tbuckley/cabot-search huggingface dataset:
Proteomic profiling to identify therapeutics targets in glioblastoma (GBM).
Authors: Sheeno P. Thyparambil, Wei-Li Liao, Eunkyung An, Anuja Bhalkikar, Robert Heaton, Karl G. Sylvester, Xuefeng B. Ling
Journal: Journal of Clinical Oncology (2020)

2555 Background: Glioblastoma (GBM) is an aggressive primary brain tumor with poor prognosis. Treatment at diagnosis is largely confined to surgery, radiation and temozolomide (TMZ) with median progression-free survival (PFS) of 7 months and median overall survival (mOS) of 15 months. GBM tumors recur in most cases and in patients with recurrent GBM, the mOS is 6.2 months. The lack of effective therapies underscores the importance of exploring other agents. We propose that quantitating therapy-associated protein biomarkers can improve treatment personalization for GBM. Methods: 97 FFPE GBM tissues were microdissected and solubilized for mass spectrometry-based proteomic analysis of therapy-associated protein biomarkers in our CLIA certified lab. We quantified protein levels of MGMT, hENT1, RRM1, TOPO1 and EGFR/TUBB3 (antibody target and payload resistance markers, respectively, for anti-EGFR ADCs) simultaneously. The multiplexed assay also quantified additional 24 clinically relevant proteins. Results: 43/57 patients were predicted to respond to TMZ based on undetectable levels of MGMT, confirming wide utility of this agent. 42/97(43%) patients were predicted to have gemcitabine sensitivity based on high expression of the response marker (hENT1 &gt; 100 amol/ug) and low expression of the resistance marker (RRM1 &lt; 700 amol/ug). 11/97(11%) patients expressed TOPO1 &gt; 1350 amol/ug (75 th percentile of all indications tested by author’s laboratory), suggesting likely response to irinotecan and topotecan. EGFR expression ranged from &lt; 100 amol/ug to &gt; 25000 amol/ug, including overexpression (&gt; 1500 amol/ug) in 22%(21/97) of cases. While expression of EGFR(81/97, 84%) suggested likely response to anti-EGFR ADC, concurrent expression of TUBB3(78/81) may indicate resistance to several known payloads, such as taxanes and MMAE. Conjugation with another payload that targets sensitivity marker TOPO1 (68% expression) is a likely option. Proteomic analysis also revealed detectable levels of multiple RTKs (FGFR(4), AXL(20), IGF1R(10), MET overexpression(1), and HER2 overexpression(2)), indicating potential response to RTK inhibitors. Exploratory investigation in tumor vs TME using proteomics and metabolomics is ongoing. Conclusions: In this population of GBM patients, proteomic analysis identified protein targets of multiple approved and investigational therapies. Gemcitabine, which crosses the blood-brain barrier, may be considered as a salvage option after TMZ failure. Proteomic quantitation of EGFR and TUBB3 may improve patient selection for EGFR-targeting ADCs.
A phase II study of osimertinib for patients with radiotherapy-naïve CNS metastasis of non-small cell lung cancer harboring EGFR mutations: The OCEAN study (LOGIK 1603/WJOG 9116L).
Authors: Kazushige Wakuda, Hiroyuki Yamaguchi, Hirotsugu Kenmotsu, Minoru Fukuda, Noriyuki Ebi, Takayuki Suetsugu, Koji Inonue, Kentaro Tanaka, Toshihide Yokoyama, Keisuke Kirita, Osamu Hataji, Satoru Miura, Kenji Chibana, Kenichi Yoshimura, Kazuhiko Nakagawa, Nobuyuki Yamamoto, Kenji Sugio
Journal: Journal of Clinical Oncology (2020)

9597 Background: Approximately 15%–30% of patients treated with EGFR-TKIs experience central nervous system (CNS) progression. Although radiotherapy is a standard treatment for CNS metastasis, the efficacy of radiotherapy against CNS is poor. The aim of OCEAN study was to assess the efficacy of osimertinib for patients with radiotherapy-naïve CNS metastasis of NSCLC harboring EGFR mutations. Methods: OCEAN study was two-cohort phase II trial, 65 patients (T790M cohort; 40 patients and first-line cohort; 25 patients) with radiotherapy-naïve CNS metastasis of EGFR mutation-positive NSCLC was included. Patients were treated with osimertinib 80 mg once daily. The primary endpoint was the response rate of brain metastasis (BMRR) assessed by the PAREXEL criteria. We set a threshold value of 50% and an expected value of 70% based on the overall response rate (ORR) of AURA trial. Based on one-sided alpha = 0.05 and power = 0.8, the sample size of T790M cohort was calculated to be 40. Key secondary endpoints were progression-free survival (PFS), and ORR, BMRR assessed by the RECIST criteria. We are exploratorily assessing the blood concentration of osimertinib at day 22, which considered to represent steady state. In this report, we present the results of T790M cohort. Results: Between October 2016 to July 2019, 40 participants were recruited in the T790M cohort. The median age was 66.5 with 30.0% male. Eight patients had symptomatic CNS metastasis and most patient had multiple CNS metastasis (77.5%). BMRR assessed by PAREXEL criteria was 66.7% (95%CI: 54.3 – 79.1%) and BMRR assessed by RECIST was 70.0% (95%CI, 49.9 – 90.1%). Median PFS was 7.1 months (95%CI, 3.4 – 13.6 months) and ORR assessed by RECIST was 40.5% (95%CI, 24.7 – 57.9%). Treatment related pneumonitis was observed in 4 patients (10.0%). There was no grade 3 or higher toxicities that were found in more than 10%. Conclusions: This first study assessed the efficacy of osimertinib for patients with radiotherapy-naïve CNS metastasis of EGFR T790M mutation-positive NSCLC. The OCEAN study met primary endpoint. The results of this study suggested that patients with brain metastasis harboring EGFR T790M mutations had better to receive osimertinib prior to brain radiotherapy. Clinical trial information: 071180017 .
多房囊性肾细胞癌一例
Authors: 田云, 姜少侠
Journal: BMJ (2009)

患者男,62岁.因体检发现左肾占位l周于2006年8月27日入院.1周前患者体检时B超检查发现左肾体积增大,上极实质内探及一囊性包块,向外突起,大小约5.0 cm×6.0 cm,边界尚清,内可见条状分隔,右肾无异常.患者无发热、腰痛,无血尿、尿频、尿急、尿痛,无排尿困难及尿量异常,体重无明显变化.既往体健,否认传染病史,无外伤、手术及输血史,无药物及食物过敏史,无烟酒及其他特殊嗜好,否认家族肿瘤及遗传病史。
MAUDE: inferring expression changes in sorting-based CRISPR screens
Authors: Carl G. de Boer, John P. Ray, Nir Hacohen, Aviv Regev
Journal: Genome biology (2020)

Abstract Improved methods are needed to model CRISPR screen data for interrogation of genetic elements that alter reporter gene expression readout. We create MAUDE (Mean Alterations Using Discrete Expression) for quantifying the impact of guide RNAs on a target gene’s expression in a pooled, sorting-based expression screen. MAUDE quantifies guide-level effects by modeling the distribution of cells across sorting expression bins. It then combines guides to estimate the statistical significance and effect size of targeted genetic elements. We demonstrate that MAUDE outperforms previous approaches and provide experimental design guidelines to best leverage MAUDE, which is available on https://github.com/Carldeboer/MAUDE .
Risk factors for the progress of subclinical atherosclerosis in newly diagnosed type 2 diabetics with multifactorial intervention
Authors: 刘志文, 周智广, 唐炜立, 周启昌, 刘玉华, 周卫东, 宁洁, 陈小燕, 谭宜, 王志远, 彭健
Journal: BMJ (2006)

目的 探讨多因素干预条件下新诊2型糖尿病患者亚临床动脉粥样硬化(AS)进展的危险因素.方法 前瞻性观察156例年龄35～70岁、病程在1年以内、无亚临床动脉粥样硬化的2型糖尿病患者在采取以抗血小板为基础的强化血糖、血脂、血压、体重等综合达标干预措施的2年中各代谢指标和亚临床动脉粥样硬化的动态变化,比较强化干预2年后发生与未发生亚临床动脉粥样硬化的患者间代谢控制的差异,采用logistic回归分析探讨亚临床动脉粥样硬化进展的危险因素.结果 156例患者经2年的综合强化干预,颈总动脉和股动脉血管内中膜厚度与基线比较差异无统计学意义,但显著高于1年时的对应值(P＜0.01);干预2年时,45例(28.8%)患者检出有血管内中膜厚度异常或动脉粥样硬化斑块,高于干预1年时的18例(11.5%,P＜0.01);糖化血红蛋白、总胆固醇、高密度脂蛋白胆固醇、稳态模型的胰岛素抵抗指数与干预1年时的对应值比较有升高趋势(P＜0.01);糖化血红蛋白的达标率亦显著低于干预1年时(P＜0.01).亚临床动脉粥样硬化组糖化血红蛋白和低密度脂蛋白胆固醇的达标率低于无动脉粥样硬化组(P＜0.01).logistic回归分析显示,低密度脂蛋白胆固醇达标可使亚临床动脉粥样硬化发生的相对危险度减少83%,糖化血红蛋白达标使相对危险度减少59%,但随访2年时,年龄每增加10岁使相对危险度增加82%.结论 多因素强化干预并不能完全阻止新诊2型糖尿病亚临床动脉粥样硬化的发生,随着时间的推移,亚临床动脉粥样硬化呈进展趋势,血糖、血脂亦呈上升趋势;低密度脂蛋白胆固醇和糖化血红蛋白是否达标以及年龄是影响新诊2型糖尿病患者发生亚临床动脉粥样硬化的主要危险因素。
Description of COVID-19 in HIV-infected individuals: a single-centre, prospective cohort
Authors: Pilar Vizcarra, María J Pérez-Elías, Carmen Quereda, Ana Moreno, María J Vivancos, Fernando Dronda, José L Casado, Santiago Moreno, Maria Jesús Pérez-Elías, Jesús Fortún, Enrique Navas, Carmen Quereda, Fernando Dronda, Santos Del Campo, Rogelio López-Vélez, Javier Cobo Reinoso, José Luis Casado, Ana Moreno, Franceca Norman, Pilar Martín-Dávila, José Manuel Hermida, José Antonio Pérez Molina, Begoña Monge, Vicente Pintado, Sergio Serrano-Villar, Matilde Sánchez-Conde, Sandra Chamorro, Rosa Escudero, Francesca Gioia, Belén Comeche, Clara Crespillo, Sabina Herrera, Raquel Ron, Javier Martínez-Sanz, Mario Pons-Guillén, María Jesús Vivancos, Pilar Vizcarra
Journal: The Lancet HIV (2020)
Celecoxib in addition to standard adjuvant therapy with 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX) in stage III colon cancer: Results from CALGB/SWOG 80702.
Authors: Jeffrey A. Meyerhardt, Qian Shi, Charles S. Fuchs, Donna Niedzwiecki, Tyler J. Zemla, Priya Kumthekar, Katherine A Guthrie, Felix Couture, J. Phillip Kuebler, Johanna C. Bendell, Pankaj Kumar, DeQuincy Andrew Lewis, Benjamin R. Tan, Monica M. Bertagnolli, Axel Grothey, Howard S. Hochster, Richard M. Goldberg, Alan P. Venook, Charles David Blanke, Anthony Frank Shields
Journal: Journal of Clinical Oncology (2020)

4003 Background: Aspirin and cyclooxygenase-2 (COX-2) inhibitors have been associated with a reduced risk of colorectal polyps and cancer in observational and randomized studies. CALGB/SWOG 80702 tested the effect of celecoxib, a COX-2 inhibitor, on reducing the risk of recurrence in stage III CC. Methods: CALGB/SWOG 80702 is a 2x2 randomized controlled phase III trial of 3 v 6 months of adjuvant FOLFOX (data previously reported as part of the IDEA collaboration) with concurrent celecoxib (400 mg daily) v placebo x 3 yrs for patients (pts) with resected stage III CC. The primary endpoint of the trial is disease-free survival (DFS), defined as time from randomization to recurrence or death from any cause. The trial was designed to provide 91% power to detect a hazard ratio (HR) of 0.79 in favor of celecoxib with 2-sided alpha = 0.05 (775 events required); due to slowing accumulation of events 4 years after complete accrual, power was lowered to 85% with same HR and alpha assumptions (696 events required). The DSMB released data on February 24, 2020 at median f/u of 5.6 yrs with 689 DFS events. Results: Between June 2010 and November 2015, 2,526 pts were consented and randomized to the trial. Treatment arms were well balanced by patient and tumor prognostic features, as well as low-dose aspirin use. Baseline characteristics included 45% female, 18% non-White, 8% Hispanic, 15% T4, 26% N2. 3-yr DFS for celecoxib was 76.3% v 73.3% for placebo (HR 0.89 [95% CI 0.77-1.04]; P = 0.14). 5-yr overall survival (OS) was 83.9% for celecoxib v 81.7% for placebo (HR 0.87 [95% CI 0.72-1.05]; P = 0.14). When considering the 4 treatment arms separately, 3-yr DFS was 77.0% for 12 months FOLFOX + celecoxib, 74.9% for 12 months FOLFOX + placebo, 75.5% for 6 months FOLFOX + celecoxib, and 71.9% for 6 months FOLFOX + placebo (log rank P = 0.22; P interaction = 0.64). There were no significant differences in grade 3-4 toxicity with celecoxib v placebo. Compliance with protocol celecoxib treatment, defined as 3 yrs of therapy completion or recurrence/death while on treatment, was 58.1% pts on celecoxib and 60.2% pts on placebo. Conclusions: The addition of celecoxib to standard chemotherapy did not significantly improve DFS or OS. Clinical trial information: NCT01150045 .
Efficacy of different vascular recanalization methods for acute ischemic stroke
Authors: Yuhui Chen, Lei Xu, Peng Qi, Jun Lu, Juan Chen, Tao Gong
Journal: BMJ (2019)

Objective
To assess the efficacy of different vascular recanalization methods for acute ischemic stroke (AIS).


Methods
The clinical data of AIS patients receiving vascular recanalization therapy in Beijing Hospital from January 2010 to July 2018 were retrospectively analyzed. Among 141 AIS patients, 64 received intravenous thrombolysis (IVT group), 57 received endovascular treatment (EVT group) and 20 received intravenous thrombolysis and endovascular treatment (IVT+EVT group). The efficacy and safety of therapy were compared among three groups.


Results
There were no significant differences in the risk factors of cerebrovascular diseases among 3 groups (P>0.05). The National Institute of Health Stroke Scale (NIHSS) scores [M(Q1, Q3)] of patients in the IVT group, EVT group and IVT+EVT group were 9.5 (6.0, 15.0), 15.0 (9.0, 19.0) and 14.0(8.3, 17.0), respectively (Z=7.19, P<0.05). The time from onset to treatment in the three groups was 205.0 (156.3, 254.3) min, 260.0 (170.0, 401.5) min, and 137.5 (90.3, 137.5) min, respectively (Z=22.83, P<0.01). The proportion of large arteries occlusion was lower in IVT group (32.8%, 21/64), compared with EVT group (86.0%, 49/57) and IVT+EVT group (95.0%, 19/20) (χ2=46.77, P<0.01). The proportion of symptomatic intracranial hemorrhage in IVT group was lower than EVT and IVT+EVT group [1.6% (1/64) vs. 15.8% (9/57) and 10.0% (2/20), χ2=8.36, P<0.05]. The favorable outcome rates in IVT, EVT and IVT+EVT groups at the 90 d (mRS score≤2) were 57.8% (37/64), 45.6% (26/57) and 40.0% (8/20) , respectively (χ2=2.79, P=0.24). The fatality rates in three groups were 10.9% (7/64), 19.3% (11/57) and 5.0% (1/20), respectively (χ2=2.84, P=0.21).


Conclusions
Intravenous thrombolysis, endovascular therapy and bridging therapy have similar effects on the prognosis of AIS. Mild severity of AIS patients are more likely to benefit from intravenous thrombolysis. AIS patients with severe disease are usually combined with large artery occlusion, and more suitable for endovascular treatment and bridging treatment.


Key words: 
Acute disease; Brain infarction; Intravenous thrombolysis; Mechanical thrombolysis
Comprehensive study of genetic features of pancreatic neuroendocrine tumors.
Authors: Vladimir S. Trifanov, Oleg I. Kit, Dmitry Yu. Gvaldin, Natalya N. Timoshkina, Sergey V. Sanamyants, Roman E. Myagkov, Umar Muhmadovich Gaziev, Yuriy A. Fomenko, Dmitry S. Petrov
Journal: Journal of Clinical Oncology (2020)

e16699 Background: Pancreatic neuroendocrine tumors (panNETs) are a heterogeneous, relatively rare type of neoplasm which distinguishes a long clinical course in a large number of cases, that leads to the fact that the prevalence rate of NETs is one of the highest. The purpose of this study was a research the mutational profiles of panNETs of various grades of malignancy and to search for new candidate genes involved in the oncogenic processes of this pathology. Methods: The study included a retrospective group of 24 patients (10 men, 14 women, median age - 60 years old) with a diagnosis of panNET, treated in the RRIO from 2011 to 2018. Comprehensive cancer panel (409 genes) were used for NGS procedure on the NextSeq 550 platform(Illumina, USA). To work with raw data, we used the standard pipeline proposed by BaseSpace (Illumina, USA). Interpretation of the identified variants was carried out in accordance with the recommendations of the Association for Molecular Pathology, American Society of Clinical Oncology and College of American Pathologists. Results: 119 mutations in 54 genes were detected in samples of panNETs. 26 genetic variations were characterized as new, not previously described for panNETs. 18% of the mutations were activating, 35% of the variants led to a loss of function of the encoded protein, 52% were not classified. Candidate genes that have not been previously described in the literature and which are potentially involved in pancreatic oncogenesis are identified: CREB1, TCF12, PRKAR1A, BCL11A and BUB1B. The largest number of mutational events occurred in the genes responsible for histone methylation; in addition, 38% described genetic alterations in the regulation of the SMAD2/3 signaling pathway. Conclusions: According to the NGS study of panNETs of low and moderate malignancy in the Russian cohort, a unique spectrum of 119 mutations was obtained, of which 26 were not previously described. The discovered molecular genetic changes in the signaling pathways underline the importance of impaired epigenetic control of transcription in pancreatic oncogenesis and open up new prospects for targeted therapy.
原发性干燥综合征的治疗
Authors: 赵岩, 张奉春
Journal: BMJ (2006)

原发性干燥综合征(primary Sjogren's syndrome,pSS)是一个主要累及外分泌腺体的慢性炎症性自身免疫病.由于其免疫性炎症反应主要表现在外分泌腺体上的上皮细胞,故又名自身免疫性外分泌腺体上皮细胞炎或自身免疫性外分泌病.pSS目前尚无根治的方法,主要是改善症状,控制和延缓因免疫反应而引起的组织器官损害的进展以及继发性感染。
Photodynamic therapy for preinvasive cervical cancer.
Authors: Viktoria A. Ivanova, Ekaterina V. Verenikina, Vera P. Nikitina, Oksana E. Zhenilo, Polina A. Kruze, Ivan S. Nikitin, Oleg I. Kit
Journal: Journal of Clinical Oncology (2020)

6035 Background: Photodynamic therapy (PDT) is an effective treatment for various cancers ensuring maximum preservation of the viability of healthy tissues surrounding the tumor. The purpose of the study was to reveal the effectiveness of PDT in treatment for preinvasive cervical cancer. Methods: The study included 45 patients aged 22-53 years with preinvasive cervical cancer. The patients were divided into two groups depending on the type of the transformation area and the tumor site: group 1–on the exocervix (type I-II), n=24; group 2–on the endocervix (type III), n=21. Infection with high-risk genotypes of HPV (16, 18, 31, 33, 35, 45, 56) was detected with PCR in 37 (82%) women. All patients received PDT with the semiconductor Latus laser up to 3 W, a single-use diffusing fiber for the exocervix irradiation and a single-use cylindrical diffusing fiber for tumors in the cervical canal. Photoditazine and photolon were used as photosensitizers. Effectiveness criteria included the normalization of the colposcopic picture, the absence of atypical cells, and the pathogen elimination confirmed by PCR. Results: A normal cytogram profile was observed after PDT in 84% of group 1 and in 88% of group 2. PCR 3 months after PDT showed a positive HPV reaction in 9.1%. Neither group of patients had negative changes in cytogram after 6 and 12 months. Repeated HPV DNA tests detected HPV DNAs in 2.8% in group 1 and 3.2% in group 2. The effectiveness of PDT did not depend on the photosensitizer. The maximum follow-up period has lasted for 4.5 years, with no recurrences registered. During this period, three young women successfully gave birth to healthy children. Conclusions: PDT is an alternative treatment for pre-tumor and initial tumor pathology of the cervix with preservation of the anatomical and functional integrity of the organ, which is important for the female reproductive function. The results support the use of PDT in treatment for preinvasive cervical cancer.
Characteristics of end-of-life (EOL) chemotherapy (CTx) received by patients with advanced cancers and association with EOL emergency department (ED) and intensive care unit (ICU) care.
Authors: Cathy Zhang, Mark W. Beiter, Maria Magdalena Gonzalez, Emebet T. Gebremeskel, Gunita Kashyap, Karen Hemeon, Joseph Grant F Rosales, Hagen F. Kennecke
Journal: Journal of Clinical Oncology (2020)

e19222 Background: Use of EOL CTx is an established quality metric in patients with advanced malignancies but less is known about which types of CTx are most commonly used and association with ED and ICU utilization. We sought to describe the different types of EOL CTx and to quantify the frequency of EOL ED and ICU care associated with them. Methods: Patients in the cancer registry of an urban cancer center who died between January 1, 2018 and October 10, 2019, and ever received CTx were included. EOL CTx was defined as any CTx given within 30 days of death, while any ED visits or ICU admissions in the last 30 days of life were defined as EOL ED and ICU care, respectively. CTx was categorized by administration route (intravenous (IV), oral (PO), other), and by type (immunotherapy (IMT), non-immunotherapy biologics (NIB), other). We used Pearson’s chi-squared to measure associations between EOL CTx and EOL ED and ICU care, logistic regression to assess how CTx type modulates those associations, and Mood’s median test to compare median IMT doses between groups. Results: Among 390 eligible patients, 32% received EOL CTx, 30% EOL ED care, and 11% EOL ICU care. Most received IV CTx (78%), and 10% received IMT. Median age at diagnosis was 69 years (interquartile range (IQR) 62 - 77), and median days from diagnosis to death was 390 (IQR 185 - 665). Most common malignancies were pancreatobiliary (40%), other gastrointestinal (15%), lung (13%) and hematologic (6%). Patients treated with EOL CTx were significantly more likely to receive IMT (p = 0.03). Receipt of any EOL CTx was significantly associated with EOL ED care (p &lt; 0.0001) and EOL ICU care (p &lt; 0.0001). Subgroup analyses showed significant modulatory effect of IMT on association of EOL CTx with EOL ED care (b = -0.89, p = 0.046), but was not significant for ICU care (b = -0.67, p = 0.29). Median doses of IMT was 2.5 (IQR 2 - 3.8) among patients who were given EOL IMT and 4 doses (IQR 2 - 6) in those that discontinued IMT before EOL (p = 0.06). Conclusions: EOL CTx is associated with significantly increased rates of EOL ED and ICU care, which may indicate poorer quality of life. While rates of use of other CTx modalities did not significantly differ at EOL, patients were more likely to receive IMT within 30 days of death, which could be due to the belief that IMT is more tolerable or more effective than other CTx modalities at EOL. IMT at EOL is associated with a reduced risk of EOL ED care, but not ICU care. Further research on strategies to reduce EOL CTx and appropriateness of IMT at EOL is warranted.
Validation of nomograms to predict non-sentinel lymph node metastasis after positive sentinel lymph node in breast cancer: Indian cohort background.
Authors: Asha Reddy, Nita S. Nair, Smruti Mokal, Tanuja Shet, Vani Parmar, Shalaka P Joshi, Garvit Chitkara, Purvi Thakkar, Rajendra Badwe
Journal: Journal of Clinical Oncology (2020)

568 Background: Axillary lymph node metastasis is still the important prognostic factor in the management of breast cancer (BC). Where we have moved towards axillary conservation in clinically node negative (cN0), the debate on what after 1-2 sentinel lymph nodes positive (SLN+ve) still continues. The ideal situation would be wherein we can accurately predict which patient has a risk of additional non SLN+ve. Several nomograms have been developed to predict the risk of NonSLN+ve. But in view of the differences in tumor size and nodal burden between our patients and the western data, we conducted a study to validate some of these nomograms in our cohort of early BC with positive LN on Low axillary sampling (LAS). Methods: Clinico-pathological data was collected for operable BC (OBC) with cN0 who underwent upfront SLNB or AS. This was entered into the various nomograms and the probability of the Non SLN+ve was calculated. Nomograms with AUC of greater than 0.7 were pre-defined as considerable discrimination. Results: From 2013 to 2018, 2350 women with cN0 OBC underwent LAS. Of which, 670 (28.5%) had a positive node on LAS. Median pT size was 3 cm with 327 (48%), LVI +ve 152 (77%) ENI +ve, 525 (78.4%) Hormone receptor +ve and 485 (72.4%) grade 3 tumors. Of 670, 239 (35.7%) had a NonSLN+ve on completion axillary dissection. The AUC values for nomograms included,ie. MSKCC, MDAnderson, Tenon, Cambridge, Shanghai, Mayo clinic and Turkish were 0.769, 0.77, 0.55, 0.74, 0.65, 0.529, 0.563 respectively. Only three nomograms, MDA, MSKCC and Cambridge had an AUC of more than 0.7. However, they were associated with poor sensitivity and specificity and high FNR (Table) making them clinically unreliable for this cohort. Conclusions: All 7 nomograms were not validated in our study. The larger T size and higher nodal burden of our cohort may be responsible for the same. We thus need to develop an Indian nomogram to predict the risk of non SLN+ve for our patients. [Table: see text]