Annual Meeting Proceedings Part 1 - American Society of Clinical ...

68s Breast Cancer—Triple-Negative/Cytotoxics/Local Therapy
1076 General Poster Session (Board #24C), Sat, 8:00 AM-12:00 PM
EEG for evaluation of “chemobrain.” Presenting Author: Halle C. F. Moore,
Cleveland Clinic, Cleveland, OH
Background: Cognitive impairment is a poorly understood and worrisome
potential complication of adjuvant chemotherapy (CT). We sought to
evaluate electroencephalography (EEG) as a means to measure neurophysiologic
function in women receiving CT for early breast cancer. Methods:
Women planning to undergo CT for operable breast cancer and age-similar
controls were evaluated at baseline, during CT and at 1 year with
neurophysiologic assessments. Testing included a brief fatigue inventory
(BFI), brief mental fatigue assessment (BMF), Processing Speed Index
(PSI) derived from Digit Symbol Coding and Symbol Search subtests of the
Wechsler Adult Intelligence Scale, and a sustained elbow flexion physical
task (PT). EEG recordings were obtained at rest and after the cognitive and
physical tasks. Data were analyzed using repeated measures of analysis of
variance. Results: Eight patient/control pairs completed baseline and
on-treatment evaluations; 7 pairs also completed the 1 year assessment (1
pair withdrawn due to a second malignancy). Subjective mental fatigue
measured by BMF is similar for patients and controls at baseline but BMF
scores increase significantly during CT for patients relative to controls
(p�0.033), recovering to no difference at one year. Differences in PSI are
not observed between patients and controls or at the different time points.
BFI scores are greater in patients at all 3 time points but endurance on the
PT is no different from controls. During chemotherapy EEG total spectrum
amplitudes in patients are greater than in controls at rest (p�0.05) and
following both the cognitive (p�0.001) and physical (p�0.001) tasks.
EEG activity prior to chemotherapy and at one year is not different between
patients and controls. For patients but not controls EEG readings after the
cognitive task demonstrate greater amplitude than pre-task readings during
the time of CT treatment only (p�0.012) with a similar trend seen for the
physical task (p�0.06). Conclusions: Patient-perceived mental and physical
fatigue during chemotherapy correspond to significant changes in EEG
brain activity patterns but not to cognitive testing or physical endurance
testing. EEG may offer a sensitive means to measure alterations in brain
function associated with CT.
1078 General Poster Session (Board #24E), Sat, 8:00 AM-12:00 PM
Comparing the outcome between multifocal, multicentric, and bilateral
breast cancer and the impact of guideline-adherent adjuvant treatment: A
retrospective multicenter cohort study of 5,308 patients. Presenting
Author: Lukas Schwentner, Department of Gynecology and Obstetrics
University Ulm, Ulm, Germany
Background: Beside unifocal-unilateral (UU) breast cancer (BC) there are
several subtypes including multifocal, multicentric and bilateral BC. This
study tries to answer the following questions:(1) Does localization (multifocal/multicentric/bilateral)
influence outcome concerning BC mortality? (2)
Is there an impact of guideline-adherent adjuvant treatment in these BC
subtypes? Methods: This German multi-center retrospective cohort study
called BRENDA included 5277 patients obtained from 1992 until 2005.
The definition of guideline adherence was based on the German national S3
breast cancer guideline (2004). Results: 4085 (77.4%) were UU, 698
(13.2%) multifocal, 282 (5.3%) multicentric and 212 (4.0%) bilateral
BC. RFS in multifocal [p�0.003; HR�1.35 (95% CI: 1.11-1.65)],
multicentric [p�0.001; HR�1.76 (95% CI: 1.31-2.34)] and bilateral
[p�0.001; HR�2.28 (95% CI: 1.76-2.97)] BC was significantly lower
compared to unilateral-unifocal BC. Concerning OAS we found only a
borderline difference between UU and unilateral-multifocal [p�0.057;
HR�1.22 (95% CI: 0.99-1.48)], but a significant difference between
multicentric [p� 0.018; HR�1.42 (95% CI: 1.06-1.90)] resp. bilateral
[p�0.001; HR�2.87 (95% CI: 2.21-3.74)] and UU-BC. There was a
significant impact by guideline adherent adjuvant therapy [UU: p�0.001,
HR�2.76,95%C.I.:2.25-3.38], [unilateral-multifocal: p�0.001,
HR�2.04,95%C.I.:1.33-3.14], [unilateral-multicentric: p�0.020,
HR�2.13,95%C.I.:1.13-4.01] and [bilateral: p�0.042,
HR�2.10,95%C.I.:1.03-4.31]. After stratifying for 100% guideline adherent
treatment and adjusting for age, tumor size, nodal status and grading
there was no significant difference in RFS/OAS in patients with multifocal
[p�0.282/p�0.610], multicentric [p�0.829/p�0.609] or bilateral BC
[p�0.457/p�0.773] compared to patients with UU-BC. Conclusions:
Patients with multicentric and bilateral BC have primarily a worse prognosis
in terms of RFS and OAS. However if guideline adherent adjuvant treatment
was applied it was no more possible to demonstrate significant differences
in survival.
1077 General Poster Session (Board #24D), Sat, 8:00 AM-12:00 PM
Analysis according to prognostic factors in patients (pts) treated with first-line
bevacizumab (BEV) combined with paclitaxel (PAC) for HER2-negative metastatic
breast cancer (mBC) in a routine oncology practice study. Presenting
Author: Iris Schrader, Gynäkolog.-onkolog. Gem.Praxis, Hannover, Germany
Background: 1st-line BEV combined with weekly PAC significantly improves progression-free
survival (PFS) and response rate (RR) vs PAC alone in HER2-negative
mBC, as shown in E2100. We analyzed data from a German routine oncology
practice study of 1st-line BEV–PAC according to prognostic factors. Methods: Pts
who had received no prior chemotherapy for mBC received BEV–PAC according to
the European label. Efficacy and safety were documented for up to 1 y (or until
progression, death, or BEV discontinuation if earlier) with additional long-term
follow-up. Efficacy was analyzed in clinically important subgroups. Results: Efficacy
data were available for 818 pts. The median duration of follow-up was 11.4 mo. The
composition of the pt population with respect to the subgroups below was generally
similar to the population treated in E2100, except for a higher proportion of pts with
visceral disease or metastases in �3 organs. RR was very similar across all
subgroups analyzed. Differences in median PFS and OS were generally in line with
the differing prognoses according to clinical characteristics. Conclusions: These data
suggest that 1st-line BEV–PAC is typically associated with median PFS �9 moin
the real-life setting, irrespective of baseline characteristics.
PFS OS
Subgroup N RR, % Median, mo p value Median, mo p value
All
Age, y
818 62 9.4 – 20.8 –
>65 262 57 9.2 0.83 20.6 0.99
70 133 57 9.3 0.38 20.6 0.34