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Cheng E, Caan BJ, Chen WY, Prado CM, Cespedes Feliciano EM. A novel body composition risk score (B-Score) and overall survival among patients with nonmetastatic breast cancer. Clin Nutr 2024; 43:981-987. [PMID: 38471402 PMCID: PMC11009043 DOI: 10.1016/j.clnu.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/15/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND & AIMS Measurements (amount, distribution, and radiodensity) of muscle and adipose tissue were reported to be individually associated with overall survival in patients with breast cancer. However, they were not typically combined to develop an overall risk score, which can identify patients at high risk of death and prioritize patients in need of dietary and lifestyle interventions. Thus, we aimed to develop a novel composite body composition risk score (B-Score). METHODS We included 3105 patients with stage II or III breast cancer at Kaiser Permanente Northern California and Dana Farber Cancer Institute. From CT scans at diagnosis, we assessed areas and radiodensity of muscle and adipose tissue at the third lumber vertebrae. We considered skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI) and SAT radiodensity as they were independent prognostic factors for overall survival. Each measurement was dichotomized using optimal stratification, with low SMI (<40.1 cm2/m2), high SATI (≥75.7 cm2/m2), and high SAT radiodensity (≥-97.2HU) considered risk factors. We calculated B-Score as the sum of these factors and estimated its association with overall survival using Cox proportional hazards regression with adjustment for clinicopathologic factors. RESULTS Mean (standard deviation) age was 53.9 (11.8) years, 70.3% were Non-Hispanic White, and 60.5% were stage II. Most patients (60.6%) had only one body composition risk factor (B-Score = 1). Compared to those with no risk factors (B-Score = 0), the risk of death increased with more body composition risk factors: the adjusted hazard ratios were 1.10 (95% CI: 0.85, 1.42), 1.47 (95% CI: 1.12, 1.92), and 2.11 (95% CI: 1.26, 3.53) for B-Scores of 1, 2, and 3, respectively (Ptrend < 0.001). CONCLUSIONS More unfavorable body composition characteristics were associated with increased risks of overall mortality in a dose-response manner. Considering body composition measurements together as a composite score (B-Score) may improve risk stratification and inform dietary and lifestyle interventions following breast cancer diagnosis.
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Affiliation(s)
- En Cheng
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States; Cancer Epidemiology, Prevention and Control Program, Montefiore Einstein Comprehensive Cancer Center, Bronx, NY, United States; Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States.
| | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Wendy Y Chen
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, United States
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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Guo Y, Chen WY. Monitoring tree canopy dynamics across heterogeneous urban habitats: A longitudinal study using multi-source remote sensing data. J Environ Manage 2024; 356:120542. [PMID: 38492424 DOI: 10.1016/j.jenvman.2024.120542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/08/2024] [Accepted: 02/29/2024] [Indexed: 03/18/2024]
Abstract
Urban trees have attracted increasing attention to serve as a green prescription for addressing various challenges facing human society like climate change and environmental deterioration. However, without healthy growth of urban trees, they cannot service any environmental, social, and economic benefits in a sustainable manner. By monitoring the canopy development, the tree growth dynamics in different urban habitats can be detected and appropriate management approaches can be executed. Using the Kowloon Peninsula, Hong Kong, as a case, this study explores how remote sensing data can help monitor and understand the impacts of heterogeneous urban habitats on tree canopy dynamics. Four algorithms based on WorldView-2 satellite image are compared to optimize the canopy segmentation. Then the individual tree canopy is integrated with Sentinel-2 satellite data to obtain canopy growth dynamics for each season from 2016 to 2020. Three indicators are applied to reflect tree canopy status, including the fluorescence correction vegetation index (FCVI, tracking leaf chlorophyll density), the soil adjusted total vegetation index (SATVI, measuring the density of woody branches and twigs), and the normalised difference phenology index (NDPI, capturing canopy water content). And four heterogeneous habitats where urban trees stand are specified. The results revealed that urban trees show varying canopy growth status, in a descending order from natural terrains, parks, residential lands, to road verges, suggesting that urban habitats curtail trees' growth significantly. Additionally, two super-typhoons in 2017 and 2018, respectively, caused serious damages to tree canopy. Relevant resiliency of tree varies, echoing the sequence of canopy growth status with those in road verges the least resilient. This study shows how remote sensing data can be used to provide a better understanding of long-term tree canopy dynamics across large-scale heterogeneous urban habitats, which is key to monitoring and maintaining the health and growth of urban trees.
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Affiliation(s)
- Yasong Guo
- Department of Geography, The University of Hong Kong, Hong Kong, China
| | - Wendy Y Chen
- Department of Geography, The University of Hong Kong, Hong Kong, China.
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Wang T, Chai B, Chen WY, Holmes MD, Erdrich J, Hu FB, Rosner BA, Tamimi RM, Willett WC, Kang JH, Eliassen AH. Metformin and other anti-diabetic medication use and breast cancer incidence in the Nurses' Health Studies. Int J Cancer 2024. [PMID: 38520039 DOI: 10.1002/ijc.34917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/13/2024] [Accepted: 02/20/2024] [Indexed: 03/25/2024]
Abstract
We aimed to examine the association between the use of metformin and other anti-diabetic medications and breast cancer incidence within two large prospective cohort studies. We followed 185,181 women who participated in the Nurses' Health Study (NHS; 1994-2016) and the NHSII (1995-2017), with baseline corresponding to the date metformin was approved for type 2 diabetes (T2D) treatment in the US Information on T2D diagnosis, anti-diabetes medications, and other covariates was self-reported at baseline and repeatedly assessed by follow-up questionnaires every 2 years. Breast cancer cases were self-reported and confirmed by medical record review. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between medication use and breast cancer were estimated using Cox proportional hazards regression models, adjusting for breast cancer risk factors. During 3,324,881 person-years of follow-up, we ascertained 9,192 incident invasive breast cancer cases, of which 451 were among women with T2D. Compared with women without T2D (n = 169,263), neither metformin use (HR = 0.97; 95% CI = 0.81-1.15) nor other anti-diabetic medications use (HR = 1.11; 95% CI = 0.90-1.36) associated with significantly lower breast cancer incidence. Among women with T2D (n = 15,918), compared with metformin never users, metformin ever use was not significantly inversely associated with breast cancer (HR = 0.92; 95% CI = 0.74-1.15). Although we observed that past use of metformin was inversely associated with breast cancer in the T2D population (HR = 0.67; 95% CI = 0.48-0.94), current use (HR = 1.01; 95% CI = 0.80-1.27) and longer duration of metformin use were not associated with breast cancer (each 2-year interval: HR = 1.01; 95% CI = 0.95-1.07). Overall, metformin use was not associated with the risk of developing breast cancer among the overall cohort population or among women with T2D.
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Affiliation(s)
- Tengteng Wang
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
- Division of Medical Oncology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Boyang Chai
- Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Wendy Y Chen
- Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Michelle D Holmes
- Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jennifer Erdrich
- Department of Surgery, The University of Arizona, Tucson, Arizona, USA
| | - Frank B Hu
- Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jae H Kang
- Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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Mayer EL, Ren Y, Wagle N, Mahtani R, Ma C, DeMichele A, Cristofanilli M, Meisel J, Miller KD, Abdou Y, Riley EC, Qamar R, Sharma P, Reid S, Sinclair N, Faggen M, Block CC, Ko N, Partridge AH, Chen WY, DeMeo M, Attaya V, Okpoebo A, Alberti J, Liu Y, Gauthier E, Burstein HJ, Regan MM, Tolaney SM. PACE: A Randomized Phase II Study of Fulvestrant, Palbociclib, and Avelumab After Progression on Cyclin-Dependent Kinase 4/6 Inhibitor and Aromatase Inhibitor for Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor-Negative Metastatic Breast Cancer. J Clin Oncol 2024:JCO2301940. [PMID: 38513188 DOI: 10.1200/jco.23.01940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/31/2023] [Accepted: 12/19/2023] [Indexed: 03/23/2024] Open
Abstract
PURPOSE Cyclin-dependent kinase (CDK) 4/6 inhibitors (CDK4/6is) are an important component of treatment for hormone receptor-positive/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC), but it is not known if patients might derive benefit from continuation of CDK4/6i with endocrine therapy beyond initial tumor progression or if the addition of checkpoint inhibitor therapy has value in this setting. METHODS The randomized multicenter phase II PACE trial enrolled patients with hormone receptor-positive/HER2- MBC whose disease had progressed on previous CDK4/6i and aromatase inhibitor (AI) therapy. Patients were randomly assigned 1:2:1 to receive fulvestrant (F), fulvestrant plus palbociclib (F + P), or fulvestrant plus palbociclib and avelumab (F + P + A). The primary end point was investigator-assessed progression-free survival (PFS) in patients treated with F versus F + P. RESULTS Overall, 220 patients were randomly assigned between September 2017 and February 2022. The median age was 57 years (range, 25-83 years). Most patients were postmenopausal (80.9%), and 40% were originally diagnosed with de novo MBC. Palbociclib was the most common previous CDK4/6i (90.9%). The median PFS was 4.8 months on F and 4.6 months on F + P (hazard ratio [HR], 1.11 [90% CI, 0.79 to 1.55]; P = .62). The median PFS on F + P + A was 8.1 months (HR v F, 0.75 [90% CI, 0.50 to 1.12]; P = .23). The difference in PFS with F + P and F + P + A versus F was greater among patients with baseline ESR1 and PIK3CA alterations. CONCLUSION The addition of palbociclib to fulvestrant did not improve PFS versus fulvestrant alone among patients with hormone receptor-positive/HER2- MBC whose disease had progressed on a previous CDK4/6i plus AI. The increased PFS seen with the addition of avelumab warrants further investigation in this patient population.
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Affiliation(s)
- Erica L Mayer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Yue Ren
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | - Nikhil Wagle
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Reshma Mahtani
- Department of Medical Oncology, Miami Cancer Institute, Miami, FL
| | - Cynthia Ma
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Angela DeMichele
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | | | - Jane Meisel
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Kathy D Miller
- Hematology/Oncology Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Yara Abdou
- Department of Medicine, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Elizabeth C Riley
- Department of Medicine, Brown Cancer Center, University of Louisville Health, Louisville, KY
| | | | - Priyanka Sharma
- Department of Medical Oncology, University of Kansas Medical Center, Westwood, KS
| | - Sonya Reid
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
| | - Natalie Sinclair
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Meredith Faggen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Caroline C Block
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Naomi Ko
- Department of Medical Oncology, Boston Medical Center, Boston, MA
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Wendy Y Chen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Michelle DeMeo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Victoria Attaya
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Amanda Okpoebo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Jillian Alberti
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | | | - Harold J Burstein
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Meredith M Regan
- Harvard Medical School, Boston, MA
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | - Sara M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
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Zhang M, Zhou K, Wang Z, Liu T, Stevens LE, Lynce F, Chen WY, Peng S, Xie Y, Zhai D, Chen Q, Shi Y, Shi H, Yuan Z, Li X, Xu J, Cai Z, Guo J, Shao N, Lin Y. A subpopulation of luminal progenitors secretes pleiotrophin to promote angiogenesis and metastasis in inflammatory breast cancer. Cancer Res 2024:741915. [PMID: 38507720 DOI: 10.1158/0008-5472.can-23-2640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/19/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024]
Abstract
Inflammatory breast cancer (IBC) is a highly aggressive subtype of breast cancer characterized by rapidly arising diffuse erythema and edema. Genomic studies have not identified consistent alterations and mechanisms that differentiate IBC from non-IBC tumors, suggesting that the microenvironment could be a potential driver of IBC phenotypes. Here, using single-cell RNA sequencing, multiplex staining, and serum analysis in IBC patients, we identified enrichment of a subgroup of luminal progenitor (LP) cells containing high expression of the neurotropic cytokine pleiotrophin (PTN) in IBC tumors. PTN secreted by the LP cells promoted angiogenesis by directly interacting with the NRP1 receptor on endothelial tip cells located in both IBC tumors and the affected skin. NRP1 activation in tip cells led to recruitment of immature perivascular cells in the affected skin of IBC, which are correlated with increased angiogenesis and IBC metastasis. Together, these findings reveal a role for crosstalk between LPs, endothelial tip cells, and immature perivascular cells via PTN-NRP1 axis in the pathogenesis of IBC, which could lead to improved strategies for treating IBC.
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Affiliation(s)
- Mengmeng Zhang
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Kaiwen Zhou
- First Affiliated Hospital of Sun Yat-sen University, China
| | - Zilin Wang
- First Affiliated Hospital of Sun Yat-sen University, China
| | - Ting Liu
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | | | - Filipa Lynce
- Dana-Farber/Harvard Cancer Center, Boston, MA, United States
| | - Wendy Y Chen
- Dana-Farber Cancer Institute, Boston, MA, United States
| | - Sui Peng
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yubin Xie
- Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Duanyang Zhai
- First Affiliated Hospital of Sun Yat-sen University, China
| | - Qianjun Chen
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yawei Shi
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R.China., Guangdong, China., China
| | - Huijuan Shi
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhongyu Yuan
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | | | - Juan Xu
- Guangdong Province Women and Children Hospital, China
| | | | - Jianping Guo
- First Affiliated Hospital of Sun Yat-sen University, guangzhou, guangdong, China
| | - Nan Shao
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R.China., Guangdong, China., China
| | - Ying Lin
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R.China., Guangdong, China., China
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Yu WH, Yuan X, Chen WY, Zhang T, Zhao G. [Analysis of 15 cases of trench foot in peacetime]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:939-941. [PMID: 38195232 DOI: 10.3760/cma.j.cn121094-20221201-00567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Trench foot was first seen in World War Ⅰ and was one of the reasons for non combat attrition. We reviewed and analyzed 15 cases of trench foot admitted from 2010 to 2021, summarized clinical treatment methods and experiences, analyzed the causes, population characteristics, treatment methods, and treatment experiences of trench foot during peacetime, strengthened attention to high-risk groups, and improved the success rate of clinical treatment.
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Affiliation(s)
- W H Yu
- Peripheral Vascular Disease Department of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
| | - X Yuan
- Graduate School of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
| | - W Y Chen
- Graduate School of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
| | - T Zhang
- Graduate School of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
| | - G Zhao
- Peripheral Vascular Disease Department of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
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Brock H, Lambrineas L, Ong HI, Chen WY, Das A, Edsell A, Proud D, Carrington E, Smart P, Mohan H, Burgess A. Preventative strategies for low anterior resection syndrome. Tech Coloproctol 2023; 28:10. [PMID: 38091118 DOI: 10.1007/s10151-023-02872-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/11/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND A common and debilitating complication of low anterior resection for rectal cancer is low anterior resection syndrome (LARS). As a multifactorial entity, LARS is poorly understood and challenging to treat. Despite this, prevention strategies are commonly overlooked. Our aim was to review the pathophysiology of LARS and explore current evidence on the efficacy and feasibility of prophylactic techniques. METHODS A literature review was performed between [1st January 2000 to 1st October 2023] for studies which investigated preventative interventions for LARS. Mechanisms by which LARS develop are described, followed by a review of prophylactic strategies to prevent LARS. Medline, Cochrane, and PubMed databases were searched, 189 articles screened, 8 duplicates removed and 18 studies reviewed. RESULTS Colonic dysmotility, anal sphincter dysfunction and neorectal dysfunction all contribute to the development of LARS, with the complex mechanism of defecation interrupted by surgery. Transanal irrigation (TAI) and pelvic floor rehabilitation (PFR) have shown benefits in preventing LARS, but may be limited by patient compliance. Intraoperative nerve monitoring (IONM) and robotic-assisted surgery have shown some promise in surgically preventing LARS. Nerve stimulation and other novel strategies currently used in treatment of LARS have yet to be investigated in their roles prophylactically. CONCLUSIONS To date, there is a limited evidence base for all preventative strategies including IONM, RAS, PFP and TAI. These strategies are limited by either access (IONM, RAS and PFP) or acceptability (PFP and TAI), which are both key to the success of any intervention. The results of ongoing trials will serve to assess acceptability, while technological advancement may improve access to some of the aforementioned strategies.
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Affiliation(s)
- H Brock
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
- Western General, Melbourne, Australia
| | - L Lambrineas
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - H I Ong
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia.
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia.
| | - W Y Chen
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - A Das
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
| | - A Edsell
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - D Proud
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
| | | | - P Smart
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
| | - H Mohan
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
| | - A Burgess
- Austin Health, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Colorectal Surgery, Austin Health, Melbourne, Australia
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Mayerhofer C, Sedrak MS, Hopkins JO, Li T, Tayob N, Faggen MG, Sinclair NF, Chen WY, Parsons HA, Mayer EL, Lange PB, Basta AS, Perilla-Glen A, Lederman RI, Wong AR, Tiwari A, McAllister SS, Mittendorf EA, Gibson CJ, Burstein HJ, Kim AS, Freedman RA, Miller PG. Clonal hematopoiesis in older patients with breast cancer receiving chemotherapy. J Natl Cancer Inst 2023; 115:981-988. [PMID: 37042724 PMCID: PMC10407695 DOI: 10.1093/jnci/djad065] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/10/2023] [Accepted: 04/05/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The expansion of hematopoietic stem cells carrying recurrent somatic mutations, termed clonal hematopoiesis (CH), is common in elderly individuals and is associated with increased risk of myeloid malignancy and all-cause mortality. Though chemotherapy is a known risk factor for developing CH, how myelosuppressive therapies affect the short-term dynamics of CH remains incompletely understood. Most studies have been limited by retrospective design, heterogeneous patient populations, varied techniques to identifying CH, and analysis of single timepoints. METHODS We examined serial samples from 40 older women with triple-negative or hormone receptor-positive breast cancer treated on the prospective ADjuVANt Chemotherapy in the Elderly trial to evaluate the prevalence and dynamics of CH at baseline and throughout chemotherapy (6 and 12 weeks). RESULTS CH was detected in 44% of patients at baseline and in 53% at any timepoint. Baseline patient characteristics were not associated with CH. Over the course of treatment, mutations exhibited a variety of dynamics, including emergence, expansion, contraction, and disappearance. All mutations in TP53 (n = 3) and PPM1D (n = 4), genes that regulate the DNA damage response, either became detectable or expanded over the course of treatment. Neutropenia was more common in patients with CH, particularly when the mutations became detectable during treatment, and CH was significantly associated with cyclophosphamide dose reductions and holds (P = .02). CONCLUSIONS Our study shows that CH is common, dynamic, and of potential clinical significance in this population. Our results should stimulate larger efforts to understand the biological and clinical importance of CH in solid tumor malignancies. TRIAL REGISTRATION ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT03858322). Clinical trial registration number: NCT03858322.
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Affiliation(s)
- Christina Mayerhofer
- Department of Stem Cell and Regenerative Biology, Harvard Stem Cell Institute, Cambridge, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Mina S Sedrak
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA
| | - Judith O Hopkins
- Novant Health Cancer Institute/SCOR NCORP, Winston Salem, NC, USA
| | - Tianyu Li
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nabihah Tayob
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Meredith G Faggen
- Dana-Farber Brigham Cancer Center at South Shore Hospital, South Weymouth, MA, USA
| | - Natalie F Sinclair
- Dana-Farber Brigham Cancer Center at Milford Regional Medical Center, Milford, MA, USA
| | - Wendy Y Chen
- Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
| | - Heather A Parsons
- Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
| | - Erica L Mayer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
| | - Paulina B Lange
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ameer S Basta
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Ruth I Lederman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Andrew R Wong
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA
| | - Abhay Tiwari
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA
| | - Sandra S McAllister
- Department of Stem Cell and Regenerative Biology, Harvard Stem Cell Institute, Cambridge, MA, USA
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
- Hematology Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Elizabeth A Mittendorf
- Harvard Medical School, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
- Division of Breast Surgery, Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - Christopher J Gibson
- Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Harold J Burstein
- Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
| | - Annette S Kim
- Brigham and Women’s Hospital, Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Rachel A Freedman
- Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
| | - Peter G Miller
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
- Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA
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9
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Romanos-Nanclares A, Guasch-Ferré M, Willett WC, Chen WY, Holmes MD, Rosner BA, Martinez-Gonzalez MA, Eliassen AH. Consumption of olive oil and risk of breast cancer in U.S. women: results from the Nurses' Health Studies. Br J Cancer 2023; 129:416-425. [PMID: 37311975 PMCID: PMC10403500 DOI: 10.1038/s41416-023-02306-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 05/05/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Olive oil consumption may reduce breast cancer risk, but it is unclear whether olive oil is beneficial for breast cancer prevention in populations outside of Mediterranean regions, namely in the U.S., where the average consumption of olive oil is low compared with Mediterranean populations. We examined whether olive oil intake was associated with breast cancer risk in two prospective cohorts of U.S. women. METHODS We used multivariable-adjusted time-varying Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence interval (CI) for breast cancer among 71,330 (Nurses' Health Study, 1990-2016) and 93,295 women (Nurses' Health Study II, 1991-2017) who were free of cancer at baseline. Diet was assessed by a validated semi-quantitative food frequency questionnaire every 4 years. RESULTS During 3,744,068 person-years of follow-up, 9,638 women developed invasive breast cancer. The multivariable-adjusted HR (95% CI) for breast cancer among women who had the highest consumption of olive oil (>1/2 tablespoon/d or >7 g/d) compared with those who never or rarely consumed olive oil, was 1.01 (0.93, 1.09). Higher olive oil consumption was not associated with any subtype of breast cancer. CONCLUSION We did not observe an association between higher olive oil intake and breast cancer risk in two large prospective cohorts of U.S. women, whose average olive oil consumption was low. Prospective studies are needed to confirm these findings and to further investigate whether different varieties of olive oil (e.g., virgin and extra virgin olive oil) may play a role in breast cancer risk.
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Affiliation(s)
- Andrea Romanos-Nanclares
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Marta Guasch-Ferré
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wendy Y Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Michelle D Holmes
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Miguel A Martinez-Gonzalez
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Hansrivijit P, Thurber EG, Malkani NP, Chen WY, Goldsmith JD, Kaiser UB, Gupta S. A 72-Year-Old Woman with Fatigue and Shortness of Breath. NEJM Evid 2023; 2:EVIDmr2300084. [PMID: 38320145 PMCID: PMC11034990 DOI: 10.1056/evidmr2300084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
A 72-Year-Old Woman with Fatigue and Shortness of BreathA 72-year-old woman presented for evaluation of fatigue, dyspnea on exertion, and weight loss. How do you approach the evaluation, and what is the most likely diagnosis?
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Affiliation(s)
- Panupong Hansrivijit
- from the Brigham and Women's Hospital/Massachusetts General Hospital Joint Nephrology Fellowship and Brigham and Women's Hospital Endocrinology Fellowship Programs
| | - Emilia G Thurber
- from the Brigham and Women's Hospital/Massachusetts General Hospital Joint Nephrology Fellowship and Brigham and Women's Hospital Endocrinology Fellowship Programs
| | - Natasha P Malkani
- from the Brigham and Women's Hospital/Massachusetts General Hospital Joint Nephrology Fellowship and Brigham and Women's Hospital Endocrinology Fellowship Programs
| | - Wendy Y Chen
- from the Brigham and Women's Hospital/Massachusetts General Hospital Joint Nephrology Fellowship and Brigham and Women's Hospital Endocrinology Fellowship Programs
| | - Jeffrey D Goldsmith
- from the Brigham and Women's Hospital/Massachusetts General Hospital Joint Nephrology Fellowship and Brigham and Women's Hospital Endocrinology Fellowship Programs
| | - Ursula B Kaiser
- from the Brigham and Women's Hospital/Massachusetts General Hospital Joint Nephrology Fellowship and Brigham and Women's Hospital Endocrinology Fellowship Programs
| | - Shruti Gupta
- from the Brigham and Women's Hospital/Massachusetts General Hospital Joint Nephrology Fellowship and Brigham and Women's Hospital Endocrinology Fellowship Programs
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11
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Lai LQ, Lin GH, Chen WY, Tu JF, Ji JS. [CT perfusion combined with energy spectrum imaging to evaluate the short-term efficacy of bronchial arterial chemoembolization for lung cancer]. Zhonghua Nei Ke Za Zhi 2023; 62:539-544. [PMID: 37096281 DOI: 10.3760/cma.j.cn112138-20220513-00366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Objective: To evaluate the clinical value of dynamic volumetric CT perfusion combined with energy spectrum imaging in bronchial arterial chemoembolization (BACE) in patients with lung cancer. Methods: The data of 31 patients with lung cancer confirmed by pathology and treated with BACE in Lishui Central Hospital from January 2018 to February 2022 were retrospectively collected, including 23 men and 8 women, aged 31-84 (67) years. All patients received perfusion scans of lesion sites within 1 week before surgery and 1 month after surgery. We collected and compared the changes in preoperative and postoperative perfusion parameters such as blood flow (BF), blood volume (BV), mean through time (MTT), permeability surface (PS) and energy spectrum parameters including arterial phase CT value (CTA), venous phase CT value (CTV), arterial phase iodine concentration (ICA), venous phase of iodine concentration (ICV), arterial standardization iodine concentration (NICA), and intravenous standardized iodine concentration (NICV) to confirm the significance of these parameters in evaluating the short-term efficacy of BACE in the treatment of advanced lung cancer. Data normality was tested using the Kolmogorov-Smirnov test and normally distributed measurement data are expressed here as mean ± standard deviation; the independent-samples t-test was used for comparisons between two groups. The measurement data that were not normally distributed are expressed as median (interquartile interval) [M (Q1, Q3)], and the comparison between the two groups used the Kruskal-Wallis test. Count data are expressed as cases (%), and comparisons between groups used the χ2 test. Results: The objective response rate (ORR) and disease control rate (DCR) at 1 month after BACE were 54.8% (17/31) and 96.8% (30/31), respectively. CT perfusion parameters and energy spectrum parameters of patients before and after BACE treatment were compared. The results showed that BF, BV, MTT, ICA, ICV and NICV were significantly decreased after BACE treatment compared with before treatment, and the differences were statistically significant[58.06 (40.47,87.22) vs.23.57(10.92, 36.24) ml·min-1·100g-1,3.33(2.86,6.09) vs.2.12(1.96,3.61)ml/100g,2.70(2.19,3.88) vs.1.53 (1.12,2.25)s, 3.51 (3.11,4.14)vs.1.74 (1.26,2.50)mg/ml,2.00 (1.30,2.45) vs.1.32(0.92,1.76)mg/ml,0.51(0.42,0.57) vs.0.33(0.23,0.39)](all P<0.05). At the same time, compared with the non-remission group, the study results showed that the difference of parameters in remission group before and after BACE was more obvious, including ΔBF, ΔBV, ΔMTT, ΔPS, ΔCTA, ΔCTV, ΔICA, ΔICV, ΔNICA, ΔNICV were significantly increased, and the difference was statistically significant [36.82(32.38, 45.34) vs.9.50(-1.43, 12.34) ml·min-1·100g-1,4.46(2.52, 5.79) vs.0.22(-0.76, 4.09) ml/100g,4.22(2.25, 6.77) vs.0.43(-2.53, 1.88) s,10.07 (2.89, 13.13) vs.-2.01(-6.77, 4.28) ml·min-1·100g-1,14.22(11.88, 20.57) vs.4.18(-5.25, 6.37) HU, 34.6(14.88, 43.15) vs.11.60(0.26, 25.05) HU,0.95(0.54, 1.47) vs.0.11(0.20, 0.59) mg/ml,1.57(1.10, 2.38) vs. 0.26(-0.21, 0.63) mg/ml,0.05(0.03, 0.08) vs.-0.02(-0.04, 0.01),0.18(0.13, 0.21)vs. 0.11(-0.06, 0.16)](all P<0.05). Conclusions: CT perfusion combined with spectral imaging could effectively evaluate the changes in tumor vascular perfusion in patients with advanced lung cancer before and after BACE treatment, which has important value in judging the short-term efficacy after treatment.
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Affiliation(s)
- L Q Lai
- Department of Intervention Department,Lishui Central Hospital, Zhejiang Provincial Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000,China
| | - G H Lin
- Department of Radiology, Lishui Central Hospital, Zhejiang Provincial Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China
| | - W Y Chen
- Department of Intervention Department,Lishui Central Hospital, Zhejiang Provincial Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000,China
| | - J F Tu
- Department of Intervention Department,Lishui Central Hospital, Zhejiang Provincial Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000,China
| | - J S Ji
- Department of Intervention Department,Lishui Central Hospital, Zhejiang Provincial Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000,China
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Peng C, Holmes MD, Chen WY, Wang T, Brantley KD, Heng YJ, Schedin PJ, Rosner BA, Willett WC, Stampfer MJ, Tamimi RM, Eliassen AH. Abstract 5758: Regular aspirin use, breast tumor characteristics and long-term breast cancer survival. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-5758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Compelling epidemiologic data, supported by experimental evidence, suggest aspirin may improve survival in breast cancer patients. However, recent clinical trials showed a lack of protective effect, though length of intervention (18 months to 4.7 years) and follow-up (20 months to 4.7 years) were limited. We sought to examine the association between post-diagnostic aspirin use (frequency, dose, and duration), timing and age of initiation on breast cancer-specific mortality. Our study included 10,493 women diagnosed with stage I, II, or III invasive breast cancer. Participants were enrolled in the large, prospective Nurses’ Health Study (NHS) and NHSII in 1980 and 1989 prior to diagnosis and followed up through June 1, 2017. We collected information on frequency, dose and duration of aspirin use. Regular aspirin use was defined as using aspirin (standard- and low-dose) ≥2 days per week, and non-regular aspirin users were those who reported use of aspirin <2 days per week. We used Cox proportional hazard models to calculate multivariable adjusted hazard ratios (HRs) for breast cancer-specific mortality. After a median follow-up of 10 years, there were 2,506 total deaths and 1,221 breast cancer-specific deaths among 10,493 stage I to III breast cancer patients over 32 years of follow-up. In multivariable models, regular use of aspirin (n=3,523; 34%) was associated with a 38% lower risk of death from breast cancer compared with non-regular users (including nonusers) (HR=0.62, 95% CI: 0.54-0.71). The association was independent of pre-diagnostic aspirin use. Associations between aspirin use and breast cancer-specific mortality were stronger with longer time since diagnosis (HRs for <5 years since diagnosis: 0.73 (95% CI: 0.59-0.90), 5-<10 years: 0.63 (95% CI: 0.49-0.80), and ≥10 years: 0.53 (95% CI: 0.41-0.69)). The relations between aspirin use and breast cancer survival were similar across categories of dose (compared to non-users, HRs for 0.5-5 tablets per week: 0.59 (95% CI: 0.51-0.68); ≥6 tablets per week: 0.60 (95% CI: 0.48-0.74)) and appeared stronger with longer duration (compared to non-users, HRs for <5 years: 0.80 (95% CI: 0.57, 1.10); ≥5 years: 0.61 (95% CI: 0.51, 0.72)). For women who initiated regular aspirin use after age 70, regular aspirin use was associated with worse survival (HR=1.74, 95% CI: 1.16-2.63); on the other hand, initiation of regular aspirin use at age ≤60 (HR=0.72, 95% CI: 0.54-0.95) or 60-≤70 (HR=0.69, 95% CI: 0.50-0.95) was associated with improved survival (p-interaction=0.02). Regular aspirin use after diagnosis of nonmetastatic breast cancer was associated with improved long-term survival over 32 years. Although the associations between post-diagnostic regular aspirin use and improved survival did not differ by BMI, smoking or tumor characteristics, women who initiated regular aspirin use >70 years of age had increased risk of death due to breast cancer.
Citation Format: Cheng Peng, Michelle D. Holmes, Wendy Y. Chen, Tengteng Wang, Kristen D. Brantley, Yujing Jan Heng, Pepper J. Schedin, Bernard A. Rosner, Walter C. Willett, Meir J. Stampfer, Rulla M. Tamimi, A. Heather Eliassen. Regular aspirin use, breast tumor characteristics and long-term breast cancer survival. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5758.
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Affiliation(s)
- Cheng Peng
- 1Brigham and Women's Hospital, Boston, MA
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Freedman R, Ren S, Tayob N, Gelman R, Smith KL, Davis R, Pereslete A, Attaya V, Cotter C, Chen WY, Santa-Maria CA, Van Poznak C, Moy B, Brufsky AM, Melisko M, O’Sullivan CC, Ashai N, Rauf Y, Nangia J, Trapani D, Savoie J, Burns R, Wolff AC, Winer E, Rimawi M, Krop I, Lin NU. Abstract PD7-03: Translational Breast Cancer Research Consortium Trial 022: Neratinib and Trastuzumab-Emtansine for HER2+ Breast Cancer Brain Metastases (BCBM). Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-pd7-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
PURPOSE: Treatment options for patients (pts) with HER2+ BCBM remain limited. We previously reported that neratinib monotherapy is associated with a volumetric central nervous system objective response rate (CNS ORR) of 8%, whereas the combination of neratinib and capecitabine resulted in a volumetric CNS ORR of 49% (in lapatinib-naïve pts). Preclinical data suggest that neratinib may overcome resistance to trastuzumab-emtansine (T-DM1) and that the combination has potential CNS efficacy. Here, we report results of neratinib plus T-DM1 in pts with HER2+ BCBM. PATIENTS AND METHODS: In this prospective, multicenter, phase II study, pts with measurable HER2+ BCBM received neratinib 160 mg orally once daily plus T-DM1 3.6 mg/kg IV every 21 days in three parallel-enrolling cohorts. Cohort 4A enrolled pts with previously untreated brain metastases. Cohort 4B enrolled pts with BCBM progressing after prior local CNS-directed therapy without prior exposure to T-DM1. Cohort 4C enrolled pts with BCBM progressing after prior local CNS-directed therapy who had previous exposure to T-DM1. Diarrhea prophylaxis with colestipol and loperamide was required during cycle 1. Cohorts 4A and 4B were single-stage with a planned enrollment of 20 patients; cohort 4C had a two-stage design, with a requirement for at least 1 of the first 9 pts to achieve a response in order to enroll a total of 24 patients. The primary endpoint was Response Assessment in Neuro-Oncology-Brain Metastases (RANO BM) in each cohort separately. Correlative studies included patient-reported outcomes (PROs) for gastrointestinal toxicity. RESULTS: We enrolled 6, 17, and 21 patients to cohorts 4A, 4B, and 4C, during 11/07/2018 – 11/01/2021. Enrollment was stopped prematurely due to slow accrual. Across Cohorts 4A-4C, the median number of prior lines of chemotherapy prior to enrollment was 2 (range 1-10); 25% received prior lapatinib and no patients received prior tucatinib. In cohorts 4B and 4C (prior CNS-treated cohorts), 33% had prior CNS surgery and >94% had prior CNS radiation. Among evaluable patients, CNS ORR in cohorts 4A (n=6), 4B (n=16), and 4C (n=21) was 50.0% (95% CI 18.8- 81.2%), 25.0% (95% CI 8.3-52.6%), and 38.1% (95% CI 19.0-61.3%), respectively. Median (range) number of cycles completed for 4A, 4B, and 4C was 4.5 (1-15), 4 (range 0-49+), and 6 (0-23); three patients on Cohort 4B remain on protocol therapy (cycles 14, 45, and 49). The overall survival at 12-months for cohorts 4A, 4B, and 4C was 83.3% (95% CI, 58.3-100%), 86.2% (95% CI 70-100%), and 83.3% (95% CI 67.6-100%). Diarrhea was the most common grade 3 toxicity (19.0–33.3% across cohorts); one grade 4 liver function event occurred in cohort 4B. Updated efficacy results will be reported at the meeting; PRO analyses are ongoing. CONCLUSION: Intracranial activity was observed for the combination of neratinib plus T-DM1 across all three enrolled cohorts, including those with prior T-DM1 exposure, suggesting synergistic effects of this treatment combination. Our data provide additional evidence for consideration of neratinib-based combinations in pts with HER2+ BCBM.
Citation Format: Rachel Freedman, Siyang Ren, Nabihah Tayob, Rebecca Gelman, Karen L. Smith, Raechel Davis, Alyssa Pereslete, Victoria Attaya, Christine Cotter, Wendy Y. Chen, Cesar Augusto Santa-Maria, Catherine Van Poznak, Beverly Moy, Adam M. Brufsky, Michelle Melisko, Ciara C. O’Sullivan, Nadia Ashai, Yasmeen Rauf, Julie Nangia, Dario Trapani, Jennifer Savoie, Robyn Burns, Antonio C. Wolff, Eric Winer, Mothaffar Rimawi, Ian Krop, Nancy U. Lin. Translational Breast Cancer Research Consortium Trial 022: Neratinib and Trastuzumab-Emtansine for HER2+ Breast Cancer Brain Metastases (BCBM) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD7-03.
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Affiliation(s)
| | | | | | | | - Karen L. Smith
- 5Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
| | | | | | | | | | | | | | | | | | - Adam M. Brufsky
- 14UPMC Hillman Cancer Center, University of Pittsburgh Medical Center
| | - Michelle Melisko
- 15University of California at San Francisco, San Francisco, California
| | | | | | | | | | | | | | - Robyn Burns
- 22Translational Breast Cancer Research Consortium
| | | | | | | | - Ian Krop
- 26Yale School of Medicine, New Haven, Connecticut
| | - Nancy U. Lin
- 27Dana-Farber Cancer Institute, Boston, Massachusetts
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Domingos TA, Peixoto RBP, Patel A, Taneja K, Chen WY, Mittendorf EA, Zimbalist A, Feliciano EMC, Dillon DA. Abstract P4-09-04: Correlation between histology and molecular subtypes in triple negative breast cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-09-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Correlation between histology and molecular subtypes in triple negative breast cancer Authors: Tabata Alves Domingos, MD; 1* Roberto Bonfim Pimenta Peixoto, MD; 1* Ashka Patel, BS1,2; Krishan Taneja, PhD; 1 Wendy Y. Chen, MD, MPH; 4,5,6 Elizabeth A. Mittendorf, MD, PhD; 5,6,7 Alexa Zimbalist, MS; 3 Elizabeth M. Cespedes Feliciano, ScD SM; 3 Deborah A. Dillon, MD 1,2 *equal contribution Author Affiliations 1. Department of Pathology, Brigham and Women’s Hospital, Boston, MA 02115 2. Breast Oncology, Dana-Farber Brigham Cancer Center, Boston, MA 02215 3. Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612 4. Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115 5. Department of Medical Oncology Dana Farber Cancer Institute, Boston, MA 02215 6. Harvard Medical School, Boston, MA 02215 7. Division of Breast Surgery, Brigham and Women’s Hospital, Boston, MA 02215 Background Recently defined molecular subtypes of triple negative breast cancer (TNBC) show distinct clinical outcomes and suggest new therapeutic targets but have not been integrated into current pathologic classification systems. Here, we describe the histopathologic features of TNBC according to four molecular subtypes: basal-like immune activated (BLIA), basal-like immune suppressed (BLIS), luminal androgen receptor (LAR) and mesenchymal (MES), classified using the NanoString BC360 gene expression assay. Methods Stage II and III invasive breast cancers were identified in the Kaiser Permanente (KP) clinical pathology archives (2005-2015) and triple negative status was determined from the KP Northern California Cancer Registry data on immunohistochemistry. Selected slides were reviewed by two pathologists who recorded key histopathologic features [histologic subtype, presence of apocrine, metaplastic or micropapillary features, nuclear grade, mitotic score, and Tumor Infiltrating Lymphocytes (TILs)] and marked the best tumor areas for molecular analysis. TILs were evaluated according to the guidelines of the International TILs Working Group. Cases were macrodissected and evaluated using the NanoString BC360 gene expression assay. Histologic features were then summarized according to molecular subtype. Results Of 72 TNBCs, 60 were classified as Basal-like (83.3%), 7 as HER2-enriched (9.7%) and 5 as Luminal A (6.9%). 41 cases were classified as BLIA (56.9%), 14 as BLIS (19.4%), 13 as LAR (18.0%) and 4 as MES (5.5%). Both BLIA and BLIS tumors showed uniformly high nuclear grade and high mitotic score but differed significantly in TILs (BLIA average 32% vs BLIS average 9%; p value< 0.001, t-test for mean difference in TILs). The majority of LAR cases (69%) showed apocrine differentiation, not present in any other molecular subtype (p value< 0.001, chi-square test for presence of apocrine differentiation). LAR cases showed high nuclear grade but a lower average mitotic score (average score of 2) compared with the basal-like subtypes. TILs in LAR tumors were intermediate (17%) between BLIA and BLIS tumors. Of the 4 MES cases, all showed high nuclear grade. TILs in the MES cases were also intermediate (14%) between BLIA and BLIS tumors. Other histologic features, including lobular subtype, metaplastic and micropapillary features were not associated with specific triple negative molecular subtypes. Conclusion TILs are high in the BLIA molecular subtype (average 32%), low in the BLIS subtype (average 9%) and intermediate in LAR (average 17%) and MES (average 14%) subtypes. Apocrine features, if present in a TNBC, are a strong predictor of LAR molecular subtype. The inclusion of TILs and apocrine features (both easily derived from H&E slides) in routine pathology reporting could improve the classification of TNBC and aid in the identification of patients more likely to respond to specific therapies for the BLIA, BLIS and LAR subtypes, especially in resource-limited settings.
Citation Format: Tabata Alves Domingos, Roberto Bonfim Pimenta Peixoto, Ashka Patel, Krishan Taneja, Wendy Y. Chen, Elizabeth A. Mittendorf, Alexa Zimbalist, Elizabeth M. Cespedes Feliciano, Deborah A. Dillon. Correlation between histology and molecular subtypes in triple negative breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-09-04.
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Affiliation(s)
| | | | - Ashka Patel
- 3Department of Pathology, Brigham and Women’s Hospital
| | | | | | | | - Alexa Zimbalist
- 7Kaiser Permanente Northern California Division of Research, California
| | | | - Deborah A. Dillon
- 9Brigham and Women’s Hospital, Breast Oncology Program, Susan F. Smith Center for Women’s Cancers, Dana-Farber Brigham Cancer Center; Harvard Medical School
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Nechuta SJ, Lipworth L, Chen WY, Shu XO, Zheng W, Blot WJ. Physical activity in association with mortality among Black women diagnosed with breast cancer in the Southern Community Cohort Study. Cancer Causes Control 2023; 34:277-286. [PMID: 36550258 PMCID: PMC10187641 DOI: 10.1007/s10552-022-01663-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Physical activity (PA) is associated with many health benefits. While PA has been associated with reduced mortality after breast cancer diagnosis in many studies, few studies have examined the role of PA in breast cancer survival among underserved and minority populations, including Black women. We investigated PA in association with mortality among Black predominantly low-income breast cancer survivors in the Southern Community Cohort Study (SCCS). METHODS Study participants were women diagnosed with incident breast cancer (n = 949) in the SCCS, which is a prospective cohort study of predominantly low-income adults aged 40-79 years recruited from 12 Southeastern states between 2002 and 2009. Participants completed a detailed baseline questionnaire, with annual follow-up for mortality via registry linkages. Cox regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations of pre-diagnosis PA (measured via a validated questionnaire) with all-cause and breast cancer-specific mortality. RESULTS Breast cancer survivors had a mean age of 61.1 years and most (79.3%) had a household income of < $25,000. In adjusted models, higher levels of total PA (MET-hours/day) were inversely associated with all-cause mortality with HRs (95% CIs): 0.79 (0.59-1.06), 0.66 (0.49-0.90), and 0.60 (0.43-0.84), for Q2, Q3, and Q4 (reference: Q1), respectively, ptrend ≤ 0.01. A similar inverse association was found for breast cancer-specific mortality. CONCLUSION Higher levels of pre-diagnosis PA were associated with improved survival among low-income Black breast cancer survivors. Resources to reduce barriers to PA participation and increase support for education and intervention efforts to promote PA among Black women are needed.
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Affiliation(s)
- Sarah J Nechuta
- School of Interdisciplinary Health, College of Health Professions, Grand Valley State University, 500 Lafayette Ave NE, Grand Rapids, MI, 49503, USA.
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Loren Lipworth
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wendy Y Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Deptartment of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Xiao Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William J Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
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Dillon DA, Feliciano EMC, Zimbalist A, Cheng E, Caan BJ, Chen WY, Mittendorf EA, Peixoto RBP, Domingos TA, Taneja K, Patel A. Abstract P5-03-02: Adiposity and immune-related gene expression in the breast tumor microenvironment. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p5-03-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background: Extreme adiposity has been associated with tumor progression and increased mortality after a breast cancer diagnosis, but the underlying mechanisms remain unclear. Pre-clinical and in vitro analyses suggest that higher levels of adiposity impair anti-tumor immunity, but studies in human breast cancer patients are lacking. Previously, we found that higher levels of subcutaneous adiposity had stronger associations with breast cancer outcomes than did higher levels of visceral adiposity or overall obesity measured by BMI, underscoring the importance of measuring adipose tissue distribution as well as overall body size to understand the adiposity-cancer link.
Methods: We identified women with a first-primary, stage 2 or 3 invasive breast cancer diagnosed and treated at Kaiser Permanente Northern California between 2005 and 2015. Using diagnostic computed tomography scans collected as part of routine clinical care, we measured subcutaneous (SAT) and visceral adipose tissue (VAT) areas in cm2 at the third lumbar vertebra. We calculated body mass index (BMI) from clinically-collected height and weight. We isolated RNA from 251 FFPE breast tumors collected at biopsy or excision; these were a preliminary, random sample within each immunohistochemical subtype groups from an ongoing study that will analyze 1400 breast tumors. We verified RNA quality prior to performing NanoString BC 360™ assays to calculate the PAM50 molecular intrinsic subtype and measure the expression levels of genes related to immune cell abundance and anti-tumor immune activity. Using linear regression models, we examined the mean change in log2 gene expression (dependent variables) associated with each adiposity exposure (BMI, SAT and VAT as independent variables).
Results: Mean (SD) age at diagnosis was 56 (13); a majority of women were either overweight (BMI 25- < 30-kg/m2: 30%) or obese (BMI>30-kg/m2: 35%), and most were diagnosed with stage 2 (61%) vs. stage 3 (39%) breast cancer with representation from each PAM50 subtype: n (%) Luminal A, 46 (18%) Luminal B, 56 (22%), HER2-overexpressing 26 (27%), and 82 (33%) basal-like. In unadjusted analyses, expression of genes related to macrophages, PD-1 and TIGIT increased with increasing subcutaneous adiposity, whereas expression of genes related to mast cells decreased (see Table 1). We found a similar (though non-significant) pattern for BMI. Associations with increasing visceral adiposity were closer to the null. After adjusting for PAM50 subtype, age and stage at diagnosis, only the association of increasing subcutaneous adiposity with increasing PD-1 expression remained statistically significant.
Conclusion: Excess subcutaneous adiposity was associated with increased PD-1 expression, whereas excess visceral adiposity or obesity defined by BMI were not. These results from the first 251 samples of an ongoing study of 1400 tumors provide evidence from human breast cancer patients to demonstrate the importance of measuring body composition to assess adipose tissue distribution and support the hypothesis that excess adiposity impairs anti-tumor immunity.
Association of Adiposity Measures with Immune-Related Gene Expression in the Breast Tumor Microenvironment (n=251 patients with stage 2-3 breast cancer at Kaiser Permanente Northern California) 195% Confidence Interval 2A 1-unit increase represents a doubling in the log expression level of the genes in the signature
Citation Format: Deborah A. Dillon, Elizabeth M. Cespedes Feliciano, Alexa Zimbalist, En Cheng, Bette J. Caan, Wendy Y. Chen, Elizabeth A. Mittendorf, Roberto Bonfim Pimenta Peixoto, Tabata Alves Domingos, Krishan Taneja, Ashka Patel. Adiposity and immune-related gene expression in the breast tumor microenvironment [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-03-02.
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Affiliation(s)
- Deborah A. Dillon
- 1Brigham and Women’s Hospital, Breast Oncology Program, Susan F. Smith Center for Women’s Cancers, Dana-Farber Brigham Cancer Center; Harvard Medical School
| | | | - Alexa Zimbalist
- 3Kaiser Permanente Northern California Division of Research, California
| | - En Cheng
- 4Kaiser Permanente Northern California Division of Research
| | - Bette J. Caan
- 5Kaiser Permanente Northern California Division of Research
| | | | | | | | | | | | - Ashka Patel
- 11Department of Pathology, Brigham and Women’s Hospital
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Mayer EL, Ren Y, Wagle N, Mahtani R, Ma C, DeMichele A, Cristofanilli M, Meisel J, Miller KD, Jolly T, Riley E, Qamar R, Sharma P, Reid S, Sinclair N, Faggen M, Block C, Ko N, Partridge A, Chen WY, DeMeo MK, Attaya V, Okpoebo A, Liu Y, Gauthier E, Burstein H, Regan M, Tolaney S. Abstract GS3-06: GS3-06 Palbociclib After CDK4/6i and Endocrine Therapy (PACE): A Randomized Phase II Study of Fulvestrant, Palbociclib, and Avelumab for Endocrine Pre-treated ER+/HER2- Metastatic Breast Cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-gs3-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background CDK4/6 inhibitors (CDK4/6i) in combination with endocrine therapy (ET) have a well-established role in the management of hormone receptor-positive (HR+)/HER2- metastatic breast cancer (MBC). The benefit of continuing CDK4/6i beyond progression in combination with a different ET has not been confirmed. Preclinical data suggest synergy between CDK4/6i and PD-L1 inhibition. The PACE trial prospectively evaluates whether continuation of the CKD4/6i palbociclib beyond progression on prior CDK4/6i and aromatase inhibitor (AI), with a change in ET to fulvestrant, improves outcomes beyond change to fulvestrant alone, as well as explores the activity of the palbociclib, fulvestrant, and avelumab triplet. Methods PACE is a multicenter randomized open-label investigator-initiated phase II trial, open at 11 U.S. sites. Eligible patients (pts) had HR+/HER2- evaluable MBC with prior progression on AI and any CDK4/6i after > 6 months (mo) of therapy in the MBC setting, or during/within 12 mo in the adjuvant setting, with no more than 1 prior line of chemotherapy for MBC. Pts were randomized 1:2:1 to fulvestrant alone (F); fulvestrant and palbociclib (F+P); or fulvestrant, palbociclib, avelumab (F+P+A), with tumor assessments every 8 weeks. Blood for circulating tumor DNA (ctDNA) analysis was collected at baseline, at times of tumor assessments, and at progression. The primary objective was to evaluate progression-free survival (PFS) with F+P vs F; secondary objectives included PFS with F+P+A vs F, objective response rate (ORR) in all arms, and safety. A sample size of 220 patients was planned to provide 80% power to detect an improvement in PFS with HR 0.6154 with F+P vs F (6.5 vs 4 mo; α(1)=0.05). Results A total of 220 pts were randomized from 9/2017-2/2022 (F: n=55, F+P: n=111, F+P+A: n=54); median age 57 years (range 25-83), 85% non-Hispanic (7.7% non-Hispanic black), 8.6% Hispanic, 6.4% unknown. 40% had de novo MBC, 60% had visceral disease, and 14% bone-only disease. 16% had 1 prior line of chemotherapy for MBC, 90% had received prior palbociclib, 4.5% ribociclib, 4.1% abemaciclib, 1.4% palbociclib and ribociclib. Pts entered the trial after a median 19 mo of prior CDK4/6i plus AI (interquartile range 12-31 mo). A total of 10 (5%) pts received protocol therapy as first line ET for MBC, 169 (77%) as second line, and 41 (17%) as beyond second line. 88% entered the trial directly after progression on CDK4/6i. After a median follow-up of 24 mo, 18 pts remained on protocol treatment. PFS was not improved with F+P vs F (median 4.6 vs 4.8 mo; HR=1.11, 90% CI 0.79-1.55; 2-sided p=0.62). Median PFS was 8.1 mo with F+P+A (HR=0.75 vs F, 90% CI 0.50-1.12; 2-sided p=0.23). ORR was 7.3% (90%CI 1.5-13.0) with F, 9.0% F+P (4.5-13.5%) and 13.0% F+P+A (5.4-20.5%). No new safety signals have been observed. Analysis of ctDNA panel sequencing encompassing 70 genes from 184 baseline samples, including correlation with known and hypothesized resistance genes, will be presented. Conclusions For ER+/HER2- breast cancer, combining palbociclib with fulvestrant beyond progression on prior CDK4/6i and AI did not significantly improve PFS compared with using fulvestrant alone. The observed longer PFS when a PD-L1 inhibitor was added to fulvestrant plus palbociclib is an intriguing signal in this ER+ population. Translational studies of blood and tumor tissue are ongoing and will be presented.
Citation Format: Erica L. Mayer, Yue Ren, Nikhil Wagle, Reshma Mahtani, Cynthia Ma, Angela DeMichele, Massimo Cristofanilli, Jane Meisel, Kathy D. Miller, Trevor Jolly, Elizabeth Riley, Rubina Qamar, Priyanka Sharma, Sonya Reid, Natalie Sinclair, Meredith Faggen, Caroline Block, Naomi Ko, Ann Partridge, Wendy Y. Chen, Michelle K. DeMeo, Victoria Attaya, Amanda Okpoebo, Yuan Liu, Eric Gauthier, Harold Burstein, Meredith Regan, Sara Tolaney. GS3-06 Palbociclib After CDK4/6i and Endocrine Therapy (PACE): A Randomized Phase II Study of Fulvestrant, Palbociclib, and Avelumab for Endocrine Pre-treated ER+/HER2- Metastatic Breast Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr GS3-06.
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Affiliation(s)
| | - Yue Ren
- 2Department of Biostatistics, Dana-Farber Cancer Institute
| | | | | | - Cynthia Ma
- 5Washington University in St. Louis, St. Louis, MO
| | | | | | | | | | - Trevor Jolly
- 10University of North Carolina Lineberger Comprehensive Cancer Center
| | | | | | - Priyanka Sharma
- 13University of Kansas Medical Center Westwood, Westwood, KS, USA
| | | | | | | | | | | | | | | | | | | | | | - Yuan Liu
- 24Pfizer Inc, San Diego, California
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Sun CX, Wang SS, Li JB, Wang YS, Ouyang QC, Yang J, Wang HB, Wang XJ, Chen WY, Yuan P, Yan M, Jiang ZF, Yin YM. [A real-world study on the efficacy and safety analysis of paclitaxel liposome in advanced breast cancer]. Zhonghua Zhong Liu Za Zhi 2023; 45:88-94. [PMID: 36709125 DOI: 10.3760/cma.j.cn112152-20220129-00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objective: To explore the application and efficacy of paclitaxel liposome in the treatment of advanced breast cancer among Chinese population in the real world. Methods: The clinical characteristics of patients with advanced breast cancer who received paclitaxel liposome as salvage treatment from January 1, 2016 to August 31, 2019 in 11 hospitals were collected and retrospectively analyzed. The primary outcome was progression free survival (PFS), and the secondary outcome included objective response rate (ORR) and safety. The survival curve was drawn by Kaplan-Meier analysis and the Cox regression model were used for the multivariate analysis. Results: Among 647 patients with advanced breast cancer who received paclitaxel liposome, the first-line treatment accounted for 43.3% (280/647), the second-line treatment accounted for 27.7% (179/647), and the third-line and above treatment accounted for 29.1% (188/647). The median dose of first-line and second-line treatment was 260 mg per cycle, and 240 mg in third line and above treatment. The median period of paclitaxel liposome alone and combined chemotherapy or targeted therapy is 4 cycles and 6 cycles, respectively. In the whole group, 167 patients (25.8%) were treated with paclitaxel liposome combined with capecitabine±trastuzumab (TX±H), 123 patients (19.0%) were treated with paclitaxel liposome alone (T), and 119 patients (18.4%) were treated with paclitaxel liposome combined with platinum ± trastuzumab (TP±H), 108 patients (16.7%) were treated with paclitaxel liposome combined with trastuzumab ± pertuzumab (TH±P). The median PFS of first-line and second-line patients (5.5 and 5.5 months, respectively) were longer than that of patients treated with third line and above (4.9 months, P<0.05); The ORR of the first line, second line, third line and above patients were 46.7%, 36.8% and 28.2%, respectively. Multivariate analysis showed that event-free survival (EFS) and the number of treatment lines were independent prognostic factors for PFS. The common adverse events were myelosuppression, gastrointestinal reactions, hand foot syndrome and abnormal liver function. Conclusion: Paclitaxel liposomes is widely used and has promising efficacy in multi-subtype advanced breast cancer.
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Affiliation(s)
- C X Sun
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - S S Wang
- Department of Medicial Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510062, China
| | - J B Li
- Senior Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - Y S Wang
- Department of Breast Surgery, Shandong Cancer Hospital, Jinan 250117, China
| | - Q C Ouyang
- Department of Breast Medical Oncology, Hunan Cancer Hospital, Changsha 410031, China
| | - J Yang
- Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - H B Wang
- Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - X J Wang
- Department of Breast Medical Oncology, Zhejiang Cancer Hospital, Hangzhou 310005, China
| | - W Y Chen
- Department of Mediacl Oncology, The Third Hospital of Nanchang, Nanchang 330008, China
| | - P Yuan
- Department of VIP Medical, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M Yan
- Department of Breast Surgery, Henan Cancer Hospital, Zhengzhou 450003, China
| | - Z F Jiang
- Senior Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - Y M Yin
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Freedman RA, Li T, Sedrak MS, Hopkins JO, Tayob N, Faggen MG, Sinclair NF, Chen WY, Parsons HA, Mayer EL, Lange PB, Basta AS, Perilla-Glen A, Lederman RI, Wong A, Tiwari A, McAllister SS, Mittendorf EA, Miller PG, Gibson CJ, Burstein HJ. 'ADVANCE' (a pilot trial) ADjuVANt chemotherapy in the elderly: Developing and evaluating lower-toxicity chemotherapy options for older patients with breast cancer. J Geriatr Oncol 2023; 14:101377. [PMID: 36163163 PMCID: PMC10080267 DOI: 10.1016/j.jgo.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Older adults with breast cancer receiving neo/adjuvant chemotherapy are at high risk for poor outcomes and are underrepresented in clinical trials. The ADVANCE (ADjuVANt Chemotherapy in the Elderly) trial evaluated the feasibility of two neo/adjuvant chemotherapy regimens in parallel-enrolling cohorts of older patients with human epidermal growth factor receptor 2-negative breast cancer: cohort 1-triple-negative; cohort 2-hormone receptor-positive. MATERIALS AND METHODS Adults age ≥ 70 years with stage I-III breast cancer warranting neo/adjuvant chemotherapy were enrolled. Cohort 1 received weekly carboplatin (area under the curve 2) and weekly paclitaxel 80 mg/m2 for twelve weeks; cohort 2 received weekly paclitaxel 80 mg/m2 plus every-three-weekly cyclophosphamide 600 mg/m2 over twelve weeks. The primary study endpoint was feasibility, defined as ≥80% of patients receiving ≥80% of intended weeks/doses of therapy. All dose modifications were applied per clinician discretion. RESULTS Forty women (n = 20 per cohort) were enrolled from March 25, 2019 through August 3, 2020 from three centers; 45% and 35% of patients in cohorts 1 and 2 were age > 75, respectively. Neither cohort achieved targeted thresholds for feasibility. In cohort 1, eight (40.0%) met feasibility (95% confidence interval [CI] = 19.1-63.9%), while ten (50.0%) met feasibility in cohort 2 (95% CI = 27.2-72.8). Neutropenia was the most common grade 3-4 toxicity (cohort 1-65%, cohort 2-55%). In cohort 1, 80% and 85% required ≥1 dose holds of carboplatin and/or paclitaxel, respectively. In cohort 2, 10% required dose hold(s) for cyclophosphamide and/or 65% for paclitaxel. DISCUSSION In this pragmatic pilot examining chemotherapy regimens in older adults with breast cancer, neither regimen met target goals for feasibility. Developing efficacious and tolerable regimens for older patients with breast cancer who need chemotherapy remains an important goal. CLINICALTRIALS gov Identifier: NCT03858322.
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Affiliation(s)
- Rachel A Freedman
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Tianyu Li
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mina S Sedrak
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA
| | - Judith O Hopkins
- Novant Health Cancer Institute / SCOR NCORP, Winston Salem, NC, USA
| | - Nabihah Tayob
- Harvard Medical School, Boston, MA, USA; Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Meredith G Faggen
- Dana-Farber Brigham Cancer Center at South Shore Hospital, South Weymouth, MA, USA
| | - Natalie F Sinclair
- Dana-Farber Brigham Cancer Center at Milford Regional Medical Center, Milford, MA, USA
| | - Wendy Y Chen
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Heather A Parsons
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Erica L Mayer
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Paulina B Lange
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ameer S Basta
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Ruth I Lederman
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Andrew Wong
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA
| | - Abhay Tiwari
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA
| | - Sandra S McAllister
- Harvard Medical School, Boston, MA, USA; Hematology Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Stem Cell Institute, Cambridge, MA, USA; Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Elizabeth A Mittendorf
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Peter G Miller
- Harvard Medical School, Boston, MA, USA; Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA; Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA
| | - Christopher J Gibson
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Harold J Burstein
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Zimbalist AS, Caan BJ, Chen WY, Mittendorf EA, Dillon DAR, Quesenberry C, Cespedes Feliciano EM. Metabolic abnormalities and survival among patients with non-metastatic breast cancer. BMC Cancer 2022; 22:1361. [PMID: 36581817 PMCID: PMC9801571 DOI: 10.1186/s12885-022-10430-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/09/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Research on the impact of metabolic abnormalities on breast cancer prognosis is limited by small samples and assessment of laboratory values at a single time point, often prior to cancer diagnosis and treatment. In this population-based cohort, time-updated laboratory values were adjusted for cancer treatment to assess the association between metabolic risk factors (glucose, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides) and breast cancer survival. METHODS 13,434 women diagnosed with stage I-III breast cancer from 2005-15 at Kaiser Permanente were included. All outpatient fasting glucose, HDL-C, LDL-C, and triglyceride values from diagnosis through 2019 or death were extracted from electronic medical records. Risk of breast cancer-specific mortality was evaluated with Cox proportional hazards models adjusted for metabolic labs, demographics, body mass index, diabetes, dyslipidemia and anti-hypertensive medications, tumor characteristics (stage, ER and HER2 receptor status) and cancer treatment (use of chemotherapy, tamoxifen, and aromatase inhibitors). RESULTS Mean (SD) age at diagnosis was 62.3 (11.8) years. Over a median follow-up of 8.6 years, 2,876 patients died; 1,080 of breast cancer. Patients with low HDL-C (≤ 45 vs. > 45 mg/dL) had higher breast cancer-specific mortality (HR, 1.77; 95% CI, 1.53-2.05), as did those with elevated fasting glucose (> 99 vs. 60-99 mg/dL) (HR, 1.19; 95% CI, 1.03-1.37). Elevated levels of triglycerides and LDL-C were not associated with breast cancer-specific mortality. CONCLUSIONS High fasting glucose and low HDL-C evaluated over time after cancer diagnosis were associated with higher breast cancer mortality independent of cancer treatments and changes in other metabolic risk factors. Future studies should address whether pharmacologic or lifestyle treatment of glucose and lipids after breast cancer diagnosis can optimize survival outcomes.
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Affiliation(s)
- Alexa S. Zimbalist
- grid.280062.e0000 0000 9957 7758Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 5Th Floor, Oakland, CA 94612 USA
| | - Bette J. Caan
- grid.280062.e0000 0000 9957 7758Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 5Th Floor, Oakland, CA 94612 USA
| | - Wendy Y. Chen
- grid.62560.370000 0004 0378 8294Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115 USA ,grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215 USA
| | - Elizabeth A. Mittendorf
- grid.62560.370000 0004 0378 8294Division of Breast Surgery, Brigham and Women’s Hospital, Boston, MA 02215 USA ,grid.65499.370000 0001 2106 9910Breast Oncology, Dana-Farber Brigham Cancer Center, Boston, MA 02215 USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA 02215 USA
| | - Deborah A. R. Dillon
- grid.38142.3c000000041936754XHarvard Medical School, Boston, MA 02215 USA ,grid.62560.370000 0004 0378 8294Department of Pathology, Brigham and Women’s Hospital, Boston, MA 02115 USA
| | - Charles Quesenberry
- grid.280062.e0000 0000 9957 7758Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 5Th Floor, Oakland, CA 94612 USA
| | - Elizabeth M. Cespedes Feliciano
- grid.280062.e0000 0000 9957 7758Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 5Th Floor, Oakland, CA 94612 USA
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Romanos-Nanclares A, Tabung FK, Willett WC, Rosner B, Holmes MD, Chen WY, Tamimi RM, Eliassen AH. Insulinemic potential of diet and risk of total and subtypes of breast cancer among US females. Am J Clin Nutr 2022; 116:1530-1539. [PMID: 36178066 PMCID: PMC9761760 DOI: 10.1093/ajcn/nqac284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/15/2022] [Accepted: 09/28/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Insulin resistance and hyperinsulinemia play important roles in the progression of multiple chronic disease and conditions. Diet modulates insulin response; however, evidence is limited regarding whether diets with higher insulinemic potential increase the risk of invasive breast cancer. OBJECTIVES We aimed to prospectively evaluate the association between a food-based empirical dietary index for hyperinsulinemia (EDIH) and the incidence of invasive breast cancer. METHODS We prospectively followed 76,686 women from the Nurses' Health Study (NHS; 1984-2016) and 93,287 women from the Nurses' Health Study II (NHSII; 1991-2017). Diet was assessed by food-frequency questionnaires every 4 y. The insulinemic potential of diet was evaluated using the previously established EDIH based on circulating C-peptide concentrations. Higher scores indicate higher insulinemic potential of the diet. Covariates included reproductive, hormonal, and anthropometric factors (height and BMI at age 18 y); race; socioeconomic status; total alcohol intake; total caloric intake; and physical activity. RESULTS During 4,216,106 person-years of follow-up, we documented 10,602 breast cancer cases (6689 NHS, 3913 NHSII). In the pooled multivariable-adjusted analyses, women in the highest, compared with the lowest, EDIH quintile (Q) were at higher breast cancer risk (HRQ5 vs. Q1 = 1.15; 95% CI: 1.07, 1.24; P-trend < 0.01). Although heterogeneity by estrogen receptor (ER) status was nonsignificant, the strongest association between EDIH and breast cancer was observed for ER-negative tumors (HRQ5 vs. Q1 = 1.21; 95% CI: 1.00, 1.46; P-trend = 0.02). Among tumor molecular subtypes, the strongest associations were observed for human epidermal growth factor receptor 2 (HER2)-enriched tumors (HRQ5 vs. Q1 = 1.62; 95% CI: 1.01, 2.61; P-trend = 0.02). CONCLUSIONS A dietary pattern contributing to hyperinsulinemia and insulin resistance was associated with greater breast cancer risk, especially ER-negative and HER2-enriched tumors. Our findings suggest that dietary modifications to reduce insulinemic potential may reduce the risk of breast cancer.
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Affiliation(s)
- Andrea Romanos-Nanclares
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Fred K Tabung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
- The Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA
| | - Walter C Willett
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle D Holmes
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wendy Y Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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22
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Cheng E, Caan BJ, Chen WY, Irwin ML, Prado CM, Cespedes Feliciano EM. Adipose tissue radiodensity and mortality among patients with nonmetastatic breast cancer. Clin Nutr 2022; 41:2607-2613. [PMID: 36306565 PMCID: PMC9722634 DOI: 10.1016/j.clnu.2022.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/02/2022] [Accepted: 09/26/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Computed tomography (CT) scans can measure quantity and distribution of adipose tissue, which are associated with breast cancer prognosis. As a novel prognostic marker, radiodensity of adipose tissue has been examined in multiple cancer types, but never in breast cancer. Lower density indicates larger adipocytes with greater lipid content, whereas higher density can reflect inflammation, fibrosis, vascularity, or even metabolic changes; and both may impact breast cancer prognosis. METHODS We included 2868 nonmetastatic patients with breast cancer diagnosed between January 2005 and December 2013 at Kaiser Permanente Northern California, an integrated healthcare system. From CT scans at diagnosis, we assessed the radiodensity of subcutaneous (SAT) and visceral adipose tissue (VAT) at the third lumbar vertebra and categorized their radiodensity into three levels: low (<1 standard deviation [SD] below the mean), middle (mean ± 1 SD), and high (>1 SD above the mean). Using multivariable Cox proportional hazards regression with adjustment for clinicopathological characteristics including body mass index, we calculated hazard ratios (HRs [95% confidence intervals]) for the associations of adipose tissue radiodensity with overall mortality and breast-cancer-specific mortality. RESULTS Median age at diagnosis of breast cancer was 56.0 years, most (63.3%) were non-Hispanic White and nearly half (45.6%) were stage II. Compared to middle SAT radiodensity, high SAT radiodensity was significantly associated with increased risk of overall mortality (HR: 1.45 [1.15-1.81]), non-significantly with breast-cancer-specific mortality (HR: 1.32 [0.95-1.84]). Neither low SAT radiodensity nor high or low VAT radiodensity was significantly associated with overall or breast-cancer-specific mortality. CONCLUSIONS High radiodensity of SAT at diagnosis of nonmetastatic breast cancer was associated with increased risk of overall mortality, independent of adiposity and other prognostic factors. Considering both radiodensity and quantity of adipose tissue at different locations could deepen understanding of the role of adiposity in breast cancer survival.
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Affiliation(s)
- En Cheng
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Wendy Y Chen
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, United States
| | - Melinda L Irwin
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Connecticut, United States
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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23
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Wang T, Heng YJ, Baker GM, Bret-Mounet VC, Quintana LM, Frueh L, Hankinson SE, Holmes MD, Chen WY, Willett WC, Rosner B, Tamimi RM, Eliassen AH. Loss of PTEN Expression, PIK3CA Mutations, and Breast Cancer Survival in the Nurses' Health Studies. Cancer Epidemiol Biomarkers Prev 2022; 31:1926-1934. [PMID: 35914729 PMCID: PMC9532372 DOI: 10.1158/1055-9965.epi-22-0672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 06/28/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The relationships between PTEN loss and/or PIK3CA mutation and breast cancer prognosis remain controversial. We aim to examine the associations in large epidemiologic cohorts. METHODS We followed women with invasive breast cancer from the Nurses' Health Studies with available data on tumor PTEN expression (n = 4,111) and PIK3CA mutation (n = 2,930). PTEN expression was evaluated by IHC and digitally scored (0%-100%). Pyrosequencing of six hotspot mutations of PIK3CA was performed. RESULTS We found loss of PTEN expression (≤10%) occurred in 17% of cases, and PIK3CA mutations were detected in 11% of cases. After adjusting for clinical and lifestyle factors, PTEN loss was not associated with worse breast cancer-specific mortality among all samples [HR, 0.85; 95% confidence intervals (CI), 0.71-1.03] or among estrogen receptor (ER)-positive tumors (HR, 0.99; 95% CI, 0.79-1.24). However, among ER-negative tumors, PTEN loss was associated with lower breast cancer-specific mortality (HR, 0.68; 95% CI, 0.48-0.95). PIK3CA mutation was not strongly associated with breast cancer-specific mortality (HR, 0.89; 95% CI, 0.67-1.17). Compared with tumors without PTEN loss and without PIK3CA mutation, those with alterations (n = 540) were not at higher risk (HR, 1.07; 95% CI, 0.86-1.34). However, women with both PTEN loss and PIK3CA mutation (n = 38) were at an increased risk of breast cancer-specific mortality (HR, 1.65; 95% CI, 0.83-3.26). CONCLUSIONS In this large epidemiologic study, the PTEN-mortality association was more pronounced for ER-negative tumors, and the joint PTEN loss and PIK3CA mutation may be associated with worse prognosis. IMPACT Further studies with a larger sample of ER-negative tumors are needed to replicate our findings and elucidate underlying mechanisms.
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Affiliation(s)
- Tengteng Wang
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital, and Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Yujing J. Heng
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Gabrielle M. Baker
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Liza M. Quintana
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Lisa Frueh
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Susan E. Hankinson
- Department of Biostatistics and Epidemiology, University of Massachusetts School of Public Health and Health Sciences, Amherst, MA
| | - Michelle D. Holmes
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital, and Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Wendy Y. Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital, and Harvard Medical School, Boston, MA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Walter C. Willett
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital, and Harvard Medical School, Boston, MA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Rulla M. Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - A. Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital, and Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
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24
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Zhang X, Lyu J, Chen WY, Chen D, Yan J, Yin S. Quantifying the capacity of tree branches for retaining airborne submicron particles. Environ Pollut 2022; 310:119873. [PMID: 35926735 DOI: 10.1016/j.envpol.2022.119873] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/07/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
Human health risks brought by fine atmospheric particles raise scholarly and policy awareness about the role of urban trees as bio-filters of air pollution. While a large number of empirical studies have focused on the characteristics of vegetation leaves and their effects on atmospheric particle retention, the dry deposition of particles on branches, which plays a significant role in capturing and retaining particles during the defoliation period and contributes substantially to total removal of atmospheric particles, is under-investigated. To fill in this knowledge gap, this case study examined the dry deposition velocities (Vd) of submicron particulate matters (PM1) on the branches of six common deciduous species in Shanghai (China) using laboratory experiments. And the association between Vd and key branch anatomical traits (including surface roughness, perimeter, rind width proportion, lenticel density, peeling, and groove/ridge characteristics) was explored. It was found that surface roughness would increase Vd, as a rougher surface significantly increases turbulence, which is conducive to particle diffusion. By contrast, peeling, branch perimeter, and lenticel density would decrease Vd. Peeling represents the exfoliated remains on the branch surfaces which may flutter considerably with airflow, leading to particle resuspension and low Vd. When branch perimeter increases, the boundary layer of branches thickens and a wake area appears, increasing the difficulty of particles to reach branch surface, and reducing Vd. While lenticels can increase the roughness of branch surface, their pointy shape would uplift airflow and cause a leeward wake area, lowering Vd. This finely wrought study contributes to a better understanding of branch dry deposition during leaf-off seasons and potential of deciduous trees serving as nature-based air filters all year round in urban environments.
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Affiliation(s)
- Xuyi Zhang
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., Shanghai 200240, China; Shanghai Yangtze River Delta Eco-Environmental Change and Management Observation and Research Station, Ministry of Science and Technology, Ministry of Education, 800 Dongchuan Rd, Shanghai 200240, China; Shanghai Urban Forest Ecosystem Research Station, National Forestry and Grassland Administration, 800 Dongchuan Rd., Shanghai 200240, China
| | - Junyao Lyu
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., Shanghai 200240, China; Shanghai Yangtze River Delta Eco-Environmental Change and Management Observation and Research Station, Ministry of Science and Technology, Ministry of Education, 800 Dongchuan Rd, Shanghai 200240, China; Key Laboratory for Urban Agriculture, Ministry of Agriculture and Rural Affairs, 800 Dongchuan Rd., Shanghai 200240, China
| | - Wendy Y Chen
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Dele Chen
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., Shanghai 200240, China; Shanghai Yangtze River Delta Eco-Environmental Change and Management Observation and Research Station, Ministry of Science and Technology, Ministry of Education, 800 Dongchuan Rd, Shanghai 200240, China; Shanghai Urban Forest Ecosystem Research Station, National Forestry and Grassland Administration, 800 Dongchuan Rd., Shanghai 200240, China
| | - Jingli Yan
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., Shanghai 200240, China; Shanghai Yangtze River Delta Eco-Environmental Change and Management Observation and Research Station, Ministry of Science and Technology, Ministry of Education, 800 Dongchuan Rd, Shanghai 200240, China; Key Laboratory for Urban Agriculture, Ministry of Agriculture and Rural Affairs, 800 Dongchuan Rd., Shanghai 200240, China
| | - Shan Yin
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., Shanghai 200240, China; Shanghai Yangtze River Delta Eco-Environmental Change and Management Observation and Research Station, Ministry of Science and Technology, Ministry of Education, 800 Dongchuan Rd, Shanghai 200240, China; Shanghai Urban Forest Ecosystem Research Station, National Forestry and Grassland Administration, 800 Dongchuan Rd., Shanghai 200240, China.
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25
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Chen WY, Su Y, Liekens I. Environmental information disclosure and public choice decisions for urban river restoration: A comparative study between Brussels (Belgium) and Guangzhou (China). J Environ Manage 2022; 319:115692. [PMID: 35820306 DOI: 10.1016/j.jenvman.2022.115692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/20/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Worldwide environmental information disclosure (EID) has been widely promoted as a policy approach to establish transparent governments, enhance public environmental awareness, and foster participatory environmental governance. While information disclosure and transparency are inherently incentivised within democratic regimes, how and through what pathways an increased flow of environmental information in the absence of democracy could lead to favourable public support for environmental/ecological projects remain under-investigated. Particularly, there exists very limited literature which compares how EID is associated with public environmental choices between different sociopolitical contexts. Taking Brussels (Belgium) and Guangzhou (China) as a comparative case, this study examines the association between citizens' perceived trustworthiness of various environmental information sources and their choice decisions regarding urban river restoration initiatives in contrasting socialpolitical contexts. Latent class modelling of two paralleled discrete choice experiments unveils a consistent classification of three distinctive groups for each city and also the combined sample, including Enthusiastic Supporters (Class 1, who are cost-insensitive and supportive of all proposed changes), Pragmatic Supporters (Class 2, who are cost-sensitive, prefer some changes they favour), and Non-Supporters (Class 3, who are unwilling to support the proposed initiatives). Incorporating respondents' trustworthiness in information sources as covariates in class membership likelihood function, respondents' membership is found to be associated solely with the most trusted information source, i.e., social contacts in Guangzhou, third parties in Brussels, and social contacts for the whole sample. Holding trust toward the most-trusted information source can increase the probability of being a member of Class 1, otherwise, more likely being a member of Class 3. Taken together with the insignificance of the variable denoting a respondent's city in explaining class membership, this study reveals that the variations in the EID levels (matured vs. emerging) and sociopolitical contexts (democratic vs. non-democratic) cannot significantly shape citizens' environmental decisions. Instead, it is respondents' perceived trustworthiness of information outlets that plays a positive role in their supportive decisions. These analytical results offer new insights about the role of EID in environmental governance and call for instilling institutional trust in China and relational trust in Belgium for facilitating effective communication and pro-environmental behaviours across the whole community.
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Affiliation(s)
- Wendy Y Chen
- Department of Geography, The University of Hong Kong, Hong Kong.
| | - Yining Su
- Department of Geography, The University of Hong Kong, Hong Kong
| | - Inge Liekens
- VITO, The Flemish Institute for Technological Research. Boeretang 200, BE-2400 Mol, Belgium
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26
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Han W, Chen WY. Embedding nature-based solutions into the social cost of carbon. Environ Int 2022; 167:107431. [PMID: 35926262 DOI: 10.1016/j.envint.2022.107431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 06/15/2023]
Abstract
China, the world's largest CO2 emitter, is making every effort to transition to a low-carbon economy and fulfill its part of a concerted global commitment to combating climate change. In tandem with decarbonizing energy and industries, feasible supplementary measures are urgently needed to help remove anthropogenic CO2 from the atmosphere. A burgeoning literature has emphasized the CO2 removal capability of land re-naturalization (such as afforestation and wetland restoration), thereby regarding cognate land-use conversions as Nature-based Solutions (NbS) and potential climate policy options. However, little empirical evidence exists concerning the effectiveness of different land re-naturalization pathways (such as converting wetlands to forests or agricultural lands to grasslands), and it also remains unclear how NbS alternatives (i.e., land-use conversions resulting in negative CO2 emission) and non-NbS options (i.e., land-use conversions resulting in positive CO2 emission) could affect the social cost of carbon (SCC), a conventional measurement for prescribing carbon mitigation approaches. This study aims to fill in this knowledge gap via embedding NbS into the dynamic integrated climate-economics (DICE) model to quantify their impacts on the SCC. Using the Pearl River Delta region (south China) as a case study for the temporal horizon during 2000-2020, we find that both positive and negative CO2 fluxes have been brought by different natural/semi-natural land conversions, affecting the SCC correspondingly. A total of 7 out of 17 types of land-use conversions could be identified as feasible NbS interventions, including forest restoration, forest-to-wetland, grassland-to-forest, grassland-to-wetland, grassland-to-cropland, cropland-to-forest, and cropland-to-wetland conversions, which could reduce the SCC values (comparing 2020 base-year with 2000 base-year) by 0.0132, 0.0009, 0.0033, 0.0030, 0.0001, 0.0082, and 0.0001 (USD/tCO2), respectively. While the SCC is mainly determined by energy and industrial structure, the overall effect of NbS is larger than the sum of land urbanization and non-NbS land-use conversions. Via embedding the real-world inter-dynamics of land-use conversions into the SCC quantification, this study presents a pioneer assessment of the impacts of NbS on the SCC in an integrated framework, sheds important insights into the effectiveness of NbS, and offers practical implications for policy-makers to devise comprehensive policies covering all feasible CO2 abatement options.
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Affiliation(s)
- Wenyi Han
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Wendy Y Chen
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong.
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27
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Chen WY, Liu XF, Shen P, Chen Q, Sun YX, Wu JG, Lu P, Zhang JY, Lin HB, Tang X, Gao P. [Accuracy of the China-PAR and WHO risk models in predicting the ten-year risks of cardiovascular disease in the Chinese population]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:1275-1281. [PMID: 35981990 DOI: 10.3760/cma.j.cn112338-20211206-00952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To externally validate and compare the accuracy of the China-PAR (Prediction for ASCVD Risk in China) model and the 2019 World Health Organization (WHO) cardiovascular disease risk charts for East Asian in predicting a 10-year cardiovascular disease in a general Chinese population. Methods: Participants aged 40-79 years without prior cardiovascular disease at baseline in the CHinese Electronic health Records Research in Yinzhou (CHERRY) were analyzed. The Kaplan-Meier analysis estimated the observed cardiovascular events (including non-fatal myocardial infarction, fatal coronary heart disease, and non-fatal or fatal stroke) rate within ten years. The expected risks were calculated using the WHO risk charts for East Asia (including the laboratory-based and non-laboratory-based models) and the China-PAR model. The expected-observed ratios were calculated to evaluate the overestimation or underestimation of the models in the cohort. Model accuracy was assessed by discrimination C-index, calibration χ2 value, and calibration plots. Results: During a median of 7.26 years of follow-up, 13 301 cardiovascular events were identified among 225 811 participants. The C-index for the China-PAR model, WHO laboratory-based model and WHO non-laboratory-based model were 0.741 (0.735-0.747), 0.747 (0.740-0.753), and 0.739 (0.733-0.746) for men, and 0.782 (0.776-0.788), 0.789 (0.783-0.795), and 0.782 (0.776-0.787) for women, respectively. The WHO laboratory-based model and non-laboratory-based model underestimated the 10-year ASCVD risk by around 15% in women and underestimated by 0.8% and 4.4% in men, respectively. The China-PAR model underestimated the risks by 19.5% and 42.3% for men and women. Conclusions: The China-PAR and WHO models all have pretty good discriminations for 10-year cardiovascular risk assessment in this general Chinese population. However, the accuracy should be improved in the highest-risk groups, suggesting further specific models are still needed for those with the highest risk, such as patients with diabetes or older persons.
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Affiliation(s)
- W Y Chen
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - X F Liu
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - P Shen
- Yinzhou District Center for Disease Control and Prevention, Ningbo 315100, China
| | - Q Chen
- Yinzhou District Center for Disease Control and Prevention, Ningbo 315100, China
| | - Y X Sun
- Yinzhou District Center for Disease Control and Prevention, Ningbo 315100, China
| | - J G Wu
- Wonders Information Co.Ltd, Shanghai 201112, China
| | - P Lu
- Wonders Information Co.Ltd, Shanghai 201112, China
| | - J Y Zhang
- Wonders Information Co.Ltd, Shanghai 201112, China
| | - H B Lin
- Yinzhou District Center for Disease Control and Prevention, Ningbo 315100, China
| | - X Tang
- Center of Real-world Evidence Evaluation, Peking University Clinical Research Institute, Beijing 100191, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing 100191, China
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28
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Rosner B, Glynn RJ, Eliassen AH, Hankinson SE, Tamimi RM, Chen WY, Holmes MD, Mu Y, Peng C, Colditz GA, Willett WC, Tworoger SS. A Multi-State Survival Model for Time to Breast Cancer Mortality among a Cohort of Initially Disease-Free Women. Cancer Epidemiol Biomarkers Prev 2022; 31:1582-1592. [PMID: 35654356 PMCID: PMC9348829 DOI: 10.1158/1055-9965.epi-21-1471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/12/2022] [Accepted: 05/26/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Identifying risk factors for aggressive forms of breast cancer is important. Tumor factors (e.g., stage) are important predictors of prognosis, but may be intermediates between prediagnosis risk factors and mortality. Typically, separate models are fit for incidence and mortality postdiagnosis. These models have not been previously integrated to identify risk factors for lethal breast cancer in cancer-free women. METHODS We combined models for breast cancer incidence and breast cancer-specific mortality among cases into a multi-state survival model for lethal breast cancer. We derived the model from cancer-free postmenopausal Nurses' Health Study women in 1990 using baseline risk factors. A total of 4,391 invasive breast cancer cases were diagnosed from 1990 to 2014 of which 549 died because of breast cancer over the same period. RESULTS Some established risk factors (e.g., family history, estrogen plus progestin therapy) were not associated with lethal breast cancer. Controlling for age, the strongest risk factors for lethal breast cancer were weight gain since age 18: > 30 kg versus ± 5 kg, RR = 1.94 [95% confidence interval (CI) = 1.38-2.74], nulliparity versus age at first birth (AAFB) < 25, RR = 1.60 (95% CI = 1.16-2.22), and current smoking ≥ 15 cigarettes/day versus never, RR = 1.42 (95% CI = 1.07-1.89). CONCLUSIONS Some breast cancer incidence risk factors are not associated with lethal breast cancer; other risk factors for lethal breast cancer are not associated with disease incidence. IMPACT This multi-state survival model may be useful for identifying prediagnosis factors that lead to more aggressive and ultimately lethal breast cancer.
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Affiliation(s)
- Bernard Rosner
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Robert J. Glynn
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - A. Heather Eliassen
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Susan E. Hankinson
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts
| | - Rulla M. Tamimi
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Wendy Y. Chen
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Michelle D. Holmes
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Yi Mu
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Cheng Peng
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Graham A. Colditz
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Siteman Cancer Center and Washington University School of Medicine, Saint Louis, Missouri
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shelley S. Tworoger
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
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Lin GH, Chen WY, Chen CM, Cheng X, Zhou BH, Ji JS. [Construction of prediction model combined dual-energy CT quantitative parameters and conventional CT features for assessing the Ki-67 expression levels in invasive breast cancer]. Zhonghua Yi Xue Za Zhi 2022; 102:1753-1759. [PMID: 35705479 DOI: 10.3760/cma.j.cn112137-20220101-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To develop a model combined with dual-energy CT quantitative parameters and conventional CT features for evaluating the expression level of Ki-67 in invasive breast cancer. Methods: A total of 191 patients with histologically confirmed invasive breast cancer in Lishui Central Hospital from March 2019 to December 2020, were retrospectively enrolled, all of them were females, aged from 25 to 77 (53.2±11.3) years. All patients underwent preoperative non-contrast chest and contrast-enhanced Dual energy CT scans, and the normalized iodine concentration (NIC) of lesions on arterial and venous phase, spectral curve slope (λHU), and normalized effective atomic number (nZeff) were measured and calculated, and their conventional CT characteristics were assessed. According to the results of immunohistochemistry (IHC), the patients were divided into Ki-67 high expression group (n=129 patients) and low expression group (n=62 patients) level. The differences in clinical data, conventional CT characteristics and dual-energy CT quantitative parameters between the two groups were analyzed. The receiver operating characteristic curve (ROC) curve was conducted to assess the efficacy of each individual model and joint model in evaluating Ki-67 expression levels, and the area under the curve (AUC), sensitivity, specificity, and accuracy were calculated, respectively. Results: In the analysis of CT features, the longest diameter, shape and enhancement pattern of the tumor were significantly difference between the two groups (all P<0.05). The NIC, nZeff on the arterial phase and NIC, nZeff and λHU [M(Q1,Q3)] on the venous phase were higher in the high Ki-67 expression group compared to the low expression group [0.13 (0.12, 0.16) vs 0.11 (0.08, 0.14), 0.71 (0.70, 0.75) vs 0.70 (0.67, 0.72), 0.40 (0.32, 0.48) vs 0.23 (0.17, 0.32), 3.10 (2.58, 3.63) vs 2.86 (2.19, 3.48), 0.88 (0.85, 0.92) vs 0.85 (0.84, 0.86), all P<0.05]. The logistic regression model, which integrated significant conventional CT features and dual-energy CT quantitative parameters, demonstrated the highest diagnostic performance for assessing Ki-67 expression levels, with an AUC of 0.924, sensitivity of 88.37%, specificity of 83.87%, and accuracy of 86.91%; the AUC of the dual-energy CT parameter model was 0.908, sensitivity of 82.17%, specificity of 88.71%, and accuracy of 84.29%. Though the diagnostic efficacy was no significant difference (P=0.238), both models showed superior to the conventional CT feature model (all P<0.001). Conclusion: A dual-energy CT quantitative parameter combined with a conventional CT feature model was successfully constructed, which has a good evaluation performance on the expression level of Ki-67 in invasive breast cancer.
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Affiliation(s)
- G H Lin
- Department of Radiology, Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China
| | - W Y Chen
- Department of Radiology, Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China
| | - C M Chen
- Department of Radiology, Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China
| | - X Cheng
- Department of Radiology, Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China
| | - B H Zhou
- Department of Radiology, Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China
| | - J S Ji
- Department of Radiology, Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China
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Sella T, Exman P, Ren S, Freret TS, Economy KE, Chen WY, Parsons HA, Lin NU, Moy B, Tung NM, Partridge AH, Tayob N, Mayer EL. Outcomes after treatment of breast cancer during pregnancy including taxanes and/or granulocyte colony-stimulating factor use: findings from a multi-institutional retrospective analysis. Breast Cancer Res Treat 2022; 194:597-606. [PMID: 35715538 DOI: 10.1007/s10549-022-06621-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/30/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Guidelines support comparable treatment for women diagnosed with breast cancer during pregnancy (PrBC) and nonpregnant women with limited case-specific modifications to ensure maternal-fetal safety. Experience during pregnancy with modern agents, such as taxanes or granulocyte colony-stimulating factors (GCSF), is limited. PATIENTS AND METHODS We retrospectively identified a multi-institutional cohort of PrBC between 1996 and 2020. Propensity score analyses with multiple imputation for missing variables were applied to determine the associations between chemotherapy exposures during pregnancy, with or without taxanes or GCSF, and a compound maternal-fetal outcome including spontaneous preterm birth, preterm premature rupture of membranes, chorioamnionitis, small for gestational age newborns, congenital malformation, or 5-min Apgar score < 7. RESULTS Among 139 PrBC pregnancies, 82 (59.0%) were exposed to chemotherapy, including 26 (31.7%) to taxane and 18 (22.0%) to GCSF. Chemotherapy use, in general, and inclusion of taxane and/or GCSF, specifically, increased over time. Pregnancies resulting in live singleton births (n = 123) and exposed to chemotherapy were as likely to reach term as those that were not (59.5% vs. 63.6%, respectively, punadjusted = 0.85). Among women treated with chemotherapy, propensity score-matched odds ratios (OR) for the composite maternal-fetal outcome were not significantly increased with taxane (OR 1.24, 95% CI 0.27-5.72) or GCSF (OR 2.11, 95% confidence interval (CI) 0.48-9.22) with similar effects in multiple imputation and sensitivity models. CONCLUSION The judicious increased use of taxane chemotherapy and/or growth factor support during pregnancy was not associated with unfavorable short-term maternal-fetal outcomes. While these findings are reassuring, case numbers remain limited and continued surveillance of these patients and progeny is warranted.
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Affiliation(s)
- Tal Sella
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA
| | - Pedro Exman
- Hospital Alemão Oswaldo Cruz, Sao Paulo, Brazil
| | - Siyang Ren
- Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Taylor S Freret
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Katherine E Economy
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Wendy Y Chen
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA
| | - Heather A Parsons
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA
| | - Nancy U Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA
| | - Beverly Moy
- Medical Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Nadine M Tung
- Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA
| | - Nabihah Tayob
- Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Erica L Mayer
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA.
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Wang T, Kang JH, Chai B, Chen WY, Holmes MD, Erdrich J, Giovannucci EL, Hu FB, Rosner BA, Tamimi RM, Willett WC, Eliassen AH. Abstract 5902: Metformin and other anti-diabetic medication use and breast cancer incidence in the Nurses’ Health Studies. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-5902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Type 2 diabetes (T2D) has been associated with increased risk of breast cancer. However, the role of metformin, the first-line anti-diabetic drug, in breast cancer carcinogenesis has not been elucidated completely. We aimed to examine further the association between the use of metformin and other anti-diabetic medication and breast cancer incidence within two large prospective cohort studies.
Methods: We followed 184,437 women who participated in the Nurses’ Health Study (NHS;1994-2016) and the NHSII (1995-2017), with the baseline tied to the date metformin was introduced into the United States market. Information on T2D diagnosis, metformin, and other anti-diabetic medication, and other covariates were self-reported at baseline and repeatedly assessed by follow-up questionnaires every two to four years. Breast cancer cases were self-reported and confirmed by medical record review. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between metformin/other anti-diabetic medication use and breast cancer incidence were estimated using Cox proportional hazards regression models.
Results: During 3,412,366 person-years of follow-up, we ascertained 9,442 incident invasive breast cancer cases, of which 720 were among women with T2D. Compared with women without T2D (n=168,498), similar risks of developing breast cancer were observed among those who ever used metformin (HR =0.95; 95%CI=0.79-1.13) and among those who received medications other than metformin (HR =1.11; 95%CI=0.91-1.37). Among women with T2D (n=15,939), compared with never metformin users, ever use of metformin overall was not associated with breast cancer (HR =0.90; 95%CI=0.72-1.13), but a lower risk of breast cancer was observed among past metformin users (HR =0.72; 95%CI=0.52-0.99). Longer duration of metformin use was not associated with risk of breast cancer (each 2-year interval: HR =0.98; 95%CI=0.93-1.03, p-trend=0.32). However, among women with substantial weight increase since age 18 (>25 kg), greater than 5 years of metformin use was associated with a lower risk of breast cancer (HR =0.62; 95%CI=0.43-0.89).
Conclusion: Although we observed inverse associations among past metformin users, similar associations were not found among current users. Overall, metformin use was not strongly associated with the risk of developing breast cancer among the general cohort population or among women with T2D.
Citation Format: Tengteng Wang, Jae H. Kang, Boyang Chai, Wendy Y. Chen, Michelle D. Holmes, Jennifer Erdrich, Edward L. Giovannucci, Frank B. Hu, Bernard A. Rosner, Rulla M. Tamimi, Walter C. Willett, A. Heather Eliassen. Metformin and other anti-diabetic medication use and breast cancer incidence in the Nurses’ Health Studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5902.
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Affiliation(s)
- Tengteng Wang
- 1Brigham and Women's Hospital and Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, MA
| | - Jae H. Kang
- 2Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Boyang Chai
- 1Brigham and Women's Hospital and Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, MA
| | - Wendy Y. Chen
- 3Brigham and Women's Hospital and Harvard Medical School, and Dana-Farber Cancer Institute, Boston, MA
| | - Michelle D. Holmes
- 1Brigham and Women's Hospital and Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, MA
| | | | | | - Frank B. Hu
- 6Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Bernard A. Rosner
- 1Brigham and Women's Hospital and Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, MA
| | | | | | - A. Heather Eliassen
- 1Brigham and Women's Hospital and Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, MA
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Luo ZZ, Chen WY, Ding Y, Chen JH, Wu QH, Tang WM, Tian LS, Li B. [Effect of behavioral intervention based on social media to promote HIV/syphilis testing in young men who have sex with men]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:892-897. [PMID: 35725347 DOI: 10.3760/cma.j.cn112338-20211101-00840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Objective: To evaluate the effect of social media based behavioral intervention on promoting joint testing of HIV and syphilis in young men who have sex with men (MSM). Methods: After the recruitment, the participants who met the inclusion criteria were randomly divided (1∶1) into two groups, i.e. social media intervention group and control group. The control group was given routine voluntary counseling and testing (VCT) services. The intervention group was also given VCT services, besides; the comprehensive strategies through social media, including regular health education message and testing information sending, were given to them to strengthen the behavioral intervention. Follow up was conducted for the participants for 12 months after the intervention. The number and the proportion of young MSM receiving HIV and syphilis testing, and the reported proportion of the young MSM with sexually transmitted diseases (STD) symptoms between the intervention group and the control group were compared to evaluate the effect of the intervention. Results: A total of 315 young MSM were recruited (158 in the intervention group and 157 in the control group), in whom 248 young MSM completed the follow up. The follow-up rate was 78.7%. There was no significant difference in baseline characteristics between the intervention group and the control group (all P>0.05). The proportion of young MSM receiving more than one joint testing in the intervention group was slightly higher than that in the control group (53.2% vs. 48.4%, rate difference (RD): 4.8%, 95%CI: -7.5%-17.0%, P=0.448) without significant difference. However, in the young MSM who used condoms in the last anal sex, the proportion of those receiving more than one joint testing in the intervention group was higher than that in the control group (63.8% vs. 46.1%, RD: 17.7%, 95%CI: 1.5%-32.6%, P=0.035). In addition, the reported proportion of young MSM with STD symptoms in the intervention group was significantly lower than that in the control group (6.3% vs. 18.0%,RD: -11.7%, 95%CI: -20.6%- -3.0%, P=0.005). Conclusion: Compared with routine VCT, social media based behavioral intervention might promote joint HIV and syphilis testing in the young MSM who used condom in the study. It could significantly reduce the reporting proportion of STD symptoms, suggesting that this method can promote the AIDS and STD prevention related behaviors in young MSM.
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Affiliation(s)
- Z Z Luo
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
| | - W Y Chen
- School of Public Health, Guangdong Medical University, Dongguan 523109, China
| | - Y Ding
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
| | - J H Chen
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
| | - Q H Wu
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
| | - W M Tang
- Dermatology Hospital of Southern Medical University, Guangzhou 510095, China
| | - L S Tian
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
| | - B Li
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518000, China
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Feliciano E, Zimbalist A, Caan BJ, Mittendorf EA, Dillon D, Quesenberry CP, Chen WY. Association of metabolic risk factors with breast cancer survival in a population-based cohort. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.12089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12089 Background: Metabolic abnormalities may impact breast cancer prognosis, but research has been limited by small samples and assessment of laboratory values at a single time point, often prior to cancer diagnosis and treatment. In a population based cohort, we utilized time-updated laboratory values and adjusted for cancer treatment to assess the association between metabolic risk factors (glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides) and breast cancer survival. Methods: 13,434 women diagnosed with stage I-III breast cancer from 2005-15 at Kaiser Permanente were included. All outpatient fasting glucose, HDL, LDL, and triglyceride values from diagnosis through 2019 or death were extracted from electronic medical records. Lab values were updated a median of 5 times between 1-7 years post-diagnosis. Risk of breast cancer-specific mortality was evaluated with Cox proportional hazards models adjusted for metabolic labs, demographics, body mass index, and diabetes, and then for dyslipidemia and anti-hypertensive medications, tumor characteristics (stage, ER and HER2 receptor status) and cancer treatment (use of chemotherapy, and tamoxifen v. aromatase inhibitors). Results: Mean (SD) age at diagnosis was 62.3 (11.8) years. Over median follow-up of 9 years, 2,876 patients died (1,080 of breast cancer). Patients with low HDL (≤45 vs. >45 mg/dL) had higher breast cancer-specific mortality (HR, 1.87; 95% CI, 1.62-2.16); high levels of glucose, triglycerides, and LDL were not associated. The increased risk associated with low HDL persisted after adjusting for tumor characteristics, cancer treatment, and medications. Conclusions: Low HDL evaluated over time after cancer diagnosis is associated with higher breast cancer mortality independent of cancer treatments and changes in other metabolic risk factors. Cholesterol may play a role in breast cancer due to its role in cell membrane structure, signaling pathways, and steroid hormone synthesis. Future studies should address whether pharmacologic or lifestyle treatment of lipids after breast cancer diagnosis can optimize survival outcomes.[Table: see text]
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Affiliation(s)
| | - Alexa Zimbalist
- Kaiser Permanente Northern California Division of Research, Oakland, CA
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Yang E, Lu W, Giobbie-Hurder A, Shin IH, Chen WY, Block CC, Partridge A, Jeselsohn RM, Tolaney SM, Freedman RA, Ligibel JA. Auricular Acupuncture During Chemotherapy Infusion in Breast Cancer Patients: A Feasibility Study. J Integr Complement Med 2022; 28:427-435. [PMID: 35238615 DOI: 10.1089/jicm.2021.0256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Breast cancer patients undergoing chemotherapy experience multiple distressing symptoms. The authors investigated the feasibility and potential benefits of auricular acupuncture during chemotherapy infusion in this population. Materials and Methods: Women with stage I-III breast cancer undergoing chemotherapy were enrolled and followed for three chemotherapy cycles. During the first cycle of chemotherapy that participants received after study enrollment, they were provided with educational materials. During the second and third cycles of chemotherapy after enrollment, they received auricular acupuncture. The primary outcome was feasibility, assessed by recruitment, retention, and completion of assessments. Secondary outcomes included symptom burden (Edmonton Symptom Assessment System-Revised Version) and anxiety (State-Trait Anxiety Inventory-State), assessed at four timepoints for each cycle: day 1, pre-education/acupuncture (T1); day 1, post-education/acupuncture (T2); day 2 (T3); and day 5 (T4). Nausea and vomiting (Multinational Association of Supportive Care in Cancer [MASCC] Antiemesis Tool) were assessed on days 2 and 5. Paired t test was used to compare patient-reported outcomes during cycle 1 (education) versus an average of outcomes during cycles 2 and 3 (acupuncture). Results: Twenty-six patients were enrolled, of which 24 completed all acupuncture sessions and 22 completed all outcome assessments. In cycles 2 and 3 versus cycle 1, participants experienced significant reductions in symptom burden (change from T1 to T4: -7.9 ± 13.6, p = 0.02), anxiety (change from T1 to T2: -3.3 ± 6.5, p = 0.02), and nausea severity on day 2 (-1.3 ± 2.6, p = 0.04). Conclusions: The delivery of auricular acupuncture during chemotherapy infusion was feasible and associated with reduction of symptom burden, anxiety, and nausea in breast cancer patients. Larger-scale clinical studies are needed to confirm these findings. Clinical Trial Registration number: NCT03170648.
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Affiliation(s)
- EunMee Yang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Weidong Lu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Anita Giobbie-Hurder
- Division of Biostatistics, Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Im Hee Shin
- Department of Medical Statistics and Informatics, School of Medicine, Daegu Catholic University, Daegu, Republic of Korea
| | - Wendy Y Chen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Caroline C Block
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ann Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rinath M Jeselsohn
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Sara M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rachel A Freedman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jennifer A Ligibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
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Chen WY, Ballman KV, Winer EP, Openshaw TH, Hahn OM, Briccetti FM, Irvin WJ, Pohlmann PR, Carey LA, Partridge AH, Weiss A, McCall LM, Matyka C, Carvan M, Holmes MD. A randomized phase III, double-blinded, placebo-controlled trial of aspirin as adjuvant therapy for breast cancer (A011502): The Aspirin after Breast Cancer (ABC) Trial. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.36_suppl.360922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
360922 Background: In-vitro and in-vivo evidence suggests that aspirin may have an anti-tumor effect. Multiple epidemiologic studies have reported improved breast cancer survival among regular aspirin users compared to non-users. Pooled data from randomized trials of aspirin for cardiovascular disease have also reported a decreased risk of metastatic cancer among aspirin users. Thus, we conducted a prospective randomized controlled trial to determine the true benefits and risks of adjuvant aspirin therapy for breast cancer survivors. Methods: The primary objective was to compare the effect of 300 mg aspirin daily versus placebo upon invasive disease-free survival (iDFS) in patients with high-risk, HER2-negative breast cancer. Secondary objectives included effects on overall survival, cardiovascular disease, toxicity, and adherence. Eligible participants included patients aged 18-70 diagnosed with a primary invasive HER2-negative breast cancer. If hormone receptor (HR)–positive, tumors needed to be node positive and diagnosed within the past 10 years. If HR negative, tumors could be node positive or T2-4N0 and diagnosed within the past 18 months. Participants were randomly selected (1:1) to aspirin 300 mg versus placebo daily for 5 years in a double-blinded fashion. Stratification factors include HR status (positive vs. negative), body mass index (< or ≥ 30 kg/m2), and stage (II vs. III). Based upon an accrual goal of 2,936 patients to reach 381 iDFS events, the study was estimated to have 80% power to detect HR 0.75. Results: From January 2017 to December 2020, 3,021 participants were enrolled. Treatment arms were well balanced in terms of key characteristics. In November 2021, the Data Safety and Monitoring Board recommended that the trial be unblinded because the stratified hazard ratio had crossed a pre-specified futility boundary. After 191 iDFS events (aspirin: 107, placebo: 84) and median follow-up of 20 months, the stratified hazard ratio comparing aspirin to placebo was 1.27 (z-score: -1.64), which is greater than the pre-specified hazard ratio of futility 1.03 (z-score < -0.192). There was no difference in the frequency of grade 3/4 adverse events by study arm. Compliance was high and similar across arms. Non-protocol use of aspirin/non-steroidal anti-inflammatory drugs was similar across arms and less than 14%, consistent with prior randomized aspirin trials. Updated results on iDFS events will be provided at presentation. Conclusions: In this double-blinded, placebo-controlled, randomized trial, there was no benefit in breast cancer invasive disease-free survival with the addition of 300 mg aspirin daily. Although inflammation may still play a role in cancer progression, aspirin is not recommended for prevention of breast cancer recurrence. Clinical trial information: NCT02927249.
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Affiliation(s)
| | | | - Eric P. Winer
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | | | | | | | | | | | | | | | - Anna Weiss
- Dana-Farber Cancer Institute, Boston, MA
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Wang YM, Chen WY, Jian WH, Gao Y, Zheng JP. [Standardization of spirometry updated in China and international: comparison and interpretation of the key updates]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:250-254. [PMID: 35279987 DOI: 10.3760/cma.j.cn112147-20210412-00244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Standardization of spirometry was jointly updated by the American Thoracic Society (ATS) and the European Respiratory Society (ERS) in 2019. Similar technical standards for spirometry recommended by the Chinese Thoracic Society (CTS) and/or the Chinese Association of Chest Physicians (CACP) are widely used in China. We compared the key similarities and differences of these recommendations and interpreted the key updates. The ATS/ERS 2019 updates expanded the scope of indications for spirometry and recommended the contraindications based on the pathophysiological perspective, while contraindications recommended by the CTS were based on the severity of contraindications. ISO 26782∶2009 standards were applied by the ATS/ERS 2019 to evaluate the performance quality (reliance for accuracy, repeatability, etc.) of spirometers, while standards adopted 24/26 waves suggested by the ATS 1994 was used by the CTS. The ATS/ERS 2019 also included the performance quality control criteria for 3-L calibration syringe, operator training and attainment and maintenance of competency, grade"U", system warning messages, instructions to patients, and standardized operator comments. Some of these criteria in the CTS were not explained in detail. However, the CTS/CACP emphasized that the spirometry record should report the indices of forced inspiratory phase and small airway function, those are not clearly required in the ATS/ERS 2019. In comparison, the ATS/ERS 2019 has stricter criteria for FEV1 and FVC acceptability than the CTS and more detailed explanations. Those outstanding parts are worth referencing for the updated version of the CTS in the future, while the criteria that combine our own conditions need to be retained and popularized.
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Affiliation(s)
- Y M Wang
- National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - W Y Chen
- National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - W H Jian
- National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Y Gao
- National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - J P Zheng
- National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
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Wang T, Heng YJ, Baker GM, Bret-Mounet VC, Hankinson SE, Holmes MD, Chen WY, Willett WC, Rosner BA, Tamimi RM, Eliassen AH. Abstract P3-12-02: Loss of PTEN expression, PIK3CA mutations, and breast cancer survival in the Nurses’ health studies. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p3-12-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: PTEN loss and/or PIK3CA mutation are hypothesized to predict more aggressive tumor behavior and worse outcomes in women with breast cancer. However, the results of previous studies with small sample size have been conflicting. Methods: We followed pre- and postmenopausal women with invasive breast cancer from the Nurses’ Health Study (diagnosed 1976-2011) and Nurses’ Health Study II (1989-2011) with data available on PTEN cytoplasmic expression (n=4316, breast cancer-specific deaths=777) and/or PIK3CA mutation (n=2930, breast cancer-specific deaths=317). PTEN protein expression was evaluated by immunohistochemistry and scored as a digitally quantified continuous measure (1-100%). Polymerase chain reaction and pyrosequencing of six hot spot mutations of PIK3CA were performed on DNA extracted from formalin-fixed paraffin-embedded tumors. Information on other covariates was self-reported at baseline and repeatedly measured with follow-up questionnaires every two to four years. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between loss of PTEN expression and/or PIK3CA mutation and breast cancer-specific mortality were estimated using Cox proportional hazards regression models. Results: In this large epidemiological study, the loss of tumor cell PTEN cytoplasmic staining expression (≤10%) occurred in 17.6% of cases, and the overall mutation of PIK3CA occurred in 10.8% of cases. After adjusting for tumor characteristics, treatment, and lifestyle factors, the loss of PTEN expression (versus expression >10%) was not associated with worse breast cancer survival among overall samples (HR =0.85; 95%CI=0.71-1.03) and among estrogen receptor (ER)-positive tumors (HR =1.11; 95%CI=0.84-1.47). However, among women with ER-negative tumors, PTEN expression loss was strongly associated with lower breast cancer mortality (HR =0.68; 95%CI=0.48-0.96). Overall mutation status of PIK3CA was not associated with breast cancer mortality (HR =1.06; 95%CI=0.78-1.45). Combining PTEN and PIK3CA status, compared with tumors without PTEN loss and without PIK3CA mutation (wild type), those with PTEN loss and/or PIK3CA mutation were not at higher risk (HR =1.05; 95%CI=0.85-1.32). However, women with PTEN loss and PIK3CA mutation jointly (n=39, breast cancer-specific deaths=15) had increased breast cancer mortality (HR =2.05; 95%CI=1.07-3.94). Conclusion: This study is the largest to date examining PTEN and PIK3CA status and breast cancer survival, in which we found that the prognostic value of PTEN status differed by ER status, and the joint status of PTEN loss of expression and PIK3CA mutation was associated with worse breast cancer survival.
Citation Format: Tengteng Wang, Yujing J Heng, Gabrielle M Baker, Vanessa C Bret-Mounet, Susan E Hankinson, Michelle D Holmes, Wendy Y. Chen, Walter C. Willett, Bernard A. Rosner, Rulla M Tamimi, A. Heather Eliassen. Loss of PTEN expression, PIK3CA mutations, and breast cancer survival in the Nurses’ health studies [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-12-02.
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Affiliation(s)
- Tengteng Wang
- Brigham and Women's Hospital and Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, MA
| | | | | | | | - Susan E Hankinson
- University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, MA
| | - Michelle D Holmes
- Brigham and Women's Hospital and Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, MA
| | - Wendy Y. Chen
- Dana-Farber Cancer Institute, and Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Walter C. Willett
- Brigham and Women's Hospital and Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, MA
| | - Bernard A. Rosner
- Brigham and Women's Hospital and Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, MA
| | - Rulla M Tamimi
- Weill Cornell Medicine and Harvard T. H. Chan School of Public Health, Boston, MA
| | - A. Heather Eliassen
- Brigham and Women's Hospital and Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, MA
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Chen CF, Zhang XM, Zhu RL, Zou HB, Li BB, Li LF, Lin ZX, Yu ZJ, Chen WY. [Efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of OSAHS with soft palate oropharyngeal obstruction]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:1270-1276. [PMID: 34963214 DOI: 10.3760/cma.j.cn115330-20210707-00436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To explore the efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Seventy-three patients(including 60 males and 13 females) with OSAHS admitted to the department of otorhinolaryngology of our hospital in recent two years were retrospectively analyzed. All the patients had velopharyngeal obstructionevaluated by electronic endoscopic Müller test and were divided into control group (34 cases) and observation group (39 cases). The patients in the control group were performed modified uvulopalatopharyngoplasty, while those in the observation group were performed relocation and expansion pharyngoplasty by suspension sutures.The scores of ESS, AHI and LSaO2 before and after treatment were collected and compared. Results: The total effective rate of the observation group was 94.87%, which was significantly higher than 79.41% of the control group. The AHI was lower and LSaO2 value was higher (χ2=-1. 896,-1. 968,P<0.05)in the observation group. The sleeping symptoms and quality of life of the two groups were significantly improved. The ESS score of the observation group was decreased more significantly than that of the control group after treatment, and the difference was statistically significant (χ2=-1.451,P<0.05). The incidence of foreign body sensation in pharynx of the observation group (89.74%) was higher than that of the control group (55.88%), and the postoperative bleeding and postoperative recurrence rate (0.00%, 2.56%) was lower than that of the control group (8.82%, 14.70%)with statistical significance (χ2=4.738,4.249,4.119,P<0.05).The incidence of transient nasopharyngeal reflux in both groups was low and statistically insignificant (χ2=0.629,P>0.05). Conclusions: Preoperative strict screening of indications plays an important role in the selection of palatopharyngeal surgery methods and curative effect. Relocation and expansion pharyngoplasty by suspension sutures can improve the clinical efficacy of OSAHS with better safety and less recurrence.
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Affiliation(s)
- C F Chen
- Guangdong Provincial Hospital of Traditional Chinese Medicine,Otorhinolaryngology & Head and Neck Department,Guangzhou 510120,China
| | - X M Zhang
- Foresea Insurance Guangzhou General Hospital,Otorhinolaryngology & Head and Neck Surgery Department,Guangzhou 511340,China
| | - R L Zhu
- Guangdong Provincial Hospital of Traditional Chinese Medicine,Otorhinolaryngology & Head and Neck Department,Guangzhou 510120,China
| | - H B Zou
- Guangdong Provincial Hospital of Traditional Chinese Medicine,Otorhinolaryngology & Head and Neck Department,Guangzhou 510120,China
| | - B B Li
- Guangdong Provincial Hospital of Traditional Chinese Medicine,Otorhinolaryngology & Head and Neck Department,Guangzhou 510120,China
| | - L F Li
- Guangdong Provincial Hospital of Traditional Chinese Medicine,Otorhinolaryngology & Head and Neck Department,Guangzhou 510120,China
| | - Z X Lin
- Guangdong Provincial Hospital of Traditional Chinese Medicine,Otorhinolaryngology & Head and Neck Department,Guangzhou 510120,China
| | - Z J Yu
- Guangdong Provincial Hospital of Traditional Chinese Medicine,Otorhinolaryngology & Head and Neck Department,Guangzhou 510120,China
| | - W Y Chen
- Guangdong Provincial Hospital of Traditional Chinese Medicine,Otorhinolaryngology & Head and Neck Department,Guangzhou 510120,China
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Sun D, Yu GH, Chen WY, Yang P, Zhang L. [Primary small lymphocytic lymphoma/chronic lymphocytic leukemia of the appendix with acute appendicitis as the first symptom: report of a case]. Zhonghua Bing Li Xue Za Zhi 2021; 50:1288-1290. [PMID: 34719175 DOI: 10.3760/cma.j.cn112151-20210421-00310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- D Sun
- Department of Pathology, Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China
| | - G H Yu
- Department of Pathology, Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China
| | - W Y Chen
- Department of Pathology, Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China
| | - P Yang
- Department of Pathology, Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China
| | - L Zhang
- Department of Pathology, Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China
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Brastianos PK, Strickland MR, Lee EQ, Wang N, Cohen JV, Chukwueke U, Forst DA, Eichler A, Overmoyer B, Lin NU, Chen WY, Bardia A, Juric D, Dagogo-Jack I, White MD, Dietrich J, Nayyar N, Kim AE, Alvarez-Breckenridge C, Mahar M, Mora JL, Nahed BV, Jones PS, Shih HA, Gerstner ER, Giobbie-Hurder A, Carter SL, Oh K, Cahill DP, Sullivan RJ. Phase II study of ipilimumab and nivolumab in leptomeningeal carcinomatosis. Nat Commun 2021; 12:5954. [PMID: 34642329 PMCID: PMC8511104 DOI: 10.1038/s41467-021-25859-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 08/25/2021] [Indexed: 11/09/2022] Open
Abstract
Leptomeningeal disease (LMD) is a common complication from solid tumor malignancies with a poor prognosis and limited treatment options. We present a single arm Phase II study of 18 patients with LMD receiving combined ipilimumab and nivolumab until progression or unacceptable toxicity (NCT02939300). The primary end point is overall survival at 3 months (OS3). Secondary end points include toxicity, cumulative time-to-progression at 3 months, and progression-free survival. A Simon two-stage design is used to compare a null hypothesis OS3 of 18% against an alternative of 44%. Median follow up based on patients still alive is 8.0 months (range: 0.5 to 15.9 months). The study has met its primary endpoint as 8 of 18 (OS3 0.44; 90% CI: 0.24 to 0.66) patients are alive at three months. One third of patients have experienced one (or more) grade-3 or higher adverse events. Two patients have discontinued protocol treatment due to unacceptable toxicity (hepatitis and colitis, respectively). The most frequent adverse events include fatigue (N = 7), nausea (N = 6), fever (N = 6), anorexia (N = 6) and rash (N = 6). Combined ipilimumab and nivolumab has an acceptable safety profile and demonstrates promising activity in LMD patients. Larger, multicenter clinical trials are needed to validate these results.
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Affiliation(s)
| | - Matthew R Strickland
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Eudocia Quant Lee
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Nancy Wang
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Justine V Cohen
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Ugonma Chukwueke
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | | | - April Eichler
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Beth Overmoyer
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Nancy U Lin
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Wendy Y Chen
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Aditya Bardia
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Dejan Juric
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | | | - Michael D White
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Jorg Dietrich
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Naema Nayyar
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Albert E Kim
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | | | - Maura Mahar
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Joana L Mora
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Brian V Nahed
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Pamela S Jones
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Helen A Shih
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | | | | | - Scott L Carter
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Kevin Oh
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Daniel P Cahill
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Ryan J Sullivan
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
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He BJ, Chen WY, Liu LL, Zhu HY, Cheng HZ, Zhang YX, Wang SF, Zhan SY. [The risk prediction models for occurrence of cervical cancer: a systematic review]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:1855-1862. [PMID: 34814624 DOI: 10.3760/cma.j.cn112338-20200806-01031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To systematically summarize and assess risk prediction models for occurrence of cervical cancer and to provide evidence for selecting the most reliable model for practice, and guide cervical cancer screening. Methods: Two groups of keywords related to cervical cancer and risk prediction model were searched on Chinese databases (CNKI, and Wanfang) and English databases (PubMed, Embase, and Cochrane Library). Original articles that developed or validated risk prediction models and published before November 21, 2019, were selected. Information form was created based on the CHARMS checklist. The PROBAST was used to assess the risk of bias. Results: 12 eligible articles were identified, describing 15 prediction models, of which five were established in China. The predicted outcomes included multiple stages from cervical precancerous lesions to cancer occurrence, i.e., abnormal Pap smear (1), occurrence or recurrence of CIN (9), and occurrence of cervical cancer (5), etc. The most frequently used predictors were HPV infection (12), age (7), smoking (5), and education (5). There were two models using machine learning to develop models. In terms of model performance, the discrimination ranged from 0.53 to 0.87, while only two models assessed the calibration correctly. Only two models were externally validated in Taiwan of China, using people in different periods. All of the models were at high risk of bias, especially in the analysis domain. The problems were concentrated in the improper handling of missing data (13), preliminary evaluation of model performance (13), improper use of internal validation (12), and insufficient sample size (11). In addition, the problems of inconsistency measurements of predictors and outcomes (8) and the flawed report of the use of blindness for outcome measures (8) were also severe. Compared with the other models, the Rothberg (2018) model had relatively high quality. Conclusions: There are a certain number of cervical cancer risk prediction models, but the quality is poor. It is urgent to improve the measurement of predictors and outcomes, the statistical analysis details such as handling missing data and evaluation of model performance and externally validate existing models to better guide screening.
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Affiliation(s)
- B J He
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - W Y Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - L L Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - H Y Zhu
- School of Public Health, Peking University, Beijing 100191, China
| | - H Z Cheng
- School of Public Health, Peking University, Beijing 100191, China
| | - Y X Zhang
- School of Public Health, Peking University, Beijing 100191, China
| | - S F Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
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Chen J, Liu YN, Ma YM, Chen WY, Cen YL, Wang WJ, Yang GH. [Role of NF-κB p65 and related cytokines in rats with liver function injury induced by dibutyl phthalate and benzo (a) pyrene]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 39:561-567. [PMID: 34488261 DOI: 10.3760/cma.j.cn121094-20200914-00529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To explore the role of nuclear factor-κB (NF-κB) p65 and related cytokines in rats with liver function injury induced by dibutyl phthalate (DBP) and benzo (a) pyrene (BaP) , in order to provide support for enriching the mechanism of liver injury induced by DBP and BaP. Methods: In September to December of 2019, a total number of 160 specific pathogen free Sprague Dawley rats were numbered in order of sex and body weight, then using the statistical table of random numbers, they were randomly divided into eight groups and each group consists of twenty animals (10 male and 10 female rats) , including blank control group, vehicle control group (given corn oil) , DBP 50 mg/kg (DBP(50)) group, DBP 250 mg/kg (DBP(250)) group, BaP 1 mg/kg (BaP(1)) group, BaP 5 mg/kg (BaP(5)) group, DBP 50 mg/kg plus BaP 1 mg/kg (DBP(50)+BaP(1)) group and DBP 250 mg/kg plus BaP 5 mg/kg (DBP(250)+BaP(5)) group, then DBP and BaP were administered to rats as a homogenous mixture in corn oil by gavage. After exposure for 90 days, liver was separated to test the mRNA and protein expression levels of NF-κB p65 by Real-time fluorescence quantitative polymerase chain reaction and Western blotting. Then serum of rats was collected to detect the levels of CXCL-13, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) by Enzyme-Linked Immunosorbent Assay, and the levels of alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , albumin (ALB) and total protein (TP) were detected by Reitman-Frankel assay. Results: The protein expression of NF-κB p65 in BaP(1) group was not statistically significant, but the mRNA and protein expression levels of NF-κB p65 in the liver tissues of rats in other exposure group were higher than those in the blank control group (P<0.05) , and the expression levels of NF-κB p65 increased more obvious in the DBP and BaP co-exposed groups than those in the low and high dose groups that single-exposed to DBP and BaP (P<0.05) . The serum levels of CXCL-13 and IL-6 of rats in other group were obviously higher than those of the blank control group except for the BaP(1) group, and the increase was more obvious in the high-dose group that co-exposed to DBP and BaP (P<0.05) . While the level of TNF-α in each exposure group was higher than those in the blank control group and the levels of TNF-α in the DBP and BaP co-exposed groups were strongly augmented compared to those in the low and high dose groups that single-exposed to DBP and BaP (P<0.05) . What's more, compared with the blank control group, the level of ALT in each exposure group was increased significantly. Except for the BaP(1) group, the levels of AST in other exposed groups were increased (P<0.05) , and the levels of ALT and AST in the DBP and BaP co-exposed groups were significantly elevated in comparison to the low and high dose groups that single-exposed to DBP and BaP (P<0.05) . On the contrary, the level of ALB in each exposure group was significantly lower than that in the blank control group, especially decreased significantly in the DBP and BaP co-exposed group (P<0.05) . The level of TP decreased only in the high-dose group that single and co-exposed to DBP and BaP, and the decrease was more significant in the DBP and BaP co-exposed group (P<0.05) . When DBP exposed alone, Pearson correlation analysis showed that NF-κB p65 protein expression level was positively correlated with IL-6, TNF-α and ALT (r=0.762, 0.951, and 0.924, P<0.05) . After BaP exposed alone, the NF-κB p65 protein expression level was positively correlated with TNF-α and ALT (r=0.911 and 0.910, P<0.05) . When DBP and BaP exposed together, NF-κB p65 protein expression level was positively correlated with CXCL-13, IL-6, TNF-α, ALT and AST (r=0.711, 0.764, 0.955, 0.903 and 0.827, P<0.05) . In addition, Pearson correlation analysis showed a positive correlation between TNF-α and ALT (r=0.833 and 0.894, P<0.05) when DBP or BaP exposed alone. Furthermore, when DBP and BaP exposed together, CXCL-13, IL-6 and TNF-α were positively correlated with ALT (r= 0.871, 0.925 and 0.942, P<0.05) , and also positively correlated with AST (r=0.910, 0.892 and 0.890, P<0.05) . Conclusion: Single and co-exposed to DBP and BaP may regulate the abnormal secretion of related cytokines by upregulating the expression level of NF-κB p65 in rat liver tissue, thus leading to hepatocyte injury in rats, and the damage effect may be enhanced when DBP and BaP are exposed together.
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Affiliation(s)
- J Chen
- School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Y N Liu
- School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Y M Ma
- School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - W Y Chen
- School of Public Health, Guizhou Medical University, Guiyang 550025, China
| | - Y L Cen
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - W J Wang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - G H Yang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
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Amenomori M, Bao YW, Bi XJ, Chen D, Chen TL, Chen WY, Chen X, Chen Y, Cui SW, Ding LK, Fang JH, Fang K, Feng CF, Feng Z, Feng ZY, Gao Q, Gomi A, Gou QB, Guo YQ, Guo YY, He HH, He ZT, Hibino K, Hotta N, Hu H, Hu HB, Huang J, Jia HY, Jiang L, Jiang P, Jin HB, Kasahara K, Katayose Y, Kato C, Kato S, Kawata K, Kozai M, Kurashige D, Le GM, Li AF, Li HJ, Li WJ, Li Y, Lin YH, Liu B, Liu C, Liu JS, Liu LY, Liu MY, Liu W, Liu XL, Lou YQ, Lu H, Meng XR, Munakata K, Nakada H, Nakamura Y, Nakazawa Y, Nanjo H, Ning CC, Nishizawa M, Ohnishi M, Ohura T, Okukawa S, Ozawa S, Qian L, Qian X, Qian XL, Qu XB, Saito T, Sakata M, Sako T, Sako TK, Shao J, Shibata M, Shiomi A, Sugimoto H, Takano W, Takita M, Tan YH, Tateyama N, Torii S, Tsuchiya H, Udo S, Wang H, Wang YP, Wu HR, Wu Q, Xu JL, Xue L, Yamamoto Y, Yang Z, Yao YQ, Yin J, Yokoe Y, Yu NP, Yuan AF, Zhai LM, Zhang CP, Zhang HM, Zhang JL, Zhang X, Zhang XY, Zhang Y, Zhang Y, Zhang Y, Zhao SP, Zhou XX. Gamma-Ray Observation of the Cygnus Region in the 100-TeV Energy Region. Phys Rev Lett 2021; 127:031102. [PMID: 34328784 DOI: 10.1103/physrevlett.127.031102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/30/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
We report observations of gamma-ray emissions with energies in the 100-TeV energy region from the Cygnus region in our Galaxy. Two sources are significantly detected in the directions of the Cygnus OB1 and OB2 associations. Based on their positional coincidences, we associate one with a pulsar PSR J2032+4127 and the other mainly with a pulsar wind nebula PWN G75.2+0.1, with the pulsar moving away from its original birthplace situated around the centroid of the observed gamma-ray emission. This work would stimulate further studies of particle acceleration mechanisms at these gamma-ray sources.
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Affiliation(s)
- M Amenomori
- Department of Physics, Hirosaki University, Hirosaki 036-8561, Japan
| | - Y W Bao
- School of Astronomy and Space Science, Nanjing University, Nanjing 210093, China
| | - X J Bi
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - D Chen
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - T L Chen
- Department of Mathematics and Physics, Tibet University, Lhasa 850000, China
| | - W Y Chen
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Xu Chen
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Chen
- School of Astronomy and Space Science, Nanjing University, Nanjing 210093, China
| | - S W Cui
- Department of Physics, Hebei Normal University, Shijiazhuang 050016, China
| | - L K Ding
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J H Fang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - K Fang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - C F Feng
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - Zhaoyang Feng
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Z Y Feng
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
| | - Qi Gao
- Department of Mathematics and Physics, Tibet University, Lhasa 850000, China
| | - A Gomi
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - Q B Gou
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Q Guo
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Y Guo
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H H He
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Z T He
- Department of Physics, Hebei Normal University, Shijiazhuang 050016, China
| | - K Hibino
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - N Hotta
- Faculty of Education, Utsunomiya University, Utsunomiya 321-8505, Japan
| | - Haibing Hu
- Department of Mathematics and Physics, Tibet University, Lhasa 850000, China
| | - H B Hu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J Huang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H Y Jia
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
| | - L Jiang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - P Jiang
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - H B Jin
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - K Kasahara
- Faculty of Systems Engineering, Shibaura Institute of Technology, Omiya 330-8570, Japan
| | - Y Katayose
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - C Kato
- Department of Physics, Shinshu University, Matsumoto 390-8621, Japan
| | - S Kato
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - K Kawata
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - M Kozai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara 252-5210, Japan
| | - D Kurashige
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - G M Le
- National Center for Space Weather, China Meteorological Administration, Beijing 100081, China
| | - A F Li
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
- School of Information Science and Engineering, Shandong Agriculture University, Taian 271018, China
| | - H J Li
- Department of Mathematics and Physics, Tibet University, Lhasa 850000, China
| | - W J Li
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
| | - Y Li
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - Y H Lin
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - B Liu
- Department of Astronomy, School of Physical Sciences, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - C Liu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J S Liu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - L Y Liu
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - M Y Liu
- Department of Mathematics and Physics, Tibet University, Lhasa 850000, China
| | - W Liu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - X L Liu
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - Y-Q Lou
- Department of Physics and Tsinghua Centre for Astrophysics (THCA), Tsinghua University, Beijing 100084, China
- Tsinghua University-National Astronomical Observatories of China (NAOC) Joint Research Center for Astrophysics, Tsinghua University, Beijing 100084, China
- Department of Astronomy, Tsinghua University, Beijing 100084, China
| | - H Lu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - X R Meng
- Department of Mathematics and Physics, Tibet University, Lhasa 850000, China
| | - K Munakata
- Department of Physics, Shinshu University, Matsumoto 390-8621, Japan
| | - H Nakada
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - Y Nakamura
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - Y Nakazawa
- College of Industrial Technology, Nihon University, Narashino 275-8575, Japan
| | - H Nanjo
- Department of Physics, Hirosaki University, Hirosaki 036-8561, Japan
| | - C C Ning
- Department of Mathematics and Physics, Tibet University, Lhasa 850000, China
| | - M Nishizawa
- National Institute of Informatics, Tokyo 101-8430, Japan
| | - M Ohnishi
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - T Ohura
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - S Okukawa
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - S Ozawa
- National Institute of Information and Communications Technology, Tokyo 184-8795, Japan
| | - L Qian
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - X Qian
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - X L Qian
- Department of Mechanical and Electrical Engineering, Shangdong Management University, Jinan 250357, China
| | - X B Qu
- College of Science, China University of Petroleum, Qingdao 266555, China
| | - T Saito
- Tokyo Metropolitan College of Industrial Technology, Tokyo 116-8523, Japan
| | - M Sakata
- Department of Physics, Konan University, Kobe 658-8501, Japan
| | - T Sako
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - T K Sako
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - J Shao
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - M Shibata
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - A Shiomi
- College of Industrial Technology, Nihon University, Narashino 275-8575, Japan
| | - H Sugimoto
- Shonan Institute of Technology, Fujisawa 251-8511, Japan
| | - W Takano
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - M Takita
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - Y H Tan
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - N Tateyama
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - S Torii
- Research Institute for Science and Engineering, Waseda University, Tokyo 162-0044, Japan
| | - H Tsuchiya
- Japan Atomic Energy Agency, Tokai-mura 319-1195, Japan
| | - S Udo
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - H Wang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y P Wang
- Department of Mathematics and Physics, Tibet University, Lhasa 850000, China
| | - H R Wu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Q Wu
- Department of Mathematics and Physics, Tibet University, Lhasa 850000, China
| | - J L Xu
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - L Xue
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - Y Yamamoto
- Department of Physics, Konan University, Kobe 658-8501, Japan
| | - Z Yang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Q Yao
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - J Yin
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - Y Yokoe
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - N P Yu
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - A F Yuan
- Department of Mathematics and Physics, Tibet University, Lhasa 850000, China
| | - L M Zhai
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - C P Zhang
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - H M Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J L Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - X Zhang
- School of Astronomy and Space Science, Nanjing University, Nanjing 210093, China
| | - X Y Zhang
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - Y Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Yi Zhang
- Key Laboratory of Dark Matter and Space Astronomy, Purple Mountain Observatory, Chinese Academy of Sciences, Nanjing 210034, China
| | - Ying Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - S P Zhao
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - X X Zhou
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
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Affiliation(s)
- Wendy Y Chen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Jennifer A Ligibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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45
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Wang H, Pan XH, Wang LY, Chen L, Zhou X, Jiang TT, Chen WY, Chen WJ, Ma QQ. [Willingness of post-exposure prophylaxis and possible related factors in men who have sex with men]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:1071-1075. [PMID: 34814509 DOI: 10.3760/cma.j.cn112338-20200609-00822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Objective: To analyze the willingness of post-exposure prophylaxis (PEP) to prevent HIV transmission and related factors in men who have sex with men (MSM). Methods: Cross sectional survey design was used in this study. After informed consent, MSM aged 18 years or above and having had homosexual anal or oral sex in the past 6 months were recruited through "i WeChat" official account between September and November, 2019. Results: Of 1 517 MSM were surveyed, the proportion of MSM who had ever heard of PEP were 72.5% (1 100/1 517) and 87.9%(1 333/1 517) of the MSM said they would like to use PEP if it is needed.Multivariate logistic regression analysis suggested that aged above 25 year (OR=1.807, 95%CI: 1.090-2.995), HIV test history (OR=1.953, 95%CI: 1.171-3.256) and being aware of PEP (OR=2.163, 95%CI: 1.468-3.186) were the positive factors for PEP use, but an aware of the HIV status of sexual partner was the negative factor for PEP (OR=0.602, 95%CI: 0.407-0.890). Among MSM who had ever heard of PEP, the positive factors for PEP use included living in Zhejiang (OR=1.942, 95%CI: 1.097-3.438), aged above 25 years (OR=2.431, 95%CI: 1.331-4.439), being aware of PEP (OR=3.714, 95%CI: 1.532-9.007) obtaining information about PEP service from MSM organization/volunteer/health organization. Conclusions: MSM's willingness to use PEP services was relatively high. Age, awareness of PEP related knowledge, and awareness of sexual partner's HIV infection status were the related factors. MSM organization/volunteer/health organization were the main forces for PEP promotion in MSM.
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Affiliation(s)
- H Wang
- Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Centre for Control and Prevention, Hangzhou 310051, China
| | - X H Pan
- Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Centre for Control and Prevention, Hangzhou 310051, China
| | - L Y Wang
- People's Medical Investment Management Limited Company,People's Medical Publishing House, Beijing 100021, China
| | - L Chen
- Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Centre for Control and Prevention, Hangzhou 310051, China
| | - X Zhou
- Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Centre for Control and Prevention, Hangzhou 310051, China
| | - T T Jiang
- Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Centre for Control and Prevention, Hangzhou 310051, China
| | - W Y Chen
- Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Centre for Control and Prevention, Hangzhou 310051, China
| | - W J Chen
- Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Centre for Control and Prevention, Hangzhou 310051, China
| | - Q Q Ma
- Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Centre for Control and Prevention, Hangzhou 310051, China
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46
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Li X, Chen WY, Cho FHT, Lafortezza R. Bringing the vertical dimension into a planar multilevel autoregressive model: A city-level hedonic analysis of homebuyers' utilities and urban river attributes. Sci Total Environ 2021; 772:145547. [PMID: 33770890 DOI: 10.1016/j.scitotenv.2021.145547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 06/12/2023]
Abstract
Throughout history, urban rivers have been regarded as valuable natural elements that satisfy various human needs and affect where people reside. With the increasing expansion of modern cities along the vertical dimension, how urban rivers affect housing values and homebuyers' purchasing decisions in a 3-D context has attracted a significant amount of attention from researchers, environmental practitioners, urban planners, and policymakers. In this paper, we attempt to estimate how homebuyers' utilities are affected by various river attributes and their interactions using the vibrant high-rise apartment housing market in Guangzhou (south China) as a case study. An appropriate 3-D weights matrix is identified using ex ante Monte Carlo simulation combined with ex post validation on the basis of information criteria. By using the identified 3-D spatial weights scheme in a multilevel autoregressive modelling framework, an intricate combination of multidimensional spatial heterogeneity and spatial dependence can be sufficiently accounted for. Our analytical results reveal that river view and riverfront location are considered as negative utilities by Guangzhou's homebuyers, showing the significant negative impacts of river pollution. Yet, the proximity to urban rivers is regarded as a positive utility, revealing that homebuyers enjoy a sense of being close to nature and an emotional bond with traditional water culture. The black-odorous river water itself devalues apartment prices and adds the negative utilities of river view and riverfront location. Riparian greening would command a price premium, as well as mitigate the negative utilities of river view and riverfront location. Although the availability of walking paths and sitting benches along river stretches is generally regarded as a positive utility, it may worsen the negative impact of river view, but enhance the positive impact of river proximity. These results provide deeper managerial insights into how different river attributes influence apartment buyers' utilities and thus help environmental managers (in collaboration with housing developers) design urban river restoration initiatives so as to create pleasant and attractive neighbourhoods for prospective homebuyers.
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Affiliation(s)
- Xun Li
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Wendy Y Chen
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong.
| | - Frankie Hin Ting Cho
- Land, Environment, Economics and Policy Institute, Xfi Building, University of Exeter, Rennes Drive, Exeter EX4 4PU, United Kingdom
| | - Raffaele Lafortezza
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong; Department of Scienze delle Produzioni Vegetali, University of Bari, Via Amendola 165/A, 70126 Bari, Italy
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47
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Farvid MS, Spence ND, Rosner BA, Chen WY, Eliassen AH, Willett WC, Holmes MD. Consumption of sugar-sweetened and artificially sweetened beverages and breast cancer survival. Cancer 2021; 127:2762-2773. [PMID: 33945630 DOI: 10.1002/cncr.33461] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The activation of insulin pathways is hypothesized to promote tumor growth and worsen breast cancer survival. Sugar-sweetened beverages (SSBs) can lead to a higher risk of insulin resistance and may affect survival. The authors prospectively evaluated the relation of postdiagnostic SSB and artificially sweetened beverage (ASB) consumption with mortality among women with breast cancer. METHODS In total, 8863 women with stage I through III breast cancer were identified during follow-up of the Nurses' Health Study (NHS; 1980-2010) and Nurses' Health Study II (NHSII; 1991-2011). Women completed a validated food frequency questionnaire every 4 years after diagnosis and were followed until death or the end of follow-up (2014 for the NHS and 2015 for the NHSII). Multivariable Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer-specific and all-cause mortality after adjusting for measures of adiposity and other potential predictors of cancer survival. RESULTS With a median follow-up of 11.5 years, 2482 deaths were prospectively documented, including 1050 deaths from breast cancer. Compared with women who had no consumption, women who had SSB consumption after diagnosis had higher breast cancer-specific mortality (>1 to 3 servings per week: HR, 1.31 [95% CI, 1.09-1.58]; >3 servings per week: HR, 1.35 [95% CI, 1.12-1.62]; Ptrend = .001) and all-cause mortality (>1 to 3 servings per week: HR, 1.21 [95% CI, 1.07-1.37]; >3 servings per week: HR, 1.28 [95% CI, 1.13-1.45]; Ptrend = .0001). In contrast, ASB consumption was not associated with higher breast cancer-specific or all-cause mortality. Furthermore, replacing 1 serving per day of SSB consumption with 1 serving per day of ASB consumption was not associated with a lower risk of mortality. CONCLUSIONS Higher postdiagnostic SSB consumption among breast cancer survivors was associated with higher breast cancer-specific mortality and death from all causes.
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Affiliation(s)
- Maryam S Farvid
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Nicholas D Spence
- Department of Sociology and Department of Health and Society, University of Toronto, Toronto, Ontario, Canada
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Wendy Y Chen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Michelle D Holmes
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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48
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Hua J, Chen WY, Liekens I, Cho FHT. Partial attribute attendance in environmental choice experiments: A comparative case study between Guangzhou (China) and Brussels (Belgium). J Environ Manage 2021; 285:112107. [PMID: 33561727 DOI: 10.1016/j.jenvman.2021.112107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 12/29/2020] [Accepted: 01/31/2021] [Indexed: 06/12/2023]
Abstract
Attribute non-attendance (ANA) in discrete choice experiment (DCE) exercises has attracted increasing, yet limited, scholarly attention. This paper attempts to investigate ANA in a comparative case study, with a focus on its patterns and their association with socioeconomic, behavioral and perceptual factors, as well as its impacts on willingness-to-pay (WTP) estimates. We deploy a four-level polytomous scale (always, often, seldom, and never considered) for respondents to state their various degrees of attribute attendance (SANA) in an identical DCE questionnaire about urban river restoration initiatives in two global cities with contrast socioeconomic contexts, yet similar request for restoring polluted and modified urban rivers, Guangzhou (south China) and Brussels (Belgium). The survey results reveal the existence of large proportions of partial attendance in two sampled cities. We use an extended mixed logit model, which incorporates separate parameters delineating each attribute's different attendance groups, to estimate respondents' average WTP values. We find that accounting for SANA could improve the goodness-of-fit of the model and affect the magnitude of mean WTP estimates. Respondents' attribute attendance level pertaining to various attributes is mainly associated with their perceived importance of urban rivers' ecosystem services, but may not be necessarily correlated with the strength of their preference for corresponding attributes as indicated by the mean WTP estimates. Whether this discontinuity between respondents' stated ANA levels and WTP estimates within Guangzhou sample questions the ability of DCEs to generate unbiased welfare estimation and policy guidance in developing countries calls for further studies.
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Affiliation(s)
- Junyi Hua
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Wendy Y Chen
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong.
| | - Inge Liekens
- VITO, The Flemish Institute for Technological Research, Boeretang 200, BE-2400, Mol, Belgium
| | - Frankie Hin Ting Cho
- Land, Environment, Economics and Policy Institute, University of Exeter, Rennes Drive, Exeter, EX4 4PU, United Kingdom
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49
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Ye MH, Chen WY, Cai BJ, Jin CH, He XL. [A convolutional neural network based model for assisting pathological diagnoses on thyroid liquid-based cytology]. Zhonghua Bing Li Xue Za Zhi 2021; 50:358-362. [PMID: 33831995 DOI: 10.3760/cma.j.cn112151-20200802-00613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To develop a convolutional neural network based model for assisting pathological diagnoses on thyroid liquid-based cytology specimens. Methods: Seven-hundred thyroid TCT slides were collected, scanned for whole slide imaging (WSI), and divided into training and test sets after labeling the correct diagnosis (benign versus malignant). The extracted regions of interest after noise filtering were cropped into pieces of 512 × 512 patch on 10 × and 40 × magnifications, respectively. A classification model was constructed using deeply learning algorithms, and applied to the training set, then automatically tuned in the test set. After data enhancement and parameters optimization, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the model were calculated. Results The training set with 560 WSI contained 4 926 cell clusters (11 164 patches), while the test set with 140 WSI contained 977 cell clusters (1 402 patches). YOLO network was selected to establish a detection model, and ResNet50 was used as a classification model. With 40 epochs training, results from 10× magnifications showed an accuracy of 90.01%, sensitivity of 89.31%, specificity of 92.51%, positive predictive value of 97.70% and negative predictive value of 70.82%. The area under curve was 0.97. The average diagnostic time was less than 1 second. Although the model for data of 40× magnifications was very sensitive (98.72%), but its specificity was poor, suggesting that the model was more reliable at 10× magnification. Conclusions: The performance of a deep-learning based model is equivalent to pathologists' diagnostic performance, but its efficiency is far beyond. The model can greatly improve consistency and efficiency, and reduce the missed diagnosis rate. In the future, larger studies should have more morphology diversity, improve model's accuracy and eventually develop a model for direct clinical use.
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Affiliation(s)
- M H Ye
- Department of Pathology, Hangzhou Medical College Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| | - W Y Chen
- Department of Pathology, Hangzhou Medical College Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| | - B J Cai
- Zhejiang Tonghuashun Intelligent Technology Co., Ltd, Hangzhou 311100, China
| | - C H Jin
- Zhejiang Tonghuashun Intelligent Technology Co., Ltd, Hangzhou 311100, China
| | - X L He
- Department of Pathology, Hangzhou Medical College Zhejiang Provincial People's Hospital, Hangzhou 310014, China
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50
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Amenomori M, Bao YW, Bi XJ, Chen D, Chen TL, Chen WY, Chen X, Chen Y, Cui SW, Ding LK, Fang JH, Fang K, Feng CF, Feng Z, Feng ZY, Gao Q, Gou QB, Guo YQ, Guo YY, He HH, He ZT, Hibino K, Hotta N, Hu H, Hu HB, Huang J, Jia HY, Jiang L, Jin HB, Kasahara K, Katayose Y, Kato C, Kato S, Kawata K, Kihara W, Ko Y, Kozai M, Le GM, Li AF, Li HJ, Li WJ, Lin YH, Liu B, Liu C, Liu JS, Liu MY, Liu W, Lou YQ, Lu H, Meng XR, Munakata K, Nakada H, Nakamura Y, Nanjo H, Nishizawa M, Ohnishi M, Ohura T, Ozawa S, Qian XL, Qu XB, Saito T, Sakata M, Sako TK, Shao J, Shibata M, Shiomi A, Sugimoto H, Takano W, Takita M, Tan YH, Tateyama N, Torii S, Tsuchiya H, Udo S, Wang H, Wu HR, Xue L, Yamamoto Y, Yang Z, Yokoe Y, Yuan AF, Zhai LM, Zhang HM, Zhang JL, Zhang X, Zhang XY, Zhang Y, Zhang Y, Zhang Y, Zhao SP, Zhou XX. First Detection of sub-PeV Diffuse Gamma Rays from the Galactic Disk: Evidence for Ubiquitous Galactic Cosmic Rays beyond PeV Energies. Phys Rev Lett 2021; 126:141101. [PMID: 33891464 DOI: 10.1103/physrevlett.126.141101] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/05/2021] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
We report, for the first time, the long-awaited detection of diffuse gamma rays with energies between 100 TeV and 1 PeV in the Galactic disk. Particularly, all gamma rays above 398 TeV are observed apart from known TeV gamma-ray sources and compatible with expectations from the hadronic emission scenario in which gamma rays originate from the decay of π^{0}'s produced through the interaction of protons with the interstellar medium in the Galaxy. This is strong evidence that cosmic rays are accelerated beyond PeV energies in our Galaxy and spread over the Galactic disk.
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Affiliation(s)
- M Amenomori
- Department of Physics, Hirosaki University, Hirosaki 036-8561, Japan
| | - Y W Bao
- School of Astronomy and Space Science, Nanjing University, Nanjing 210093, China
| | - X J Bi
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - D Chen
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - T L Chen
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - W Y Chen
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Xu Chen
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Chen
- School of Astronomy and Space Science, Nanjing University, Nanjing 210093, China
| | - S W Cui
- Department of Physics, Hebei Normal University, Shijiazhuang 050016, China
| | - L K Ding
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J H Fang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - K Fang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - C F Feng
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - Zhaoyang Feng
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Z Y Feng
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
| | - Qi Gao
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - Q B Gou
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Q Guo
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Y Guo
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H H He
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Z T He
- Department of Physics, Hebei Normal University, Shijiazhuang 050016, China
| | - K Hibino
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - N Hotta
- Faculty of Education, Utsunomiya University, Utsunomiya 321-8505, Japan
| | - Haibing Hu
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - H B Hu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J Huang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H Y Jia
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
| | - L Jiang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H B Jin
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - K Kasahara
- Faculty of Systems Engineering, Shibaura Institute of Technology, Omiya 330-8570, Japan
| | - Y Katayose
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - C Kato
- Department of Physics, Shinshu University, Matsumoto 390-8621, Japan
| | - S Kato
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - K Kawata
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - W Kihara
- Department of Physics, Shinshu University, Matsumoto 390-8621, Japan
| | - Y Ko
- Department of Physics, Shinshu University, Matsumoto 390-8621, Japan
| | - M Kozai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara 252-5210, Japan
| | - G M Le
- National Center for Space Weather, China Meteorological Administration, Beijing 100081, China
| | - A F Li
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
- School of Information Science and Engineering, Shandong Agriculture University, Taian 271018, China
| | - H J Li
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - W J Li
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
| | - Y H Lin
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - B Liu
- Department of Astronomy, School of Physical Sciences, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - C Liu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J S Liu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - M Y Liu
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - W Liu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y-Q Lou
- Department of Physics and Tsinghua Centre for Astrophysics (THCA), Tsinghua University, Beijing 100084, China
- Tsinghua University-National Astronomical Observatories of China (NAOC) Joint Research Center for Astrophysics, Tsinghua University, Beijing 100084, China
- Department of Astronomy, Tsinghua University, Beijing 100084, China
| | - H Lu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - X R Meng
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - K Munakata
- Department of Physics, Shinshu University, Matsumoto 390-8621, Japan
| | - H Nakada
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - Y Nakamura
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H Nanjo
- Department of Physics, Hirosaki University, Hirosaki 036-8561, Japan
| | - M Nishizawa
- National Institute of Informatics, Tokyo 101-8430, Japan
| | - M Ohnishi
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - T Ohura
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - S Ozawa
- National Institute of Information and Communications Technology, Tokyo 184-8795, Japan
| | - X L Qian
- Department of Mechanical and Electrical Engineering, Shandong Management University, Jinan 250357, China
| | - X B Qu
- College of Science, China University of Petroleum, Qingdao, 266555, China
| | - T Saito
- Tokyo Metropolitan College of Industrial Technology, Tokyo 116-8523, Japan
| | - M Sakata
- Department of Physics, Konan University, Kobe 658-8501, Japan
| | - T K Sako
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - J Shao
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - M Shibata
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - A Shiomi
- College of Industrial Technology, Nihon University, Narashino 275-8575, Japan
| | - H Sugimoto
- Shonan Institute of Technology, Fujisawa 251-8511, Japan
| | - W Takano
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - M Takita
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - Y H Tan
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - N Tateyama
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - S Torii
- Research Institute for Science and Engineering, Waseda University, Tokyo 169-8555, Japan
| | - H Tsuchiya
- Japan Atomic Energy Agency, Tokai-mura 319-1195, Japan
| | - S Udo
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - H Wang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H R Wu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - L Xue
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - Y Yamamoto
- Department of Physics, Konan University, Kobe 658-8501, Japan
| | - Z Yang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Yokoe
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - A F Yuan
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - L M Zhai
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - H M Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J L Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - X Zhang
- School of Astronomy and Space Science, Nanjing University, Nanjing 210093, China
| | - X Y Zhang
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - Y Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Yi Zhang
- Key Laboratory of Dark Matter and Space Astronomy, Purple Mountain Observatory, Chinese Academy of Sciences, Nanjing 210034, China
| | - Ying Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - S P Zhao
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - X X Zhou
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
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