyer, C. Moore, A. Valmonte, A. Jameson, J. Keck, K. Patel, J. Kavanagh
Journal: Journal of Clinical Oncology (2004)

5062 Background: TLK286 (Telcyta) is a glutathione analog prodrug activated by GST P1–1, which is overexpressed in ovarian cancer. Activation by GST P1–1 releases two electrophilic fragments that induce apoptosis mediated through the stress response signaling pathway. TLK286 has demonstrated significant single agent activity by RECIST in two Phase 2 trials in platinum resistant ovarian cancer. In vitro, TLK286 is not cross resistant to doxorubicin and has shown synergistic inhibition in OVCAR 3 cells. Methods: This dose-ranging study administered TLK286 at 500, 750 or 960 mg/m2 with Doxil at 40 or 50 mg/m2 every 4 weeks until tumor progression or unacceptable toxicity. The objectives were to determine the MTD and objective tumor response rate (ORR) by RECIST. Results: 17 patients (pts) have been enrolled (3 at 500/40, 3 at 750/40, 4 at 960/40 and 7 at 960/50). At interim analysis, 16 pts median age 55 (range 30–76), prior chemotherapy regimens median 2 (range 1–4) have received 59+ cycles (range 1–10+). All pts failed prior therapy with platinum (62% resistant and 38% refractory), paclitaxel (82%), and additional therapies: gemcitabine (31%), topotecan (19%) and docetaxel (13%). The MTD of TLK286/Doxil dose of 960/50 mg/m2 has been well tolerated without DLTs. Most common TLK286/Doxil related adverse events were: fatigue, nausea, vomiting, anemia, neutropenia, thrombocytopenia and leukopenia with no cumulative toxicity. Grade 4 neutropenia (2 pts) and fatigue (1 pt) were observed. At TLK286/Doxil 960/50 mg/m2, 2 PRs (ORR=33% and DSR=67%) were reported. Conclusions: TLK286/Doxil combination at the MTD was well tolerated in platinum refractory or resistant ovarian cancer patients with early evidence of enhanced activity. TLK286/Doxil at 960 mg/m2/50 mg/m2 is the recommended combination dose for future studies in ovarian and breast cancer. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Telik, Inc. Telik, Inc. Telik, Inc. Telik, Inc. Telik, Inc.
Dynamics of molecular response to dasatinib (BMS-354825) in patients (pts) with chronic myelogenous leukemia (CML) resistant or intolerant to imatinib
Authors: A. Quintás-Cardama, H. Kantarjian, D. Jones, M. Talpaz, E. Jabbour, S. O’Brien, R. Luthra, W. Wierda, C. Nicaise, J. Cortes
Journal: Journal of Clinical Oncology (2006)

6525 Background: Mutations in the BCR-ABL kinase domain are a common mechanism (40%) of imatinib-resistance. Dasatinib is 300-fold more potent than imatinib against Abl and has activity against all BCR-ABL mutants, except T315I. We investigated the molecular response to dasatinib in pts with CML intolerant or resistant to imatinib. Methods: Fifty-three pts in chronic (CP) (n=29), accelerated (AP) (n=14) and blast (BP) (n=10) phase CML received dasatinib for a median of 22 wks (range, 7 to 42). Pts had received a median of 4 therapies (range, 1 to 8) including imatinib (n=53), IFN (n=32), and AMN107 (n=9). Imatinib was stopped (41 resistant and 12 intolerant) after a median of 34 mo (range, 2.5 to 82). Quantitative reverse transcription PCR in peripheral blood samples was performed prior to dasatinib and every 3 mo thereafter. Median BCR-ABL/ABL ratio (%) at dasatinib start was 78.34 (range, 0.009 to 100). Twenty-four of 42 assessed pts harbored 16 different BCR-ABL mutants. The most common mutations were H396R (n=5), G250E (n=4), and M351T (n=3). Results: BCR-ABL reductions occurred in 48 (90%) pts: &lt;1-log in 12 (23%) pts (7 CP, 2 AP, 3 BP) after a median of 12 wks (range, 4 to 38); &gt;1-log in 15 (28%) pts (5 CP, 6 AP, 4 BP) after a median of 12 wks (range, 4 to 35); &gt;2-logs in 10 (19%) pts (7 CP, 2 AP, 1 BP) after a median of 14.5 wks (range, 4 to 36) and &gt;3-logs in 9 (17%) pts (5CP, 3 AP, 1 BP) after a median of 16 wks (range, 4 to 36). BCR-ABL/ABL ratio &lt;0.05 was seen in 5 (9.5%) CP pts. After a median follow-up of 26 wks (range, 6 to 41), 12 (23%) pts stopped dasatinib due to death (n=2), disease progression (n=6), BMT (n=1), or intolerance (n=3). Dose reductions (31/53, 58%) were associated with BCR-ABL increments in 13 pts (&gt;1 log in 10). Twenty-nine (55%) pts had at least 1 follow-up PCR analysis after their lowest transcript level, and in 9 pts the BCR-ABL/ABL ratio increased &gt;1 log (F359V, Y253H, S348L, H396P, F317L, G250E, F359C), in 4 pts &gt;2 logs (E255V/K, V299L) and in 2 pts &gt;3 logs (F359V, H396R). T315 mutants have not been detected. Conclusion: Dasatinib is associated with significant molecular responses in imatinib-resistant/intolerant CML across multiple BCR-ABL mutants. Longer follow-up is needed to define the stability and durability of these responses. [Table: see text]
Early recurrence of breast cancer after sentinel node navigation surgery: A multicenter prospective study in Japan
Authors: S. Imoto, S. Morita, M. Kitajima, T. Aikou, Y. Kitagawa
Journal: Journal of Clinical Oncology (2009)

e11530 Background: To assess lymphatic mapping technique and prognosis after sentinel node navigation surgery (SNNS), the Japanese society for SNNS conducted a non-randomized multi-center prospective study on SNNS in early breast cancer. Primary endpoint is to evaluate the success rate and adverse events of SNNS, and secondary endpoint is to observe the outcome of patients who underwent SNNS during 5 years. Methods: We demonstrated the results of primary endpoint at 2007 ASCO annual meeting (#606). Fourteen hundred and sixty-eight cases had pre-registration from 65 investigators at 23 institutions between July 2004 and October 2005. As 46 cases were withdrawn for some reasons and 11 cases were diagnosed as benign disease, 1,411 cases were entered in this study and will be observed until 2010. At this meeting, early recurrence at 3 years follow-up is reported. Results: As of June 2008, 38 of the 1,138 cases (3%) treated with SNNS alone and 16 of the 258 (6%) cases treated with SNNS followed by axillary lymph node dissection (ALND) relapsed. Seven cases died of disease. From the patient background, 50 cases had invasive ductal carcinoma, one had non-invasive ductal carcinoma, and three had special type. Thirty-three cases had negative nodes, 3 had micrometastatic nodes, and 18 had macrometastatic nodes. Fifty-two cases received chemotherapy and/or endocrine therapy. Regional recurrence including axillary, parasternal, and/or supraclavicular nodes was found in 11 cases after SNNS and in 2 cases after SNNS followed by ALND. Conclusions: Annual regional recurrence rate after SNNS was about 0.3%. SNNS in breast cancer is reliable to optimize surgical management in the axilla without increase of regional recurrence. No significant financial relationships to disclose.