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  • American Association for Cancer Research (AACR)  (8)
  • 1
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2005
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 14, No. 9 ( 2005-09-01), p. 2147-2153
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 14, No. 9 ( 2005-09-01), p. 2147-2153
    Abstract: Differences in breast cancer incidence across racial groups are well documented. African Americans have the highest rates of premenopausal breast cancer and Asians have lower breast cancer rates across all age groups. We hypothesized that levels of premenopausal endogenous hormones and growth factors, risk factors that have been predictive of breast cancer, would differ by race. Using a cross-sectional study design, we tested this hypothesis in the Nurses' Health Study II. We assayed estradiol, progesterone, prolactin, sex hormone binding globulin (SHBG), insulin-like growth factor-I (IGF-I), and IGFBP-3 in 111 African American and 111 Asian American women, matched to 111 Caucasian women on age, day of luteal phase, and day, time, and fasting status at blood collection. We analyzed the association between race and hormone levels using robust linear regression methods. In multivariate models, compared with Caucasians, African Americans had 18% higher levels of estradiol (P & lt; 0.01), 17% higher free estradiol (P & lt; 0.01), 11% lower SHBG (P = 0.05), 11% higher IGF-I (P & lt; 0.01), 25% higher free IGF-I (P & lt; 0.01), and 9% lower IGFBP-3 (P & lt; 0.01) levels. In multivariate models, compared with Caucasian women, Asian Americans had 22% higher calculated free estradiol (P & lt; 0.01), 31% lower SHBG (P & lt; 0.01), and 25% higher free IGF-I (P & lt; 0.01) levels. No racial differences were found in progesterone and prolactin levels. Our study showed hormone differences consistent with breast cancer risk between Caucasians and African Americans but inconsistent with breast cancer risk between Asian Americans and Caucasians. Further research is needed to explore differences across racial groups and the link between endogenous hormones and breast cancer risk.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2005
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  • 2
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 80, No. 4_Supplement ( 2020-02-15), p. P6-08-28-P6-08-28
    Abstract: Background: HBOC testing guidelines were established to identify patients with clinically actionable variants and limit economic burden. We report the impact of germline results on health outcome based on clinical decision making and treatment interventions, regardless of guidelines, in a multi-center registry. Methods: 20 community-based and academic sites participated in an IRB approved registry. Patients with breast cancer were tested with an 80-gene panel and clinical information was collected. Results: Data on 912 patients has been analyzed to date. 68% were recently diagnosed and the remaining were diagnosed in the past. 50.5% met NCCN criteria; 49.5% did not. Pathogenic/likely pathogenic (P/LP) germline mutations were found in 8.65% of patients. Of all patients with P/LP findings, 85% had variants in cancer-risk genes with established management recommendations and 80% had germline variants conferring eligibility for clinical trials and precision medicine-based cancer treatments, such as PARP inhibitors. When results were evaluated based on an 11 gene panel of genes most commonly associated with breast cancer, 4.9% (or X) were found to have variants and X percent of these had variants conferring eligibility for clinical trials and precision medicine. X Patients with variants outside of the 11 gene panel had eligibility for clinical trials and precision medicine. There was no significant association between BRCAPRO scores and patients having a P/LP finding, whether in BRCA1/2 alone (p=0.42) or for any cancer gene (p=0.57). For 62% of patients with P/LP germline mutations, clinicians reported results impacted patients’ health outcome; and for 69%, results impacted the health outcome of patients’ relatives. Physician reported impact on patient outcome associated significantly with the presence of P/LP germline findings (p & lt;0.00001). There was no significant difference in the clinician reported clinical utility of variants of uncertain significance (VUS) compared to negative results (p=0.467). Conclusions: Comprehensive panel testing of breast cancer patients impacts physician assessed patient outcomes and informs changes in surgical treatment strategy, medical therapies and proactive screening. The data suggest that BRCAPRO calculators are poor predictors of germline presence of P/LP findings. Physicians in this study demonstrate the ability to discern the clinically actionable value of P/LP mutations from non-actionable VUS. Multigene panels impact breast cancer patient care by identifying precision medicine treatment interventions and guiding long-term medical management and preventive surveillance for patients and family members. More patients are provided opportunities for precision medicine when a larger panel is used. Table 1. Comprehensive panel clinical management and treatment implications. Germline variants with implications for patient management and treatment. *P/LP variants in these genes confer potential clinical trial eligibility, e.g. NCT02401347.Table 1PatientsVariantsWith breast cancer management guidelines45 (56%)46 (55%)(ATM*, BRCA1*, BRCA2*, CHEK2*, NBN*, NF1, PALB2*, TP53*)With cancer management implications31 (38%)33 (39%)(BARD1*, FH, MITF, MSH6*, MUTYH*, PTCH1, RAD50*, RAD51C*, RAD51D*, RB1, RET, VHL)Evidence of actionability accruing5 (6%)5 (6%)(BLM, DIS3L2, RECQL4)Total8184 Citation Format: Peter Beitsch, Pat Whitworth, Kevin Hughes, Ian Grady, Karen Barbosa, Rakesh Patel, Michael Kinney, Paul Baron, Barry Rosen, Gia Compagnoni, Linda ann Smith, Rache Simmons, Cynara Coomer, Dennis Holmes, Eric Brown, Linsey Gold, Lisa Curcio, Patricia Clark, Tony Ruiz, Heather MacDonald, Sadia Khan, Lee Riley, Sam Lyons, Shan Yang, Mary K Hardwick, Edward D Esplin, Robert L Nussbaum. Comprehensive germline multigene panel testing changes clinical care for patients with breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-08-28.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
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  • 3
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 69, No. 24_Supplement ( 2009-12-15), p. 5082-5082
    Abstract: Background: Docetaxel/cyclophosphamide (TC) has superior activity to doxorubicin/cyclophosphamide (AC) in the adjuvant treatment of patients (pts) with early breast cancer and is devoid of known cardiac toxicity (Jones et al, JCO 27:1177-1183, 2009). Although the addition of trastuzumab (H) to anthracycline-based adjuvant regimens is effective, it is associated with increased cardiac toxicity. Therefore, a short course of the nonanthracycline TC regimen coupled with H appeared to be a logical combination for women with lower risk HER2+ breast cancer. We report the cardiac safety of the TC+H regimen for the first group of women to complete 1 year of treatment.Patients and Methods: 263 pts were registered to the study and stratified by nodal status (positive/negative). Pts must have had baseline left ventricular ejection fraction (LVEF) ≥50% by MUGA or ECHO. On Day 1 of each 21-day cycle for a total of 4 cycles, pts received: (T) 75 mg/m2 IV, followed by (C) 600 mg/m2 IV. Weekly (H) was also given at 4 mg/kg IV (loading dose, over 90 minutes Day 1, Cycle 1 only) and 2 mg/kg IV Days 1, 8, 15 thereafter throughout chemotherapy. After completion of chemotherapy, H was administered at 6 mg/kg IV every 3 weeks to complete 12 months of therapy with H. Decreased LVEF was defined as a decrease from baseline (start of treatment) to completion of TC+H, or when assessed at 3-month intervals until the completion of H treatment. H was withheld if there was a 15% or more decline in LVEF (absolute %). Treatment was discontinued after 2 or 3 treatment delays at investigator's discretion (same rules as prior studies). This report focuses on cardiac safety occurring during the 3 months of chemotherapy plus 1 year of H therapy.Results: To date, 260 pts completed 1 year of treatment and comprised the cardiac safety population; median age was 55 yrs (30-76); 90% of pts had ECOG 0; 64% were ER+, 47% were PR+, and 77% had no lymph node involvement. 184 pts (70%) completed planned treatment and 23 pts (9%) discontinued treatment due to adverse events. A total of 61 pts (23.5%) had declines of ≥10% LVEF; 8 pts (3.1%) had 2 or more LVEF declines ≥10% and were taken off treatment before 1 year of H was completed, and 16 pts (6.1%) had declines of LVEF below 50% during treatment. No patient had clinical CHF.Scheduled MUGA/ECHO ResultsMonthPatients, no.Median LVEF, % (range)Patients with decrease LVEF ≥10%, no.Patients with LVEF & lt;50%, no.Baseline26064 (49,89)––1-324163 (40,85)154-623062 (40,85)2157-921763 (36,89)265≥1018763 (48,80)131Conclusions: H combined with 4 cycles of the nonanthracycline TC regimen produced a low rate of cardiac events, mainly asymptomatic drops in LVEF, but no reported cases of CHF. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5082.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2009
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  • 4
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 30, No. 4 ( 2021-04-01), p. 623-642
    Abstract: It is not known whether modifiable lifestyle factors that predict survival after invasive breast cancer differ by subtype. Methods: We analyzed data for 121,435 women diagnosed with breast cancer from 67 studies in the Breast Cancer Association Consortium with 16,890 deaths (8,554 breast cancer specific) over 10 years. Cox regression was used to estimate associations between risk factors and 10-year all-cause mortality and breast cancer–specific mortality overall, by estrogen receptor (ER) status, and by intrinsic-like subtype. Results: There was no evidence of heterogeneous associations between risk factors and mortality by subtype (Padj & gt; 0.30). The strongest associations were between all-cause mortality and BMI ≥30 versus 18.5–25 kg/m2 [HR (95% confidence interval (CI), 1.19 (1.06–1.34)]; current versus never smoking [1.37 (1.27–1.47)] , high versus low physical activity [0.43 (0.21–0.86)], age ≥30 years versus & lt;20 years at first pregnancy [0.79 (0.72–0.86)]; & gt;0– & lt;5 years versus ≥10 years since last full-term birth [1.31 (1.11–1.55)]; ever versus never use of oral contraceptives [0.91 (0.87–0.96)] ; ever versus never use of menopausal hormone therapy, including current estrogen–progestin therapy [0.61 (0.54–0.69)]. Similar associations with breast cancer mortality were weaker; for example, 1.11 (1.02–1.21) for current versus never smoking. Conclusions: We confirm associations between modifiable lifestyle factors and 10-year all-cause mortality. There was no strong evidence that associations differed by ER status or intrinsic-like subtype. Impact: Given the large dataset and lack of evidence that associations between modifiable risk factors and 10-year mortality differed by subtype, these associations could be cautiously used in prognostication models to inform patient-centered care.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2021
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  • 5
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 71, No. 24_Supplement ( 2011-12-15), p. PD07-03-PD07-03
    Abstract: Introduction: TC is an effective adjuvant chemotherapy regimen in early stage breast cancer (ESBC) patients. Jones et al (J Clin Oncol 2009 Mar 10;27(3): 1177–1183) demonstrated a significantly superior 5-year DFS and OS for TC compared to AC. Because TC was superior to AC in a subset analysis of HER2+ breast cancer treated without trastuzumab, we tested TC in combination with 1 year of trastuzumab in lower risk HER2+ ESBC, predominately node negative disease. Methods: This was an open-label, phase II study of TC+H in HER2+ patients based on HER2 overexpression determined at the local level. Tissue was collected for central review of HER2 and TOP2A status. There was no lower limit of tumor size for lymph node negative cancers. Every 21 days, patients received docetaxel (T) 75mg/m2 IV, plus cyclophosphamide (C) 600mg/m2 IV, plus weekly trastuzumab (H) 4mg/kg IV (loading dose) and 2mg/kg IV thereafter for a total of 4 cycles. After 4 cycles of TC+H, patients continued on H for a total of 1 year. Appropriate patients received radiotherapy. Cardiotoxicity (decreased left ventricular ejection faction) was assessed by MUGA or ECHO at baseline, at completion of TC+H, and then at 3-month intervals until completion of trastuzumab treatment. The primary endpoint was DFS at 2 years with continued follow-up for 3 years. Secondary endpoints were OS and safety. Results: 486 patients received treatment, and 397(82%) completed a full year of H. Median age was 55 years(range: 24–75.8), ECOG PS 0=426(87.7%) and 1=60(12.3%); 280(57.6%) were Stage 1, 200(41.2%) were Stage II, and 6(1.2%) were Stage III. Disease-free survival and OS at 2 and 3 years are listed in the table below according to various features. The most common Grade 3/4 toxicities were neutropenia (47.1%) and febrile neutropenia (6.2%). There were 5 deaths: 1 due to PD, 1 aspiration, and 1 respiratory distress syndrome (possibly related to treatment), 1 cardiopulmonary arrest, and 1 unknown. There were 13 cases of recurrent breast cancer (local 5, or local/distant 8). Cardiac dysfunction occurred in 28(5.8%) patients, with 12(2.5%) being Grade 1, 14(2.9%) Grade 2, and 2(0.4%) grades 3/4. Sixteen patients had to stop H due to cardiac dysfunction with H. Central assessment of TOP2A status was performed by FISH in 90% of cases: TOP2A-amplified (42%), deleted (27%), and normal (31%). However TOP2A status had no effect on outcome. Conclusions: 1) The HER TC regimen was evaluated in 486 patients with HER2 overexpressed ESBC and found to be effective at the primary endpoint of 2 years. 2) Efficacy was demonstrated in node negative cancer including 94 cancers & lt;1 cm. 3) Toxicity was acceptable with a low rate of cardiac dysfunction, mainly reversible. 4) The HER TC regimen is an option for patients with lower risk HER2 overexpressing ESBC. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD07-03.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2011
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  • 6
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 69, No. 2_Supplement ( 2009-01-15), p. 2111-
    Abstract: Abstract #2111 Background: Docetaxel/cyclophosphamide (TC) has demonstrated superior activity to doxorubicin/cyclophosphamide (AC) in the adjuvant treatment of patients (pts) with early breast cancer and is devoid of known cardiac toxicity (Jones et al, SABCS 2007, abstract 12). Although the addition of trastuzumab (H) to anthracycline-based adjuvant regimens has proven effective, it has also been associated with increased cardiac toxicity. Therefore, a short course of the nonanthracycline TC regimen coupled with H appeared to be a logical combination for women with lower risk HER2+ breast cancer. We report safety and tolerability of the TC+H regimen. & #x2028; Patients and Methods: 256 of a planned 260 patients (pts) were registered to the study and stratified by positive or negative nodes. On Day 1 of each 21-day cycle for a total of 4 cycles, pts received (in order): (T) 75 mg/m2 IV, followed by (C) 600 mg/m2 IV. Weekly (H) was also given at 4 mg/kg IV (loading dose, over 90 minutes Day 1, Cycle 1 only) and 2 mg/kg IV (Days 1, 8, 15) thereafter throughout chemotherapy. After completion of chemotherapy, H was administered at a dose of 6 mg/kg IV every 3 weeks to complete 12 months of therapy with H. Pts must have had LVEF & gt;50% at the time of registration and had regular cardiac evaluation throughout the study (MUGA or ECHO). & #x2028; Results: To date, 231 pts were treated and comprise the safety population; this first report focused on toxicity occurring during the first 4 months of co-administration of chemotherapy and H. The median age was 55 years; 84% of pts were ECOG 0; 61% were ER+. Selected treatment-related toxicities in ≥3% of pts are listed in Table 1. Of the 231 pts, 10 pts came off treatment due to adverse events: hypersensitivity (3), gastrointestinal (2), hematologic (2), pulmonary (1), skin (1), and cardiac (1). To date, only 1 patient has had a significant drop in LVEF to 40%, and was taken off treatment. & #x2028; & #x2028; Conclusion: 4 cycles of TC combined with H is a well-tolerated adjuvant treatment with an acceptable toxicity profile for lower risk patients with HER2+ breast cancer. & #x2028; This research was supported, in part, by a research grant from sanofi-aventis, Bridgewater, NJ. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2111.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2009
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  • 7
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 19, No. 8 ( 2010-08-01), p. 2023-2034
    Abstract: Background: Supplement use among cancer patients is high, and folic acid intake in particular may adversely affect the progression of colorectal cancer. Few studies have evaluated the use of folic acid–containing supplements (FAS) and its predictors in colorectal cancer patients. Objective: To assess the use of FAS, change in use, and its predictors after colorectal cancer diagnosis. Design: We used logistic regression models to investigate predictors of FAS use and its initiation after colorectal cancer diagnosis in 1,092 patients recruited through the Colon Cancer Family Registry. Results: The prevalence of FAS use was 35.4% before and 55.1% after colorectal cancer diagnosis (P = 0.004). Women were more likely than men to use FAS after diagnosis [odds ratio (OR), 1.47; 95% confidence interval (95% CI), 1.14-1.89], as were those consuming more fruit (Ptrend & lt; 0.0001) or vegetables (Ptrend = 0.001), and U.S. residents (P & lt; 0.0001). Less likely to use FAS after diagnosis were nonwhite patients (OR, 0.66; 95% CI, 0.45-0.97), current smokers (OR, 0.67; 95% CI, 0.46-0.96), and those with higher meat intake (Ptrend = 0.03). Predictors of FAS initiation after diagnosis were generally similar to those of FAS use after diagnosis, although associations with race and vegetable intake were weaker and those with exercise stronger. Conclusions: Our analysis showed substantial increases in the use of FAS after diagnosis with colorectal cancer, with use or initiation more likely among women, Caucasians, U.S. residents, and those with a health-promoting life-style. Impact: Studies of cancer prognosis that rely on prediagnostic exposure information may result in substantial misclassification. Cancer Epidemiol Biomarkers Prev; 19(8); 2023–34. ©2010 AACR.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2010
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  • 8
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 21, No. 19 ( 2015-10-01), p. 4305-4311
    Abstract: Purpose: We conducted a randomized phase III study to determine whether patients with early breast cancer would benefit from the addition of capecitabine (X) to a standard regimen of doxorubicin (A) plus cyclophosphamide (C) followed by docetaxel (T). Experimental Design: Treatment comprised eight cycles of AC→T (T dose: 100 mg/m2 on day 1) or AC→XT (X dose: 825 mg/m2 twice daily, days 1–14; T dose: 75 mg/m2 on day 1). The primary endpoint was 5-year disease-free survival (DFS). Results: Of 2,611 women, 1,304 were randomly assigned to receive AC→T and 1,307 to receive AC→XT. After a median follow-up of 5 years, the study failed to meet its primary endpoint [HR, 0.84; 95% confidence interval (CI), 0.67–1.05; P = 0.125] . A significant improvement in overall survival, a secondary endpoint, was seen with AC→XT versus AC→T (HR, 0.68; 95% CI, 0.51–0.92; P = 0.011). There were no unexpected adverse events. Of patients with estrogen receptor (ER)–positive/HER2-negative disease, 70% of whom were node-positive, 26% and 59% had tumors with a centrally assessed Ki-67 score of & lt;10% or & lt;20%, respectively, and only 17 (2%) and 53 (6%) DFS events, respectively, occurred in these groups at 7 years. Conclusions: The very low event rate in patients with ER-positive, low Ki-67 cancers, regardless of nodal status, strongly suggests that these patients should not be enrolled in adjuvant trials that assess 5-year DFS rates and that central Ki-67 analyses can identify these patients. Clin Cancer Res; 21(19); 4305–11. ©2015 AACR.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
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