Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.61
Hanbyoul Cho, Gwan Hee Han, Jae-Hoon Kim
61 Background: Transcriptional factor, Forkhead box protein O1 (FOXO1) has been reported to play an imported role in human cancer, but the role in epithelial ovarian cancer (EOC) has not yet been clarified. Here, we evaluatedthe expression and clinical significance of FOXO1 in EOC. Methods: Immunohistochemical analyses of FOXO1 and PAX3 in 212 in EOCs, 57 borderline ovarian tumors and 153 benign epithelial ovarian tumors and 79 nonadjacent normal epithelial tissues were performed using tissue microarray analysis. The data were compared with clinicopathological variables including the survival of EOC patients. Also, the effect of FOXO1 on cell growth were assessed in EOC cell lines. Results: The expressions of FOXO1 and PAX3 protein were significantly higher in EOC tissues than in nonadjacent normal epithelial tissues, benign tissues and borderline tumors respectively (all p< 0.001). Overexpression of FOXO1 was significantly associated with poor grade ( p = 0.004). FOXO1 expression showed trend of positive correlation with that of PAX3 in EOC tissues ( Spearman’s rho0.118, p= 0.149). Multivariate survival analysis revealed that the high expression of FOXO1 (hazard ratio = 2.74 [95% CI, 1.22–13.10], p = 0.001) could be an independent prognostic factor for overall survival. Most importantly, high expression of both FOXO1 and PAX3 showed high hazard ratio (hazard ratio = 5.53 [95% CI, 2.47–12.40], p< 0.001) for overall survival. In vitro result revealed that knockdown of FOXO1 was associated decreased cell viability and migration. Conclusions: This study reveals that high expression of FOXO1/PAX3 is an indicator of poor prognosis in EOC. Our results not only suggest the promising potential of FOXO1 and PAX3 as a prognostic and survival marker, but also warrant further studies on a possible link between the biological function of FOXO1 and PAX3 of EOC.
{"title":"Prognostic implication of forkhead box protein O1 (FOXO1) and paired box gene 3 (PAX3) in epithelial ovarian cancer.","authors":"Hanbyoul Cho, Gwan Hee Han, Jae-Hoon Kim","doi":"10.1200/jgo.2019.5.suppl.61","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.61","url":null,"abstract":"61 Background: Transcriptional factor, Forkhead box protein O1 (FOXO1) has been reported to play an imported role in human cancer, but the role in epithelial ovarian cancer (EOC) has not yet been clarified. Here, we evaluatedthe expression and clinical significance of FOXO1 in EOC. Methods: Immunohistochemical analyses of FOXO1 and PAX3 in 212 in EOCs, 57 borderline ovarian tumors and 153 benign epithelial ovarian tumors and 79 nonadjacent normal epithelial tissues were performed using tissue microarray analysis. The data were compared with clinicopathological variables including the survival of EOC patients. Also, the effect of FOXO1 on cell growth were assessed in EOC cell lines. Results: The expressions of FOXO1 and PAX3 protein were significantly higher in EOC tissues than in nonadjacent normal epithelial tissues, benign tissues and borderline tumors respectively (all p< 0.001). Overexpression of FOXO1 was significantly associated with poor grade ( p = 0.004). FOXO1 expression showed trend of positive correlation with that of PAX3 in EOC tissues ( Spearman’s rho0.118, p= 0.149). Multivariate survival analysis revealed that the high expression of FOXO1 (hazard ratio = 2.74 [95% CI, 1.22–13.10], p = 0.001) could be an independent prognostic factor for overall survival. Most importantly, high expression of both FOXO1 and PAX3 showed high hazard ratio (hazard ratio = 5.53 [95% CI, 2.47–12.40], p< 0.001) for overall survival. In vitro result revealed that knockdown of FOXO1 was associated decreased cell viability and migration. Conclusions: This study reveals that high expression of FOXO1/PAX3 is an indicator of poor prognosis in EOC. Our results not only suggest the promising potential of FOXO1 and PAX3 as a prognostic and survival marker, but also warrant further studies on a possible link between the biological function of FOXO1 and PAX3 of EOC.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45656032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.100
Tomohiro Tanaka, T. Yoshida, K. Masuda, Y. Takeyasu, Y. Shinno, Y. Matsumoto, Y. Okuma, Y. Goto, H. Horinouchi, N. Yamamoto, Y. Ohe
100 Background: Immunosenescence, an age-related impairment of the immune system, dampens acquired immunity and promotes inflammation. Therefore, it could also influence the degree of effectiveness of immune checkpoint inhibitors. Methods: We retrospectively reviewed the data of 52 NSCLC patients aged ≧75 years old treated with nivolumab or pembrolizumab from December 2015 to April 2019. Immunosenescence was assessed by the modified Glasgow Prognostic Scale (mGPS), Neutrophil-to-lymphocyte ratio (NLR), and Charlson Comorbidity Index (CCI), which are related to nutrition, inflammation and comorbidity, respectively. The Cox proportional hazard model and Kaplan-Meier curves were used to identify factors associated with survival. Results: The median follow-up duration was 19.5M (IQR:1-41). The patient characteristics were as follows: median age 79.7 years; male/female ratio, 41/11; PS0/1/2/3, 10/32/8/2; adeno/squamous histology/others, 33/15/4;stage III/IV/recurrence, 2/26/24; PD-L1 (22C3) (%)unknown/0/1-49/50-100, 18/2/8/24; driver mutation status positive/negative, 11/41; nivolumab/pembrolizumab, 29/23; treatment line 1/2/3/4 or more, 28/15/3/6; median number of treatment cycles 7.0 (1-53). The overall response rate (ORR) and disease control rate (DCR) were29.1% and 56.2%, respectively. The median progression-free survival (PFS) was 4.2 months (95% CI 1.8-7.5). The mGPS was significantly associated with the DCR (High/Low = 37.5/68.8%, p = 0.02) and the PFS (score 0-1/2 = 4.1/0.6 months) (HR: 0.37, 95% CI 0.18-0.74, p <0.01). However, neither the CCI nor the NLR wasassociated with the PFS (CCI: High/Low = 3.8/1.8 months, p = 0.64, and NLR: High (>3.5)/Low (≦3.5) = 3.8/5.6 months, p = 0.89). Multivariate regression analysis identified the mGPS as a significant predictor of the PFS(HR: 0.40, p = 0.008). Conclusions: A high mGPS score was significantly associated with a lower DCR and shorter PFS in elderly NSCLC patients treated with anti-PD-1 antibody.
100背景:免疫衰老是一种与年龄相关的免疫系统损伤，它会抑制获得性免疫并促进炎症。因此，它也可能影响免疫检查点抑制剂的有效程度。方法:回顾性分析2015年12月至2019年4月接受纳武单抗或派姆单抗治疗的52例年龄≥75岁的非小细胞肺癌患者的资料。免疫衰老采用改良的格拉斯哥预后量表(mGPS)、中性粒细胞与淋巴细胞比值(NLR)和Charlson共病指数(CCI)进行评估，这三个指标分别与营养、炎症和共病有关。采用Cox比例风险模型和Kaplan-Meier曲线确定与生存率相关的因素。结果:中位随访时间为195m (IQR:1-41)。患者特征如下:中位年龄79.7岁;男女比例41/11;PS0/1/2/3 10/32/8/2;腺/鳞状组织/其他，33/15/4;III/IV期/复发，2/26/24;未知PD-L1 (c3) 22日(%)/ 0/1 - 49/50 - 100,18/2/8/24;驱动突变状态为阳性/阴性，11/41;nivolumab / pembrolizumab, 29/23;处理线1/2/3/4以上，28/15/3/6;治疗周期中位数为7.0(1-53)。总有效率(ORR)和疾病控制率(DCR)分别为29.1%和56.2%。中位无进展生存期(PFS)为4.2个月(95% CI 1.8-7.5)。mGPS与DCR(高/低= 37.5/68.8%，p = 0.02)和PFS(评分0-1/2 = 4.1/0.6个月)(HR: 0.37, 95% CI 0.18-0.74, p = 3.5)/低(≦3.5)= 3.8/5.6个月，p = 0.89)有显著相关性。多因素回归分析发现mGPS是PFS的显著预测因子(HR: 0.40, p = 0.008)。结论:在抗pd -1抗体治疗的老年NSCLC患者中，高mGPS评分与较低的DCR和较短的PFS显著相关。
{"title":"Prognostic role of immunosenscence associated with index in elderly non-small cell lung cancer patients treated with an anti-PD-1 antibody.","authors":"Tomohiro Tanaka, T. Yoshida, K. Masuda, Y. Takeyasu, Y. Shinno, Y. Matsumoto, Y. Okuma, Y. Goto, H. Horinouchi, N. Yamamoto, Y. Ohe","doi":"10.1200/jgo.2019.5.suppl.100","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.100","url":null,"abstract":"100 Background: Immunosenescence, an age-related impairment of the immune system, dampens acquired immunity and promotes inflammation. Therefore, it could also influence the degree of effectiveness of immune checkpoint inhibitors. Methods: We retrospectively reviewed the data of 52 NSCLC patients aged ≧75 years old treated with nivolumab or pembrolizumab from December 2015 to April 2019. Immunosenescence was assessed by the modified Glasgow Prognostic Scale (mGPS), Neutrophil-to-lymphocyte ratio (NLR), and Charlson Comorbidity Index (CCI), which are related to nutrition, inflammation and comorbidity, respectively. The Cox proportional hazard model and Kaplan-Meier curves were used to identify factors associated with survival. Results: The median follow-up duration was 19.5M (IQR:1-41). The patient characteristics were as follows: median age 79.7 years; male/female ratio, 41/11; PS0/1/2/3, 10/32/8/2; adeno/squamous histology/others, 33/15/4;stage III/IV/recurrence, 2/26/24; PD-L1 (22C3) (%)unknown/0/1-49/50-100, 18/2/8/24; driver mutation status positive/negative, 11/41; nivolumab/pembrolizumab, 29/23; treatment line 1/2/3/4 or more, 28/15/3/6; median number of treatment cycles 7.0 (1-53). The overall response rate (ORR) and disease control rate (DCR) were29.1% and 56.2%, respectively. The median progression-free survival (PFS) was 4.2 months (95% CI 1.8-7.5). The mGPS was significantly associated with the DCR (High/Low = 37.5/68.8%, p = 0.02) and the PFS (score 0-1/2 = 4.1/0.6 months) (HR: 0.37, 95% CI 0.18-0.74, p <0.01). However, neither the CCI nor the NLR wasassociated with the PFS (CCI: High/Low = 3.8/1.8 months, p = 0.64, and NLR: High (>3.5)/Low (≦3.5) = 3.8/5.6 months, p = 0.89). Multivariate regression analysis identified the mGPS as a significant predictor of the PFS(HR: 0.40, p = 0.008). Conclusions: A high mGPS score was significantly associated with a lower DCR and shorter PFS in elderly NSCLC patients treated with anti-PD-1 antibody.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44036848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.91
Tran Duc Canh, Bui Anh Tuyet, P. Dat, Nguyen Van Chu
91 Background: Gastric cancer is in the top three most common cancers in Vietnam and the disease is mainly detected in late stage. There is a lack of evaluation of the pre-neoplasia stage of gastric cancer and selection an appropriate and effective treatment remains still in debate. Hence, the study aims to evaluate, for the first time, the safety and efficacy of the application of endoscopic submucosal dissection (ESD) technique on Vietnamese patients with pre-neoplasia lesion in stomach. Methods: We included all patients diagnosed with lower or high-grade gastric dysplasia and hopitalized in the Department of Endoscopic and Functional Exploration in K Hospital from March 2018 to June 2019. Eligible patients were applied by the ESD technique as the standard treatment. We evaluated the efficacy and safety of after the intervention of ESD by the neoplasia recurrence rate after 3 months and the occurrence of adverse events during and after the ESD procedure described in frequency and percentage. Results: During the investigational period, we chose 65 pre-neoplasia gastric patients for the application of ESD technique. The male/female ratio was 1.09 and the mean age of patients was 58.07 years. The duration of hospitalization was about 3 days. We found 57 patients (87.69%) with location of the lesions in pylorus. The average of tumor sizes was 20.46 mm. All patients were treated with curative en bloc resection and no case was found as failure. Out of 65 patients, we found 2 patients (3%) with bleeding complication, no perforation and other post-surgery complication were identified. The average of procedure time was short (67.53 minutes). The histopathological specimen results revealed that 20 patients (30.76%) were diagnosed as cancer and 40 patients (61.53%) were diagnosed as high-grade dysplasia, all patients had a margin negative after ESD. After 3 months of treatment, all patients have no pre-neoplastic recurrence. Conclusions: Our result showed that the ESD technique is relatively safe and effective for Vietnamese patients with pre-neoplasia at stomach.
{"title":"Preliminary results of endoscopic submucosal dissection in Vietnamese patients with gastric pre-neoplasia lesion.","authors":"Tran Duc Canh, Bui Anh Tuyet, P. Dat, Nguyen Van Chu","doi":"10.1200/jgo.2019.5.suppl.91","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.91","url":null,"abstract":"91 Background: Gastric cancer is in the top three most common cancers in Vietnam and the disease is mainly detected in late stage. There is a lack of evaluation of the pre-neoplasia stage of gastric cancer and selection an appropriate and effective treatment remains still in debate. Hence, the study aims to evaluate, for the first time, the safety and efficacy of the application of endoscopic submucosal dissection (ESD) technique on Vietnamese patients with pre-neoplasia lesion in stomach. Methods: We included all patients diagnosed with lower or high-grade gastric dysplasia and hopitalized in the Department of Endoscopic and Functional Exploration in K Hospital from March 2018 to June 2019. Eligible patients were applied by the ESD technique as the standard treatment. We evaluated the efficacy and safety of after the intervention of ESD by the neoplasia recurrence rate after 3 months and the occurrence of adverse events during and after the ESD procedure described in frequency and percentage. Results: During the investigational period, we chose 65 pre-neoplasia gastric patients for the application of ESD technique. The male/female ratio was 1.09 and the mean age of patients was 58.07 years. The duration of hospitalization was about 3 days. We found 57 patients (87.69%) with location of the lesions in pylorus. The average of tumor sizes was 20.46 mm. All patients were treated with curative en bloc resection and no case was found as failure. Out of 65 patients, we found 2 patients (3%) with bleeding complication, no perforation and other post-surgery complication were identified. The average of procedure time was short (67.53 minutes). The histopathological specimen results revealed that 20 patients (30.76%) were diagnosed as cancer and 40 patients (61.53%) were diagnosed as high-grade dysplasia, all patients had a margin negative after ESD. After 3 months of treatment, all patients have no pre-neoplastic recurrence. Conclusions: Our result showed that the ESD technique is relatively safe and effective for Vietnamese patients with pre-neoplasia at stomach.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41514548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.118
Jie Xu, Lu Xie, W. Guo, Xin Sun, Kuisheng Liu, Bingxin Zheng, T. Ren, Yi Huang, Xiaodong Tang, T. Yan, Rongli Yang
118 Background: Both protracted irinotecan and anti-angiogenesis therapy have shown promising results in Ewing sarcoma. We did this phase Ib/II trial to first define the proper dose of irinotecan in combination with anlotinib in Ewing sarcoma (phase Ib) and then evaluate efficacy (phase II). Methods: Patients diagnosed with recurrent or refractory Ewing sarcoma were enrolled and sub-classified into cohort A (≥16y) or cohort B ( < 16y). In the dose-defining phase Ib portion, anlotinib was given at a fixed dose of 12mg D1-14 every 21 days, while the de-escalated 3+3 design was used to detect the recommended dose of irinotecan in each cohort from an initial level of 20mg/m2/d dx5x2. Recommended phase 2 dose (RP2D) was defined as the highest dose at which no more than 30% patients experience a DLT in the first two courses. In the next dose-expanding phase II portion, the primary endpoint was objective response rate at 12 weeks (ORR12w). Results: 41 patients were finally enrolled with 29 in cohortA and 12 in cohortB. For cohortA, first 5 patients were treated at initial level in phase Ib portion, two of whom subsequently experienced delayed diarrhea as dose-limiting toxicity (DLT). Additional six patients were then treated at a lower dose of 15mg/m2. Since no more DLT was recorded, it was used as RP2D. 23/24 patients in cohort A phase II were available for response evaluation at 12 weeks, with one complete response (CR), 14 partial response (PR) , 2 stable disease (SD) and 6 progressive disease (PD). ORR12wwas 62.5%. For cohort B, no DLT was noticed in the first six patients treated at the initial level which was used as RP2D later. Finally, 12 patients were included in cohort B. ORR12wwas 83.3% with two CR, 8 PR and two PD. Although effective, cohort B were closed because of slow enrollment. Most common grade 3/4 adverse events were leukopenia (28.5%), neutropenia (24.4%), anemia (8.7%) and diarrhea (3.7%). The genotype of UGT1A1*1 and UGT1A1*28 were not associated with the risk of diarrhea. Conclusions: The combination of irinotecan and anlotinib demonstrated an acceptable toxicity profile with promising evidence of clinical efficacy in advanced Ewing sarcoma. Clinical trial information: NCT03416517.
{"title":"Anlotinib, vincristine, and irinotecan for advanced Ewing sarcoma after failure of standard multimodal therapy: A multicenter, two-cohort, phase Ib/II trial (NCT03416517).","authors":"Jie Xu, Lu Xie, W. Guo, Xin Sun, Kuisheng Liu, Bingxin Zheng, T. Ren, Yi Huang, Xiaodong Tang, T. Yan, Rongli Yang","doi":"10.1200/jgo.2019.5.suppl.118","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.118","url":null,"abstract":"118 Background: Both protracted irinotecan and anti-angiogenesis therapy have shown promising results in Ewing sarcoma. We did this phase Ib/II trial to first define the proper dose of irinotecan in combination with anlotinib in Ewing sarcoma (phase Ib) and then evaluate efficacy (phase II). Methods: Patients diagnosed with recurrent or refractory Ewing sarcoma were enrolled and sub-classified into cohort A (≥16y) or cohort B ( < 16y). In the dose-defining phase Ib portion, anlotinib was given at a fixed dose of 12mg D1-14 every 21 days, while the de-escalated 3+3 design was used to detect the recommended dose of irinotecan in each cohort from an initial level of 20mg/m2/d dx5x2. Recommended phase 2 dose (RP2D) was defined as the highest dose at which no more than 30% patients experience a DLT in the first two courses. In the next dose-expanding phase II portion, the primary endpoint was objective response rate at 12 weeks (ORR12w). Results: 41 patients were finally enrolled with 29 in cohortA and 12 in cohortB. For cohortA, first 5 patients were treated at initial level in phase Ib portion, two of whom subsequently experienced delayed diarrhea as dose-limiting toxicity (DLT). Additional six patients were then treated at a lower dose of 15mg/m2. Since no more DLT was recorded, it was used as RP2D. 23/24 patients in cohort A phase II were available for response evaluation at 12 weeks, with one complete response (CR), 14 partial response (PR) , 2 stable disease (SD) and 6 progressive disease (PD). ORR12wwas 62.5%. For cohort B, no DLT was noticed in the first six patients treated at the initial level which was used as RP2D later. Finally, 12 patients were included in cohort B. ORR12wwas 83.3% with two CR, 8 PR and two PD. Although effective, cohort B were closed because of slow enrollment. Most common grade 3/4 adverse events were leukopenia (28.5%), neutropenia (24.4%), anemia (8.7%) and diarrhea (3.7%). The genotype of UGT1A1*1 and UGT1A1*28 were not associated with the risk of diarrhea. Conclusions: The combination of irinotecan and anlotinib demonstrated an acceptable toxicity profile with promising evidence of clinical efficacy in advanced Ewing sarcoma. Clinical trial information: NCT03416517.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41489644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.9
N. Prasongsook, K. Seetalarom, S. Saichaemchan, Kitipong Udomdamrongkul
9 Background: Web-based patient reported outcome (PRO) improved quality of life (QoL), and overall survival (OS) in patients with advanced NSCLC who were treating with specific therapy. Lung Cancer Care application is a mobile application program that provides patients with individually tailored information on patient reported outcome. This study aims to invent a novel mobile application evaluating PRO for Thai NSCLC patients, and to evaluate the validity of mobile application. Methods: Our mobile application-based PRO was designed for monitoring quality of life. The validity of the application was tested following guidelines for translating, and validating a questionnaire. The quality of life score (FACT-L score). After the validated mobile application-based PRO, patients with advanced NSCLC were randomized to use mobile application-based PRO versus routine follow-up. The primary endpoint was quality of life (QoL). Secondary endpoint was OS. Results: Thirty-three patients with advanced NSCLC were enrolled. The mean of FACT-L score at baseline in mobile application-based PRO arm and routine follow up arm was similar (90.08 ± 5.66 vs 91.78 ± 5.26, p-value= 0.82). Patients with mobile application group had more FACT-L score at 3 months than patients with routine follow up arm (106 ± 5.97 vs 99.96 ± 5.74, p-value = 0.07). There was a trend towards increased in different mean of FACT-L score at baseline and 3 months in patients with mobile application compared to patients with routine follow up ( p-value = 0.05). The median follow-up time was 5.43 months, patients with mobile application had longer median OS than patients with routine follow up (4 months vs 2.9 months, p-value = 0.5). Conclusions: Lung Cancer Care application based on self-reported symptoms is a novel electronic device for real-time patient care monitoring. Our study results showed trend towards improved quality of life from using this novel mobile application. However, there was small samples for pilot testing, the relatively large sampling errors may reduce the statistical power needed to validate this tool.
9背景：基于网络的患者报告结果（PRO）改善了接受特定治疗的晚期NSCLC患者的生活质量（QoL）和总生存率（OS）。Lung癌症Care应用程序是一个移动应用程序，为患者提供关于患者报告结果的个人定制信息。本研究旨在发明一种新的移动应用程序，用于评估泰国NSCLC患者的PRO，并评估移动应用程序的有效性。方法：我们设计了基于移动应用程序的PRO，用于监测生活质量。根据翻译和验证问卷的指导原则，对申请的有效性进行了测试。生活质量评分（FACT-L评分）。在验证了基于移动应用程序的PRO后，将晚期NSCLC患者随机分为使用基于移动应用的PRO和常规随访。主要终点是生活质量（QoL）。次要终结点是操作系统。结果：纳入了33例晚期NSCLC患者。基于移动应用程序的PRO组和常规随访组的基线FACT-L评分平均值相似（90.08±5.66 vs 91.78±5.26，p值=0.82）。移动应用程序组患者在3个月时的FACT-L评分高于常规随访组患者（106±5.97 vs 99.96±5.74，p值=0.07）基线和3个月的移动应用患者与常规随访患者相比（p值=0.05）。中位随访时间为5.43个月，与常规随访患者相比，移动应用的患者OS中位数更长（4个月vs 2.9个月，p值=0.5）。结论：基于自我报告症状的肺癌护理应用是一种新型的实时患者护理监测电子设备。我们的研究结果表明，使用这种新型移动应用程序有提高生活质量的趋势。然而，试点测试的样本很小，相对较大的采样误差可能会降低验证该工具所需的统计能力。
{"title":"A pilot study of using smartphone application versus routine follow up for patients' care in advanced non-small cell lung cancer (NSCLC).","authors":"N. Prasongsook, K. Seetalarom, S. Saichaemchan, Kitipong Udomdamrongkul","doi":"10.1200/jgo.2019.5.suppl.9","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.9","url":null,"abstract":"9 Background: Web-based patient reported outcome (PRO) improved quality of life (QoL), and overall survival (OS) in patients with advanced NSCLC who were treating with specific therapy. Lung Cancer Care application is a mobile application program that provides patients with individually tailored information on patient reported outcome. This study aims to invent a novel mobile application evaluating PRO for Thai NSCLC patients, and to evaluate the validity of mobile application. Methods: Our mobile application-based PRO was designed for monitoring quality of life. The validity of the application was tested following guidelines for translating, and validating a questionnaire. The quality of life score (FACT-L score). After the validated mobile application-based PRO, patients with advanced NSCLC were randomized to use mobile application-based PRO versus routine follow-up. The primary endpoint was quality of life (QoL). Secondary endpoint was OS. Results: Thirty-three patients with advanced NSCLC were enrolled. The mean of FACT-L score at baseline in mobile application-based PRO arm and routine follow up arm was similar (90.08 ± 5.66 vs 91.78 ± 5.26, p-value= 0.82). Patients with mobile application group had more FACT-L score at 3 months than patients with routine follow up arm (106 ± 5.97 vs 99.96 ± 5.74, p-value = 0.07). There was a trend towards increased in different mean of FACT-L score at baseline and 3 months in patients with mobile application compared to patients with routine follow up ( p-value = 0.05). The median follow-up time was 5.43 months, patients with mobile application had longer median OS than patients with routine follow up (4 months vs 2.9 months, p-value = 0.5). Conclusions: Lung Cancer Care application based on self-reported symptoms is a novel electronic device for real-time patient care monitoring. Our study results showed trend towards improved quality of life from using this novel mobile application. However, there was small samples for pilot testing, the relatively large sampling errors may reduce the statistical power needed to validate this tool.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41599529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.113
P. Shilo, A. Kanina
113 Background: Health-Related Quality of Life (HRQoL) is an important issue for elderly patients with colon cancer. We created the expert system which allows to predict low level of HRQoL and accessed it’s quality by using several simulation studies. Methods: We performed a systematic review to figure out the known factors associated with low level of HRQoL in elderly colon cancer patients. The searches were performed in PubMed. We accessed the possible impact of several factors affecting HRQoL, including symptoms, comorbidities and treatment toxicity. All relevant factors were included in prediction model. We assigned the different weights to different factors based on evaluation of clinical studies to develop the logistic regression and Markov stochastic model later. As we needed a binary dependent variable we performed the ROC analysis to figure out an optimal cutoff of HRQoL. Then we simulated a partly virtual dataset based on elderly colon cancer patients diagnosed in Davidovskiy Hospital to evaluate the prediction model quality. All statistical calculations were performed in RStudio. The simulation part was performed using simFrame R package. Results: Twenty two studies with a total number of 2516 patients were included in our systematic review. The 39 factors with different weights were included prediction model with different weights assigned. The weights range varied from 1 to 18.6. The adjusted proportion of summary score's variance (R2 ) varied from 0.09 to 0.47 in univariate analysis. The final logistic regression model quality was moderate: the Nagelkerke R-square coefficient was 57.9. However, the developed model showed a 76% sensitivity and 61% specificity in predicting of lower HRQoL level. Conclusions: Our prediction model allows to prospectively manage of elderly colon cancer patients, making the emphasis on HRQoL. However, the present study has some restrictions: simulation nature of internal validation, possible underestimating of the rare events impact. The long-term comprehensive approach with external validation using large real data analysis is needed to evaluate our prediction model.
{"title":"Development of expert system that improve the decision-making process with an emphasis on health-related quality of life in elderly patients with a colon cancer.","authors":"P. Shilo, A. Kanina","doi":"10.1200/jgo.2019.5.suppl.113","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.113","url":null,"abstract":"113 Background: Health-Related Quality of Life (HRQoL) is an important issue for elderly patients with colon cancer. We created the expert system which allows to predict low level of HRQoL and accessed it’s quality by using several simulation studies. Methods: We performed a systematic review to figure out the known factors associated with low level of HRQoL in elderly colon cancer patients. The searches were performed in PubMed. We accessed the possible impact of several factors affecting HRQoL, including symptoms, comorbidities and treatment toxicity. All relevant factors were included in prediction model. We assigned the different weights to different factors based on evaluation of clinical studies to develop the logistic regression and Markov stochastic model later. As we needed a binary dependent variable we performed the ROC analysis to figure out an optimal cutoff of HRQoL. Then we simulated a partly virtual dataset based on elderly colon cancer patients diagnosed in Davidovskiy Hospital to evaluate the prediction model quality. All statistical calculations were performed in RStudio. The simulation part was performed using simFrame R package. Results: Twenty two studies with a total number of 2516 patients were included in our systematic review. The 39 factors with different weights were included prediction model with different weights assigned. The weights range varied from 1 to 18.6. The adjusted proportion of summary score's variance (R2 ) varied from 0.09 to 0.47 in univariate analysis. The final logistic regression model quality was moderate: the Nagelkerke R-square coefficient was 57.9. However, the developed model showed a 76% sensitivity and 61% specificity in predicting of lower HRQoL level. Conclusions: Our prediction model allows to prospectively manage of elderly colon cancer patients, making the emphasis on HRQoL. However, the present study has some restrictions: simulation nature of internal validation, possible underestimating of the rare events impact. The long-term comprehensive approach with external validation using large real data analysis is needed to evaluate our prediction model.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46724621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.13
Po-Jung Su, Yu-Ann Fang, Yung-Chun Chang, Yung-Chia Kuo, Yung-Chang Lin
13 Background: For de novo metastatic prostate cancer (mPC)) patients, their prognosis may be really different. Some of these patients response very well to hormone therapy with durable survival, but others may be not. For those poor prognosis patients, if we could predict them as high risk patients when diagnosed, and provide aggressive upfront chemotherapy or novel hormonal therapy, they might get better treatment outcomes. Methods: We used data of prostate cancer patients from 2000 to 2016 in Chang Gung Research Database. There are 799 de novo mPC patients with castration. We predicted the possibility for these patients progressed to metastatic castration-resistant prostate cancer (mCRPC) in 1 year and find the high risk group patients. Then we figured out the best features for prediction from the best classifier with Recursive Feature Elimination. Results: The de nove mPC patients who pregressed to mCRPC in 1 year, whose mOS is 21.9 months is worse than who progressed to mCRPC beyond 1 year significantly, whose mOS is 80.7 months. (adjusted hazard ratio[aHR]: 6.43, P<0.001). The overall performance of machine learning by XGBoost is the best in all predictive models for high risk patients. (AUC=0.7000, Accuracy=0.7143). We excluded the features with missing data over 50%, then put all other features in the model. (AUC=0.7042, Accuracy=0.7239). But we got the best performance with only 11 features, including age, time from diagnosis to castration, nadir PSA, hemoglobin, eosinophil/white blood cell ratio, alkaline phosphatase, alanine transaminase, blood urea nitrogen, creatinine, prothrombin time, and secondary primary cancer, by Recursive Feature Elimination. (AUC=0.7131, Accuracy=0.7267). Conclusions: We found the predictive model has better predictive accuracy and shorter manuscript time with less features selected by Recursive Feature Elimination.We can predict high risk group in de novo mPC patients and make better clinical decision for treatment with this XGBoost model.
{"title":"Establish a predictive model for high-risk de novo metastatic prostate cancer patients by machine learning.","authors":"Po-Jung Su, Yu-Ann Fang, Yung-Chun Chang, Yung-Chia Kuo, Yung-Chang Lin","doi":"10.1200/jgo.2019.5.suppl.13","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.13","url":null,"abstract":"13 Background: For de novo metastatic prostate cancer (mPC)) patients, their prognosis may be really different. Some of these patients response very well to hormone therapy with durable survival, but others may be not. For those poor prognosis patients, if we could predict them as high risk patients when diagnosed, and provide aggressive upfront chemotherapy or novel hormonal therapy, they might get better treatment outcomes. Methods: We used data of prostate cancer patients from 2000 to 2016 in Chang Gung Research Database. There are 799 de novo mPC patients with castration. We predicted the possibility for these patients progressed to metastatic castration-resistant prostate cancer (mCRPC) in 1 year and find the high risk group patients. Then we figured out the best features for prediction from the best classifier with Recursive Feature Elimination. Results: The de nove mPC patients who pregressed to mCRPC in 1 year, whose mOS is 21.9 months is worse than who progressed to mCRPC beyond 1 year significantly, whose mOS is 80.7 months. (adjusted hazard ratio[aHR]: 6.43, P<0.001). The overall performance of machine learning by XGBoost is the best in all predictive models for high risk patients. (AUC=0.7000, Accuracy=0.7143). We excluded the features with missing data over 50%, then put all other features in the model. (AUC=0.7042, Accuracy=0.7239). But we got the best performance with only 11 features, including age, time from diagnosis to castration, nadir PSA, hemoglobin, eosinophil/white blood cell ratio, alkaline phosphatase, alanine transaminase, blood urea nitrogen, creatinine, prothrombin time, and secondary primary cancer, by Recursive Feature Elimination. (AUC=0.7131, Accuracy=0.7267). Conclusions: We found the predictive model has better predictive accuracy and shorter manuscript time with less features selected by Recursive Feature Elimination.We can predict high risk group in de novo mPC patients and make better clinical decision for treatment with this XGBoost model.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":"27 24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65926642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.16
W. Cheung, E. Lim, S. Kong
16 Background: Social media channels, such as Twitter, represent relatively new technology platforms for scientific users to disseminate research findings and communicate their views and interpretations to colleagues and followers. To date, the associations between the use of Twitter and the scientific impact of its users are unclear. Methods: All Canadian oncologists who are full members of the American Society of Clinical Oncology were identified from the online membership directory. Users of Twitter were defined as those with an active Twitter account, as of June 2019, and posted at least one tweet within the past year. Data regarding the number of tweets, likes, and followers were collected by an online search of Twitter. Scientific impact of each individual was assessed based on a user’s h-index and number of citations from Google Scholar as well as score from Research Gate. Associations were examined with summary statistics and correlation coefficients. Results: We identified 676 eligible oncologists of whom 80 (12%) and 596 (88%) currently use and do not use Twitter. Among the users, the median number (IQR) of tweets, likes, and followers were 196 (45-865), 325 (86-1,246), and 198 (89-449), respectively. The scientific impact of Twitter users versus non-users was statistically similar (see Table). Likewise, within the group of users, there was no correlation between the number of tweets, likes, and followers and the scientific impact of individuals (correlation coefficients 0.38, 0.34, and 0.41, respectively, all p > 0.05). Conclusions: Only 1 in 10 oncologists use Twitter, but those who use Twitter leveraged this technology platform frequently. There was no association between the use of Twitter and the scientific impact of its users. Views from a minority of oncologists are represented on Twitter. Such bias underscores the need to exercise caution when using social media for scientific knowledge exchange. Regular evaluations of new technologies are warranted to ensure the quality and rigor of their scientific content. [Table: see text]
{"title":"Associations between the use of Twitter as a technology platform in oncology and the scientific impact of its users.","authors":"W. Cheung, E. Lim, S. Kong","doi":"10.1200/jgo.2019.5.suppl.16","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.16","url":null,"abstract":"16 Background: Social media channels, such as Twitter, represent relatively new technology platforms for scientific users to disseminate research findings and communicate their views and interpretations to colleagues and followers. To date, the associations between the use of Twitter and the scientific impact of its users are unclear. Methods: All Canadian oncologists who are full members of the American Society of Clinical Oncology were identified from the online membership directory. Users of Twitter were defined as those with an active Twitter account, as of June 2019, and posted at least one tweet within the past year. Data regarding the number of tweets, likes, and followers were collected by an online search of Twitter. Scientific impact of each individual was assessed based on a user’s h-index and number of citations from Google Scholar as well as score from Research Gate. Associations were examined with summary statistics and correlation coefficients. Results: We identified 676 eligible oncologists of whom 80 (12%) and 596 (88%) currently use and do not use Twitter. Among the users, the median number (IQR) of tweets, likes, and followers were 196 (45-865), 325 (86-1,246), and 198 (89-449), respectively. The scientific impact of Twitter users versus non-users was statistically similar (see Table). Likewise, within the group of users, there was no correlation between the number of tweets, likes, and followers and the scientific impact of individuals (correlation coefficients 0.38, 0.34, and 0.41, respectively, all p > 0.05). Conclusions: Only 1 in 10 oncologists use Twitter, but those who use Twitter leveraged this technology platform frequently. There was no association between the use of Twitter and the scientific impact of its users. Views from a minority of oncologists are represented on Twitter. Such bias underscores the need to exercise caution when using social media for scientific knowledge exchange. Regular evaluations of new technologies are warranted to ensure the quality and rigor of their scientific content. [Table: see text]","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43955973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.89
P. Makondi
89 Background: Liver cancer (LC) is in the seventh most common cancer and the fourth largest cause of cancer deaths. Although significant progress has been made in the prevention and treatment of viral hepatitis; alcoholic liver disease, obesity and diabetes are now emerging as major causes for LC. Recently there has been increase in identification of biomarkers which can predict LC risk and disease progression, but the roles of HOMER3 gene in LC are not known. Methods: First the expression of HOMER3 between normal and tumor tissues was determined using The Cancer Genome Atlas (TCGA), Genetic Expression Omnibus (GEO) and protein atlas datasets. HOMER3 expression at different clinical stage and overall survival (OS) was also determined. The role of HOMER3 on OS in relation to cancer stage, hepatitis virus infection and alcohol intake was also determined. STRING database determined HOMER3 interaction network and TCGA was used to verify the correlation status, and the roles of the network genes on OS. The pathways enriched by HOMER3 were determined by Gene Set Enrichment Analysis (GSEA). Results: HOMER3 was significantly highly expressed in tumor tissues as compared to normal tissues. The expression of HOMER3 correlated positively with clinical stage, with highest expression in advanced stages (Stage 3 and 4), and high HOMER3 expression was associated with poor OS. HOMER3’ s high expression was associated with poor OS in advanced stage, alcohol intake, and in those negative of viral hepatitis infection. HOMER3 interacted with HOMER1, SHANK1, GRM5, GRM1, DLGAP1, SHANK2, DLG4, SHANK3, DLG2 and DLGAP4, with positive correlation to HOMER1, SHANK1, GRM5, GRM1, DLGAP1, DLG4 and DLGAP4 and negative correlation to SHANK2, SHANK3 and DLG2. HOMER1 and DLGAP4 high expression were associated with poor OS while SHANK2, SHANK3 and DLG2 high expression were associated with favorable OS. GRM5 and GRM1 high expression were associated with favorable OS despite being positively correlated with HOMER3. ECM receptor interaction and Notch signaling were the upregulated pathways while Metabolism of xenobiotics by cytochrome p450 and PPAR signaling were the downregulated pathways. Conclusions: HOMER3 may is have a role in liver cancer progression of which its targeting may improve LC outcome.
{"title":"The role of HOMER3 in liver cancer progression.","authors":"P. Makondi","doi":"10.1200/jgo.2019.5.suppl.89","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.89","url":null,"abstract":"89 Background: Liver cancer (LC) is in the seventh most common cancer and the fourth largest cause of cancer deaths. Although significant progress has been made in the prevention and treatment of viral hepatitis; alcoholic liver disease, obesity and diabetes are now emerging as major causes for LC. Recently there has been increase in identification of biomarkers which can predict LC risk and disease progression, but the roles of HOMER3 gene in LC are not known. Methods: First the expression of HOMER3 between normal and tumor tissues was determined using The Cancer Genome Atlas (TCGA), Genetic Expression Omnibus (GEO) and protein atlas datasets. HOMER3 expression at different clinical stage and overall survival (OS) was also determined. The role of HOMER3 on OS in relation to cancer stage, hepatitis virus infection and alcohol intake was also determined. STRING database determined HOMER3 interaction network and TCGA was used to verify the correlation status, and the roles of the network genes on OS. The pathways enriched by HOMER3 were determined by Gene Set Enrichment Analysis (GSEA). Results: HOMER3 was significantly highly expressed in tumor tissues as compared to normal tissues. The expression of HOMER3 correlated positively with clinical stage, with highest expression in advanced stages (Stage 3 and 4), and high HOMER3 expression was associated with poor OS. HOMER3’ s high expression was associated with poor OS in advanced stage, alcohol intake, and in those negative of viral hepatitis infection. HOMER3 interacted with HOMER1, SHANK1, GRM5, GRM1, DLGAP1, SHANK2, DLG4, SHANK3, DLG2 and DLGAP4, with positive correlation to HOMER1, SHANK1, GRM5, GRM1, DLGAP1, DLG4 and DLGAP4 and negative correlation to SHANK2, SHANK3 and DLG2. HOMER1 and DLGAP4 high expression were associated with poor OS while SHANK2, SHANK3 and DLG2 high expression were associated with favorable OS. GRM5 and GRM1 high expression were associated with favorable OS despite being positively correlated with HOMER3. ECM receptor interaction and Notch signaling were the upregulated pathways while Metabolism of xenobiotics by cytochrome p450 and PPAR signaling were the downregulated pathways. Conclusions: HOMER3 may is have a role in liver cancer progression of which its targeting may improve LC outcome.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43979764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.109
Viswanath Gopalakrishnan, S. Sankaran, Mallikarjuna Se, C. Prakash, M. Bakre
109 Background: The utility of multigene prognostic tests in aiding treatment decisions for early stage hormone positive breast cancer patients is well recognized. CanAssist-Breast (CAB) is an immunohistochemistry (IHC) based prognostic test that uses a proprietary algorithm to combine IHC grading of 5 biomarkers and three clinical paramaters (tumor size, node status and Grade) to stratify patients into high or low risk of distant recurrence. CAB has thus far been validated on a retrospective cohort of > 1000 predominantly Asian patients. Distant Metastasis Free Survival (DMFS) of more than 95% was observed with significant separation (P < 0.001) between low-risk and high-risk groups. In this study we demonstrate the usefulness of CanAssist-Breast (CAB) in guiding physicians assess risk of cancer recurrence and to make informed treatment decisions for patients. Methods: A total of 353 Asian patients tested by > 100 physicians were included in this study. Clinical parameters were compiled from hospital data. Treatment decisions were confirmed for > 150 of these patients assess the level of adherence. Risk prediction using the modified Adjuvant! Online protocol was used to compare with performance of CAB. Luminal subtying was performed as per the St. Gallen’s criteria. Results: Majority of patients tested had node negative, T2 and Grade 2 disease. Age and luminal subtypes did not affect the performance of CAB. On comparison with Adjuvant! Online (AOL), CAB categorized twice the number of patients into low-risk. Impact of CAB testing on treatment decisions showed that 96% of low-risk patients were not given chemotherapy and 84% of high-risk patients were given chemotherapy. Overall, we observed that 92% patients were either given or not given chemotherapy based on whether they were stratified as high-risk or low-risk for distant recurrence respectively. Conclusions: CAB stratifies higher percentage of patients into low risk group as compared to AOL. We observed wide acceptance of CAB as a prognostic test for assisting treatment decsions in clinical settings. CAB helped avoid chemotherapy in 70% of patients tested thus providing a cost effective alternative to other prognostic tests currently available.
{"title":"Impact of CanAssist-Breast in clinical treatment decisions in early stage HR+ breast cancer patients: Asian Scenario.","authors":"Viswanath Gopalakrishnan, S. Sankaran, Mallikarjuna Se, C. Prakash, M. Bakre","doi":"10.1200/jgo.2019.5.suppl.109","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.109","url":null,"abstract":"109 Background: The utility of multigene prognostic tests in aiding treatment decisions for early stage hormone positive breast cancer patients is well recognized. CanAssist-Breast (CAB) is an immunohistochemistry (IHC) based prognostic test that uses a proprietary algorithm to combine IHC grading of 5 biomarkers and three clinical paramaters (tumor size, node status and Grade) to stratify patients into high or low risk of distant recurrence. CAB has thus far been validated on a retrospective cohort of > 1000 predominantly Asian patients. Distant Metastasis Free Survival (DMFS) of more than 95% was observed with significant separation (P < 0.001) between low-risk and high-risk groups. In this study we demonstrate the usefulness of CanAssist-Breast (CAB) in guiding physicians assess risk of cancer recurrence and to make informed treatment decisions for patients. Methods: A total of 353 Asian patients tested by > 100 physicians were included in this study. Clinical parameters were compiled from hospital data. Treatment decisions were confirmed for > 150 of these patients assess the level of adherence. Risk prediction using the modified Adjuvant! Online protocol was used to compare with performance of CAB. Luminal subtying was performed as per the St. Gallen’s criteria. Results: Majority of patients tested had node negative, T2 and Grade 2 disease. Age and luminal subtypes did not affect the performance of CAB. On comparison with Adjuvant! Online (AOL), CAB categorized twice the number of patients into low-risk. Impact of CAB testing on treatment decisions showed that 96% of low-risk patients were not given chemotherapy and 84% of high-risk patients were given chemotherapy. Overall, we observed that 92% patients were either given or not given chemotherapy based on whether they were stratified as high-risk or low-risk for distant recurrence respectively. Conclusions: CAB stratifies higher percentage of patients into low risk group as compared to AOL. We observed wide acceptance of CAB as a prognostic test for assisting treatment decsions in clinical settings. CAB helped avoid chemotherapy in 70% of patients tested thus providing a cost effective alternative to other prognostic tests currently available.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42691028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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