Key clinical point: In women with dense breasts, who are generally at an intermediate risk for breast cancer (BC), screening with magnetic resonance imaging (MRI) alone or with mammography increased the rates of screen-detected early-stage cancer and false-positive recalls compared with mammography alone.

Major finding: The rate of screen-detected early-stage cancer in women with dense breasts was higher with MRI alone vs MRI + mammography (difference 11.7/1000 examinations; 95% CI 4.6-18.8/1000 examinations) and MR + mammography vs mammography alone (difference 4.0/1000 examinations; 95% CI 1.4-6.7/1000 examinations); however, false-positive recall rates were higher with MRI + mammography vs mammography alone (difference 149.8/1000 examinations; 95% CI 135.7-163.9/1000 examinations) and comparable with both MRI and MRI + mammography.

Study details: This cohort study analyzed the data of women aged 40-79 years who had undergone screening with MRI (2611 screenings), MRI + mammography (6518 screenings), or mammography (65,180 screenings) from the Breast Cancer Surveillance Consortium registry.

Disclosures: This study was funded by the US Patient-Centered Outcomes Research Institute award and other sources. The authors declared no conflicts of interest.

Source: Kerlikowske K et al. Supplemental magnetic resonance imaging plus mammography compared with magnetic resonance imaging or mammography by extent of breast density. J Natl Cancer Inst. 2023 (Oct 27). doi: 10.1093/jnci/djad201

Key clinical point: In women with dense breasts, who are generally at an intermediate risk for breast cancer (BC), screening with magnetic resonance imaging (MRI) alone or with mammography increased the rates of screen-detected early-stage cancer and false-positive recalls compared with mammography alone.

Major finding: The rate of screen-detected early-stage cancer in women with dense breasts was higher with MRI alone vs MRI + mammography (difference 11.7/1000 examinations; 95% CI 4.6-18.8/1000 examinations) and MR + mammography vs mammography alone (difference 4.0/1000 examinations; 95% CI 1.4-6.7/1000 examinations); however, false-positive recall rates were higher with MRI + mammography vs mammography alone (difference 149.8/1000 examinations; 95% CI 135.7-163.9/1000 examinations) and comparable with both MRI and MRI + mammography.

Study details: This cohort study analyzed the data of women aged 40-79 years who had undergone screening with MRI (2611 screenings), MRI + mammography (6518 screenings), or mammography (65,180 screenings) from the Breast Cancer Surveillance Consortium registry.

Disclosures: This study was funded by the US Patient-Centered Outcomes Research Institute award and other sources. The authors declared no conflicts of interest.

Source: Kerlikowske K et al. Supplemental magnetic resonance imaging plus mammography compared with magnetic resonance imaging or mammography by extent of breast density. J Natl Cancer Inst. 2023 (Oct 27). doi: 10.1093/jnci/djad201

Key clinical point: In women with dense breasts, who are generally at an intermediate risk for breast cancer (BC), screening with magnetic resonance imaging (MRI) alone or with mammography increased the rates of screen-detected early-stage cancer and false-positive recalls compared with mammography alone.

Major finding: The rate of screen-detected early-stage cancer in women with dense breasts was higher with MRI alone vs MRI + mammography (difference 11.7/1000 examinations; 95% CI 4.6-18.8/1000 examinations) and MR + mammography vs mammography alone (difference 4.0/1000 examinations; 95% CI 1.4-6.7/1000 examinations); however, false-positive recall rates were higher with MRI + mammography vs mammography alone (difference 149.8/1000 examinations; 95% CI 135.7-163.9/1000 examinations) and comparable with both MRI and MRI + mammography.

Study details: This cohort study analyzed the data of women aged 40-79 years who had undergone screening with MRI (2611 screenings), MRI + mammography (6518 screenings), or mammography (65,180 screenings) from the Breast Cancer Surveillance Consortium registry.

Disclosures: This study was funded by the US Patient-Centered Outcomes Research Institute award and other sources. The authors declared no conflicts of interest.

Source: Kerlikowske K et al. Supplemental magnetic resonance imaging plus mammography compared with magnetic resonance imaging or mammography by extent of breast density. J Natl Cancer Inst. 2023 (Oct 27). doi: 10.1093/jnci/djad201

A large Canadian clinical trial has found that using small-volume tubes to collect blood samples for laboratory testing of intensive care unit patients can reduce blood transfusions without affecting lab results.

“We showed in a large pragmatic cluster trial that automatically collect less blood for laboratory testing reduced red blood cell transfusions by about 10 units of red blood cells per 100 patients in the ICU,” lead study author Deborah M. Siegal, MD, associate professor at the University of Ottawa and scientist at the Ottawa Hospital Research Institute, said.

The study was coordinated by the Population Health Research Institute, an affiliate of McMaster University in Hamilton (Ont.) Health Sciences, where Dr. Siegal worked before moving to Ottawa.

The STRATUS randomized clinical trial, published in JAMA, involved 25 adult medical-surgical ICUs across Canada, where 21,201 patients were randomized to either standard-volume or small-volume tubes for collecting blood samples. During the course of the study, each site switched to the small-volume collection tubes.

“We also showed there were no negative effects on lab testing, and by that we measured the sufficiency of  the specimens,” Dr. Siegal added. “We were able to show that there wasn’t a problem with the amount of blood that was available for the tests to be done.”

The samples were collected from February 2019 through January 2021, through the period of COVID-19 restrictions. Dr. Siegal explained that 6,210 patients admitted early in the COVID-19 pandemic were excluded from the primary analysis, but were included in secondary analyses.

 

Study results

While the study found no significant difference in RBC units per patient per ICU stage – a relative risk of .91 (95% confidence interval, 0.79-1.05; P = .19), it did find an absolute reduction of 7.24 RBC units/100 patients per ICU stay. 

Findings from the secondary analyses, which included 27,411 patients, were:

• A 12% reduction in RBC units per patient per ICU stay after switching from standard-volume to small-volume tubes (RR, 0.88; 95%  CI, 0.77-1; P = .04).
• An absolute reduction of 9.84 RBC units/100 patients per ICU stay (95% CI, 0.24-20.76).

In the primary analysis population, the median transfusion-adjusted hemoglobin was not statistically different between the standard- and small-volume collection tube groups, with an average difference of 0.1 g/dL (95% CI, –0.04 to .23), but it was lower in the secondary population, with a mean difference of .17 g/dL (95% CI, 0.05-0.29).

“Those patients that we analyzed in the secondary analysis population received about 36,000 units of blood, just in 25 ICU units in Canada in less than 2 years,” Dr. Siegal said. “If we saved 10 units per 100 patients, that’s 1,500 units of blood. That really speaks to a small effect at the individual patient level but really potential for widespread effect. We are now in a period of blood product shortage not only in Canada but worldwide.”

 

First clinical trial for small tubes

Dr. Siegal noted this was the first clinical trial to compare standard- and small-volume blood collection tools, “and also to show there is both a benefit and a lack of harm,” Dr. Siegal said. “We thought that a randomized trial was the best way to move the needle. If we could design a trial of a large population of patients to show benefit and no harm, it would be a win, and that’s in fact what happened.”

She added, “The tubes essentially have the same cost, work the same, and go on the same equipment the same way the standard-volume tubes do, so it wasn’t a practice change for people in the hospital.”

The study also found an identical low rate of unusable specimens did not differ regardless of the type of collection tube: less than .03%.

Dr. Siegal said the study group is collaborating with hematology stakeholders in Canada, including Canadian Blood Services, which provides blood plasma to the country’s provincial and territorial health systems, and is reaching out to the American Society of Hematology.

“We’re going to target both hematologists and critical  care providers and, even more broadly than the critical care community, hospitals, because anemia is big problem in hospitals,” Dr. Siegal said. “I think we can think about this more broadly.”

The study received funding from the Hamilton Academic Health Sciences Organization. Dr. Siegal disclosed relationships with Bristol-Myers Squibb-Pfizer, AstraZeneca and Roche.

A large Canadian clinical trial has found that using small-volume tubes to collect blood samples for laboratory testing of intensive care unit patients can reduce blood transfusions without affecting lab results.

“We showed in a large pragmatic cluster trial that automatically collect less blood for laboratory testing reduced red blood cell transfusions by about 10 units of red blood cells per 100 patients in the ICU,” lead study author Deborah M. Siegal, MD, associate professor at the University of Ottawa and scientist at the Ottawa Hospital Research Institute, said.

The study was coordinated by the Population Health Research Institute, an affiliate of McMaster University in Hamilton (Ont.) Health Sciences, where Dr. Siegal worked before moving to Ottawa.

The STRATUS randomized clinical trial, published in JAMA, involved 25 adult medical-surgical ICUs across Canada, where 21,201 patients were randomized to either standard-volume or small-volume tubes for collecting blood samples. During the course of the study, each site switched to the small-volume collection tubes.

“We also showed there were no negative effects on lab testing, and by that we measured the sufficiency of  the specimens,” Dr. Siegal added. “We were able to show that there wasn’t a problem with the amount of blood that was available for the tests to be done.”

The samples were collected from February 2019 through January 2021, through the period of COVID-19 restrictions. Dr. Siegal explained that 6,210 patients admitted early in the COVID-19 pandemic were excluded from the primary analysis, but were included in secondary analyses.

 

Study results

While the study found no significant difference in RBC units per patient per ICU stage – a relative risk of .91 (95% confidence interval, 0.79-1.05; P = .19), it did find an absolute reduction of 7.24 RBC units/100 patients per ICU stay. 

Findings from the secondary analyses, which included 27,411 patients, were:

• A 12% reduction in RBC units per patient per ICU stay after switching from standard-volume to small-volume tubes (RR, 0.88; 95%  CI, 0.77-1; P = .04).
• An absolute reduction of 9.84 RBC units/100 patients per ICU stay (95% CI, 0.24-20.76).

In the primary analysis population, the median transfusion-adjusted hemoglobin was not statistically different between the standard- and small-volume collection tube groups, with an average difference of 0.1 g/dL (95% CI, –0.04 to .23), but it was lower in the secondary population, with a mean difference of .17 g/dL (95% CI, 0.05-0.29).

“Those patients that we analyzed in the secondary analysis population received about 36,000 units of blood, just in 25 ICU units in Canada in less than 2 years,” Dr. Siegal said. “If we saved 10 units per 100 patients, that’s 1,500 units of blood. That really speaks to a small effect at the individual patient level but really potential for widespread effect. We are now in a period of blood product shortage not only in Canada but worldwide.”

 

First clinical trial for small tubes

Dr. Siegal noted this was the first clinical trial to compare standard- and small-volume blood collection tools, “and also to show there is both a benefit and a lack of harm,” Dr. Siegal said. “We thought that a randomized trial was the best way to move the needle. If we could design a trial of a large population of patients to show benefit and no harm, it would be a win, and that’s in fact what happened.”

She added, “The tubes essentially have the same cost, work the same, and go on the same equipment the same way the standard-volume tubes do, so it wasn’t a practice change for people in the hospital.”

The study also found an identical low rate of unusable specimens did not differ regardless of the type of collection tube: less than .03%.

Dr. Siegal said the study group is collaborating with hematology stakeholders in Canada, including Canadian Blood Services, which provides blood plasma to the country’s provincial and territorial health systems, and is reaching out to the American Society of Hematology.

“We’re going to target both hematologists and critical  care providers and, even more broadly than the critical care community, hospitals, because anemia is big problem in hospitals,” Dr. Siegal said. “I think we can think about this more broadly.”

The study received funding from the Hamilton Academic Health Sciences Organization. Dr. Siegal disclosed relationships with Bristol-Myers Squibb-Pfizer, AstraZeneca and Roche.

A large Canadian clinical trial has found that using small-volume tubes to collect blood samples for laboratory testing of intensive care unit patients can reduce blood transfusions without affecting lab results.

“We showed in a large pragmatic cluster trial that automatically collect less blood for laboratory testing reduced red blood cell transfusions by about 10 units of red blood cells per 100 patients in the ICU,” lead study author Deborah M. Siegal, MD, associate professor at the University of Ottawa and scientist at the Ottawa Hospital Research Institute, said.

The study was coordinated by the Population Health Research Institute, an affiliate of McMaster University in Hamilton (Ont.) Health Sciences, where Dr. Siegal worked before moving to Ottawa.

The STRATUS randomized clinical trial, published in JAMA, involved 25 adult medical-surgical ICUs across Canada, where 21,201 patients were randomized to either standard-volume or small-volume tubes for collecting blood samples. During the course of the study, each site switched to the small-volume collection tubes.

“We also showed there were no negative effects on lab testing, and by that we measured the sufficiency of  the specimens,” Dr. Siegal added. “We were able to show that there wasn’t a problem with the amount of blood that was available for the tests to be done.”

The samples were collected from February 2019 through January 2021, through the period of COVID-19 restrictions. Dr. Siegal explained that 6,210 patients admitted early in the COVID-19 pandemic were excluded from the primary analysis, but were included in secondary analyses.

 

Study results

While the study found no significant difference in RBC units per patient per ICU stage – a relative risk of .91 (95% confidence interval, 0.79-1.05; P = .19), it did find an absolute reduction of 7.24 RBC units/100 patients per ICU stay. 

Findings from the secondary analyses, which included 27,411 patients, were:

• A 12% reduction in RBC units per patient per ICU stay after switching from standard-volume to small-volume tubes (RR, 0.88; 95%  CI, 0.77-1; P = .04).
• An absolute reduction of 9.84 RBC units/100 patients per ICU stay (95% CI, 0.24-20.76).

In the primary analysis population, the median transfusion-adjusted hemoglobin was not statistically different between the standard- and small-volume collection tube groups, with an average difference of 0.1 g/dL (95% CI, –0.04 to .23), but it was lower in the secondary population, with a mean difference of .17 g/dL (95% CI, 0.05-0.29).

“Those patients that we analyzed in the secondary analysis population received about 36,000 units of blood, just in 25 ICU units in Canada in less than 2 years,” Dr. Siegal said. “If we saved 10 units per 100 patients, that’s 1,500 units of blood. That really speaks to a small effect at the individual patient level but really potential for widespread effect. We are now in a period of blood product shortage not only in Canada but worldwide.”

 

First clinical trial for small tubes

Dr. Siegal noted this was the first clinical trial to compare standard- and small-volume blood collection tools, “and also to show there is both a benefit and a lack of harm,” Dr. Siegal said. “We thought that a randomized trial was the best way to move the needle. If we could design a trial of a large population of patients to show benefit and no harm, it would be a win, and that’s in fact what happened.”

She added, “The tubes essentially have the same cost, work the same, and go on the same equipment the same way the standard-volume tubes do, so it wasn’t a practice change for people in the hospital.”

The study also found an identical low rate of unusable specimens did not differ regardless of the type of collection tube: less than .03%.

Dr. Siegal said the study group is collaborating with hematology stakeholders in Canada, including Canadian Blood Services, which provides blood plasma to the country’s provincial and territorial health systems, and is reaching out to the American Society of Hematology.

“We’re going to target both hematologists and critical  care providers and, even more broadly than the critical care community, hospitals, because anemia is big problem in hospitals,” Dr. Siegal said. “I think we can think about this more broadly.”

The study received funding from the Hamilton Academic Health Sciences Organization. Dr. Siegal disclosed relationships with Bristol-Myers Squibb-Pfizer, AstraZeneca and Roche.

Key clinical point: Despite treatment with neoadjuvant chemotherapy (NAC), patients with locally advanced inflammatory breast cancer (BC) showed poorer survival outcomes than those with noninflammatory BC.

Major finding: Patients with inflammatory vs noninflammatory locally advanced BC who received NAC had significantly lower rates of 5-year overall survival (58.9% vs 86.7%; P  =  .00005), relapse-free survival (53.0% vs 80.3%; P  =  .0001), and distant relapse-free survival (53.3% vs 80.9%; P  =  .0001).

Study details: This retrospective analysis included 84 patients with stage III inflammatory BC and 81 matched-control individuals with stage III noninflammatory BC, all of whom received neoadjuvant chemotherapy.

Disclosures: This study did not receive any specific funding. KU Park declared being a consultant with Bayer LLC. The other authors declared no conflicts of interest.

Source: Johnson KCC et al. Survival outcomes seen with neoadjuvant chemotherapy in the management of locally advanced inflammatory breast cancer (IBC) versus matched controls. Breast. 2023;72:103591 (Oct 13). doi: 10.1016/j.breast.2023.103591

Key clinical point: Despite treatment with neoadjuvant chemotherapy (NAC), patients with locally advanced inflammatory breast cancer (BC) showed poorer survival outcomes than those with noninflammatory BC.

Major finding: Patients with inflammatory vs noninflammatory locally advanced BC who received NAC had significantly lower rates of 5-year overall survival (58.9% vs 86.7%; P  =  .00005), relapse-free survival (53.0% vs 80.3%; P  =  .0001), and distant relapse-free survival (53.3% vs 80.9%; P  =  .0001).

Study details: This retrospective analysis included 84 patients with stage III inflammatory BC and 81 matched-control individuals with stage III noninflammatory BC, all of whom received neoadjuvant chemotherapy.

Disclosures: This study did not receive any specific funding. KU Park declared being a consultant with Bayer LLC. The other authors declared no conflicts of interest.

Source: Johnson KCC et al. Survival outcomes seen with neoadjuvant chemotherapy in the management of locally advanced inflammatory breast cancer (IBC) versus matched controls. Breast. 2023;72:103591 (Oct 13). doi: 10.1016/j.breast.2023.103591

Key clinical point: Despite treatment with neoadjuvant chemotherapy (NAC), patients with locally advanced inflammatory breast cancer (BC) showed poorer survival outcomes than those with noninflammatory BC.

Major finding: Patients with inflammatory vs noninflammatory locally advanced BC who received NAC had significantly lower rates of 5-year overall survival (58.9% vs 86.7%; P  =  .00005), relapse-free survival (53.0% vs 80.3%; P  =  .0001), and distant relapse-free survival (53.3% vs 80.9%; P  =  .0001).

Study details: This retrospective analysis included 84 patients with stage III inflammatory BC and 81 matched-control individuals with stage III noninflammatory BC, all of whom received neoadjuvant chemotherapy.

Disclosures: This study did not receive any specific funding. KU Park declared being a consultant with Bayer LLC. The other authors declared no conflicts of interest.

Source: Johnson KCC et al. Survival outcomes seen with neoadjuvant chemotherapy in the management of locally advanced inflammatory breast cancer (IBC) versus matched controls. Breast. 2023;72:103591 (Oct 13). doi: 10.1016/j.breast.2023.103591

Key clinical point: Oral selective estrogen receptor degraders (SERD) improved the progression-free survival (PFS) outcomes in patients with estrogen receptor-positive (ER+) human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (BC), particularly in those with ESR1 mutations.

Major finding: Compared with endocrine therapies (ET) of the physician’s choice, oral SERD led to a greater improvement in PFS outcomes in the overall population (hazard ratio [HR] 0.783; P < .001) and in the subgroup of patients with ESR1 mutations (HR 0.557; P < .001); however, no PFS benefit was observed in the ESR1 wild-type subgroup (P  =  .543).

Study details: Findings are from a meta-analysis of individual patient data from four randomized clinical trials including 1290 patients with ER+/HER2− metastatic BC who received oral SERD or ET of physician’s choice.

Disclosures: This study did not receive any specific funding. Some authors declared receiving honoraria, research funding, or travel grants from or serving in advisory or consulting roles for various sources.

Source: Wong NZH et al. Efficacy of oral SERDs in the treatment of ER+, HER2 - metastatic breast cancer, a stratified analysis of the ESR1 wild type and mutant subgroups. Ann Oncol. 2023 (Oct 21). doi: 10.1016/j.annonc.2023.10.122

Key clinical point: Oral selective estrogen receptor degraders (SERD) improved the progression-free survival (PFS) outcomes in patients with estrogen receptor-positive (ER+) human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (BC), particularly in those with ESR1 mutations.

Major finding: Compared with endocrine therapies (ET) of the physician’s choice, oral SERD led to a greater improvement in PFS outcomes in the overall population (hazard ratio [HR] 0.783; P < .001) and in the subgroup of patients with ESR1 mutations (HR 0.557; P < .001); however, no PFS benefit was observed in the ESR1 wild-type subgroup (P  =  .543).

Study details: Findings are from a meta-analysis of individual patient data from four randomized clinical trials including 1290 patients with ER+/HER2− metastatic BC who received oral SERD or ET of physician’s choice.

Disclosures: This study did not receive any specific funding. Some authors declared receiving honoraria, research funding, or travel grants from or serving in advisory or consulting roles for various sources.

Source: Wong NZH et al. Efficacy of oral SERDs in the treatment of ER+, HER2 - metastatic breast cancer, a stratified analysis of the ESR1 wild type and mutant subgroups. Ann Oncol. 2023 (Oct 21). doi: 10.1016/j.annonc.2023.10.122

Key clinical point: Oral selective estrogen receptor degraders (SERD) improved the progression-free survival (PFS) outcomes in patients with estrogen receptor-positive (ER+) human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (BC), particularly in those with ESR1 mutations.

Major finding: Compared with endocrine therapies (ET) of the physician’s choice, oral SERD led to a greater improvement in PFS outcomes in the overall population (hazard ratio [HR] 0.783; P < .001) and in the subgroup of patients with ESR1 mutations (HR 0.557; P < .001); however, no PFS benefit was observed in the ESR1 wild-type subgroup (P  =  .543).

Study details: Findings are from a meta-analysis of individual patient data from four randomized clinical trials including 1290 patients with ER+/HER2− metastatic BC who received oral SERD or ET of physician’s choice.

Disclosures: This study did not receive any specific funding. Some authors declared receiving honoraria, research funding, or travel grants from or serving in advisory or consulting roles for various sources.

Source: Wong NZH et al. Efficacy of oral SERDs in the treatment of ER+, HER2 - metastatic breast cancer, a stratified analysis of the ESR1 wild type and mutant subgroups. Ann Oncol. 2023 (Oct 21). doi: 10.1016/j.annonc.2023.10.122

Key clinical point: Neoadjuvant immunotherapy with camrelizumab plus chemotherapy with nab-paclitaxel and epirubicin showed promising anti-tumor activity and a manageable safety profile in patients with early triple-negative breast cancer (TNBC).

Major finding: The majority of patients achieved a pathological complete response rate (64.1%; 95% CI 47.2%-78.8%) and an objective response rate (89.7%; 95% CI 74.8%-96.7%). Decreased white blood cell (56.4%), neutropenia (41.0%), and anemia (20.5%) were the most common grade 3 or 4 adverse events, and no treatment-related deaths were reported.

Study details: This phase 2 trial included 39 treatment-naive patients with early TNBC who received neoadjuvant camrelizumab, nab-paclitaxel, and epirubicin every 3 weeks for 6 cycles.

Disclosures: This study was supported by Jiangsu Hengrui Pharmaceuticals Co., Ltd, China. The authors declared no conflicts of interest.

Source: Wang C et al. Neoadjuvant camrelizumab plus nab-paclitaxel and epirubicin in early triple-negative breast cancer: A single-arm phase II trial. Nat Commun. 2023;14:6654 (Oct 20). doi: 10.1038/s41467-023-42479-w

Key clinical point: Neoadjuvant immunotherapy with camrelizumab plus chemotherapy with nab-paclitaxel and epirubicin showed promising anti-tumor activity and a manageable safety profile in patients with early triple-negative breast cancer (TNBC).

Major finding: The majority of patients achieved a pathological complete response rate (64.1%; 95% CI 47.2%-78.8%) and an objective response rate (89.7%; 95% CI 74.8%-96.7%). Decreased white blood cell (56.4%), neutropenia (41.0%), and anemia (20.5%) were the most common grade 3 or 4 adverse events, and no treatment-related deaths were reported.

Study details: This phase 2 trial included 39 treatment-naive patients with early TNBC who received neoadjuvant camrelizumab, nab-paclitaxel, and epirubicin every 3 weeks for 6 cycles.

Disclosures: This study was supported by Jiangsu Hengrui Pharmaceuticals Co., Ltd, China. The authors declared no conflicts of interest.

Source: Wang C et al. Neoadjuvant camrelizumab plus nab-paclitaxel and epirubicin in early triple-negative breast cancer: A single-arm phase II trial. Nat Commun. 2023;14:6654 (Oct 20). doi: 10.1038/s41467-023-42479-w

Key clinical point: Neoadjuvant immunotherapy with camrelizumab plus chemotherapy with nab-paclitaxel and epirubicin showed promising anti-tumor activity and a manageable safety profile in patients with early triple-negative breast cancer (TNBC).

Major finding: The majority of patients achieved a pathological complete response rate (64.1%; 95% CI 47.2%-78.8%) and an objective response rate (89.7%; 95% CI 74.8%-96.7%). Decreased white blood cell (56.4%), neutropenia (41.0%), and anemia (20.5%) were the most common grade 3 or 4 adverse events, and no treatment-related deaths were reported.

Study details: This phase 2 trial included 39 treatment-naive patients with early TNBC who received neoadjuvant camrelizumab, nab-paclitaxel, and epirubicin every 3 weeks for 6 cycles.

Disclosures: This study was supported by Jiangsu Hengrui Pharmaceuticals Co., Ltd, China. The authors declared no conflicts of interest.

Source: Wang C et al. Neoadjuvant camrelizumab plus nab-paclitaxel and epirubicin in early triple-negative breast cancer: A single-arm phase II trial. Nat Commun. 2023;14:6654 (Oct 20). doi: 10.1038/s41467-023-42479-w

Key clinical point: Premenopausal women with invasive lobular carcinoma (ILC) vs invasive ductal carcinoma (IDC) had better breast cancer-specific survival (BCSS) outcomes within 10 years after disease diagnosis, but the prognosis worsened in the long run.

Major finding: In the Surveillance, Epidemiology, and End Results (SEER) database, patients with ILC vs IDC showed improved BCSS outcomes during the first 10 years after diagnosis (hazard ratio [HR] 0.73; P < .001); however, after 10 years, the trend reversed and BCSS outcomes worsened by 80% in patients with ILC (HR 1.80; P < .001). ILC was also associated with worsened long-term prognosis in patients from the Korean Breast Cancer Registry and Asan Medical Center Research database.

Study details: This retrospective cohort study analyzed the data from three databases and included 225,938 premenopausal women (age < 50 years) with stages I-III ILC or IDC.

Disclosures: This study was supported by a grant from the Korea Health Technology R&D Project. O Metzger declared receiving grant funding and personal fees from various sources.

Source: Yoon TI et al. Survival outcomes in premenopausal patients with invasive lobular carcinoma. JAMA Netw Open. 2023;6(11):e2342270 (Nov 8). doi: 10.1001/jamanetworkopen.2023.42270

Key clinical point: Premenopausal women with invasive lobular carcinoma (ILC) vs invasive ductal carcinoma (IDC) had better breast cancer-specific survival (BCSS) outcomes within 10 years after disease diagnosis, but the prognosis worsened in the long run.

Major finding: In the Surveillance, Epidemiology, and End Results (SEER) database, patients with ILC vs IDC showed improved BCSS outcomes during the first 10 years after diagnosis (hazard ratio [HR] 0.73; P < .001); however, after 10 years, the trend reversed and BCSS outcomes worsened by 80% in patients with ILC (HR 1.80; P < .001). ILC was also associated with worsened long-term prognosis in patients from the Korean Breast Cancer Registry and Asan Medical Center Research database.

Study details: This retrospective cohort study analyzed the data from three databases and included 225,938 premenopausal women (age < 50 years) with stages I-III ILC or IDC.

Disclosures: This study was supported by a grant from the Korea Health Technology R&D Project. O Metzger declared receiving grant funding and personal fees from various sources.

Source: Yoon TI et al. Survival outcomes in premenopausal patients with invasive lobular carcinoma. JAMA Netw Open. 2023;6(11):e2342270 (Nov 8). doi: 10.1001/jamanetworkopen.2023.42270

Key clinical point: Premenopausal women with invasive lobular carcinoma (ILC) vs invasive ductal carcinoma (IDC) had better breast cancer-specific survival (BCSS) outcomes within 10 years after disease diagnosis, but the prognosis worsened in the long run.

Major finding: In the Surveillance, Epidemiology, and End Results (SEER) database, patients with ILC vs IDC showed improved BCSS outcomes during the first 10 years after diagnosis (hazard ratio [HR] 0.73; P < .001); however, after 10 years, the trend reversed and BCSS outcomes worsened by 80% in patients with ILC (HR 1.80; P < .001). ILC was also associated with worsened long-term prognosis in patients from the Korean Breast Cancer Registry and Asan Medical Center Research database.

Study details: This retrospective cohort study analyzed the data from three databases and included 225,938 premenopausal women (age < 50 years) with stages I-III ILC or IDC.

Disclosures: This study was supported by a grant from the Korea Health Technology R&D Project. O Metzger declared receiving grant funding and personal fees from various sources.

Source: Yoon TI et al. Survival outcomes in premenopausal patients with invasive lobular carcinoma. JAMA Netw Open. 2023;6(11):e2342270 (Nov 8). doi: 10.1001/jamanetworkopen.2023.42270

Key clinical point: Vaginal estrogen therapy did not worsen mortality outcomes in patients with breast cancer (BC) and genitourinary symptoms and can be considered if nonhormonal treatments prove unsuccessful.

Major finding: BC-specific mortality was not worsened in patients with BC who received vaginal estrogen therapy vs no hormone replacement therapy (hazard ratio 0.77; 95% CI 0.63-0.94).

Study details: Findings are from an analysis of two large cohorts including 49,237 females with BC, of which 5% of females used vaginal estrogen therapy after BC diagnosis.

Disclosures: This study was supported by grants from Cancer Research UK. Some authors declared receiving grants, personal fees, or nonfinancial support from and having other ties with several sources.

Source: McVicker L et al. Vaginal estrogen therapy use and survival in females with breast cancer. JAMA Oncol. 2023 (Nov 2). doi: 10.1001/jamaoncol.2023.4508

Key clinical point: Vaginal estrogen therapy did not worsen mortality outcomes in patients with breast cancer (BC) and genitourinary symptoms and can be considered if nonhormonal treatments prove unsuccessful.

Major finding: BC-specific mortality was not worsened in patients with BC who received vaginal estrogen therapy vs no hormone replacement therapy (hazard ratio 0.77; 95% CI 0.63-0.94).

Study details: Findings are from an analysis of two large cohorts including 49,237 females with BC, of which 5% of females used vaginal estrogen therapy after BC diagnosis.

Disclosures: This study was supported by grants from Cancer Research UK. Some authors declared receiving grants, personal fees, or nonfinancial support from and having other ties with several sources.

Source: McVicker L et al. Vaginal estrogen therapy use and survival in females with breast cancer. JAMA Oncol. 2023 (Nov 2). doi: 10.1001/jamaoncol.2023.4508

Key clinical point: Vaginal estrogen therapy did not worsen mortality outcomes in patients with breast cancer (BC) and genitourinary symptoms and can be considered if nonhormonal treatments prove unsuccessful.

Major finding: BC-specific mortality was not worsened in patients with BC who received vaginal estrogen therapy vs no hormone replacement therapy (hazard ratio 0.77; 95% CI 0.63-0.94).

Study details: Findings are from an analysis of two large cohorts including 49,237 females with BC, of which 5% of females used vaginal estrogen therapy after BC diagnosis.

Disclosures: This study was supported by grants from Cancer Research UK. Some authors declared receiving grants, personal fees, or nonfinancial support from and having other ties with several sources.

Source: McVicker L et al. Vaginal estrogen therapy use and survival in females with breast cancer. JAMA Oncol. 2023 (Nov 2). doi: 10.1001/jamaoncol.2023.4508

Key clinical point: Patients with moderate-to-severe atopic dermatitis (AD) presenting with classic or generalized lichenoid and inflammatory phenotypes vs other non-classic phenotypes and with Eczema Area and Severity Index (EASI) scores < 29 vs ≥ 29 showed an early response to dupilumab by achieving a mild disease state.

Major finding: Factors with a significant predictive value for an early response to dupilumab included the classic phenotype (odds ratio [OR] 6.92; 95% CI 2.04-23.48) or generalized lichenoid and inflammatory phenotypes (OR 4.22; 95% CI 1.22-14.66) vs the nummular eczema phenotype and a baseline EASI score of ≤ 24 (OR 3.13; 95% CI 1.81-5.41) or 24-29 (OR 1.79; 95% CI 1.05-3.07) vs ≥ 29.

Study details: Findings are from a retrospective single-center observational study including 492 patients (age > 12 years) with moderate-to-severe AD treated with dupilumab.

Disclosures: This study did not receive any external funding. S Ferrucci and AV Marzano declared serving as speakers or advisory board members of various organizations. The other authors declared no conflicts of interest.

Source: Ferrucci S et al. Predictive factors of early response to dupilumab in patients with moderate-to-severe atopic dermatitis. J Clin Med. 2023;12(20):6575 (Oct 17). doi: 10.3390/jcm12206575.

Key clinical point: Patients with moderate-to-severe atopic dermatitis (AD) presenting with classic or generalized lichenoid and inflammatory phenotypes vs other non-classic phenotypes and with Eczema Area and Severity Index (EASI) scores < 29 vs ≥ 29 showed an early response to dupilumab by achieving a mild disease state.

Major finding: Factors with a significant predictive value for an early response to dupilumab included the classic phenotype (odds ratio [OR] 6.92; 95% CI 2.04-23.48) or generalized lichenoid and inflammatory phenotypes (OR 4.22; 95% CI 1.22-14.66) vs the nummular eczema phenotype and a baseline EASI score of ≤ 24 (OR 3.13; 95% CI 1.81-5.41) or 24-29 (OR 1.79; 95% CI 1.05-3.07) vs ≥ 29.

Study details: Findings are from a retrospective single-center observational study including 492 patients (age > 12 years) with moderate-to-severe AD treated with dupilumab.

Disclosures: This study did not receive any external funding. S Ferrucci and AV Marzano declared serving as speakers or advisory board members of various organizations. The other authors declared no conflicts of interest.

Source: Ferrucci S et al. Predictive factors of early response to dupilumab in patients with moderate-to-severe atopic dermatitis. J Clin Med. 2023;12(20):6575 (Oct 17). doi: 10.3390/jcm12206575.

Key clinical point: Patients with moderate-to-severe atopic dermatitis (AD) presenting with classic or generalized lichenoid and inflammatory phenotypes vs other non-classic phenotypes and with Eczema Area and Severity Index (EASI) scores < 29 vs ≥ 29 showed an early response to dupilumab by achieving a mild disease state.

Major finding: Factors with a significant predictive value for an early response to dupilumab included the classic phenotype (odds ratio [OR] 6.92; 95% CI 2.04-23.48) or generalized lichenoid and inflammatory phenotypes (OR 4.22; 95% CI 1.22-14.66) vs the nummular eczema phenotype and a baseline EASI score of ≤ 24 (OR 3.13; 95% CI 1.81-5.41) or 24-29 (OR 1.79; 95% CI 1.05-3.07) vs ≥ 29.

Study details: Findings are from a retrospective single-center observational study including 492 patients (age > 12 years) with moderate-to-severe AD treated with dupilumab.

Disclosures: This study did not receive any external funding. S Ferrucci and AV Marzano declared serving as speakers or advisory board members of various organizations. The other authors declared no conflicts of interest.

Source: Ferrucci S et al. Predictive factors of early response to dupilumab in patients with moderate-to-severe atopic dermatitis. J Clin Med. 2023;12(20):6575 (Oct 17). doi: 10.3390/jcm12206575.

Key clinical point: Adults with moderate-to-severe atopic dermatitis (AD) are at a significantly higher risk for renal malignancy, with the risk for overall malignancy being higher in adults with AD regardless of the disease severity.

Major finding: Compared with adults without AD, those with moderate-to-severe AD had a significantly increased risk for renal malignancy (adjusted hazard ratio [aHR] 1.533; 95% CI 1.209-1.944); moreover, the risk for overall malignancy was higher in adults with mild (aHR 1.061; 95% CI 1.006-1.118) and moderate-to-severe (aHR 1.061; 95% CI 1.014-1.110) AD.

Study details: Findings are from a population-based cohort study including 22,430 adults with mild AD, 34,187 adults with moderate-to-severe AD, and 3,810,530 adults without AD.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Oh J et al. Increased risk of renal malignancy in patients with moderate to severe atopic dermatitis. Cancers (Basel). 2023;15(20):5007 (Oct 16). doi: 10.3390/cancers15205007

Key clinical point: Adults with moderate-to-severe atopic dermatitis (AD) are at a significantly higher risk for renal malignancy, with the risk for overall malignancy being higher in adults with AD regardless of the disease severity.

Major finding: Compared with adults without AD, those with moderate-to-severe AD had a significantly increased risk for renal malignancy (adjusted hazard ratio [aHR] 1.533; 95% CI 1.209-1.944); moreover, the risk for overall malignancy was higher in adults with mild (aHR 1.061; 95% CI 1.006-1.118) and moderate-to-severe (aHR 1.061; 95% CI 1.014-1.110) AD.

Study details: Findings are from a population-based cohort study including 22,430 adults with mild AD, 34,187 adults with moderate-to-severe AD, and 3,810,530 adults without AD.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Oh J et al. Increased risk of renal malignancy in patients with moderate to severe atopic dermatitis. Cancers (Basel). 2023;15(20):5007 (Oct 16). doi: 10.3390/cancers15205007

Key clinical point: Adults with moderate-to-severe atopic dermatitis (AD) are at a significantly higher risk for renal malignancy, with the risk for overall malignancy being higher in adults with AD regardless of the disease severity.

Major finding: Compared with adults without AD, those with moderate-to-severe AD had a significantly increased risk for renal malignancy (adjusted hazard ratio [aHR] 1.533; 95% CI 1.209-1.944); moreover, the risk for overall malignancy was higher in adults with mild (aHR 1.061; 95% CI 1.006-1.118) and moderate-to-severe (aHR 1.061; 95% CI 1.014-1.110) AD.

Study details: Findings are from a population-based cohort study including 22,430 adults with mild AD, 34,187 adults with moderate-to-severe AD, and 3,810,530 adults without AD.

Disclosures: This study did not receive any external funding. The authors declared no conflicts of interest.

Source: Oh J et al. Increased risk of renal malignancy in patients with moderate to severe atopic dermatitis. Cancers (Basel). 2023;15(20):5007 (Oct 16). doi: 10.3390/cancers15205007

TOPLINE:

More than half of Mohs surgeons report at least one sharps injury in the past year, mostly self-inflicted, survey finds.

METHODOLOGY:

• Data on the incidence of sharps injuries among dermatologic surgeons is limited.
• In a cross-sectional analysis of anonymous survey responses from members of the American College of , researchers aimed to determine the incidence and types of sharps injuries among Mohs surgeons.
• The researchers used descriptive statistics for continuous and nominal variables (percentage and frequencies) to report survey data and Fisher exact or chi-square analysis of categorical variables to obtain P values.

TAKEAWAY:

• Of the 60 survey respondents, more than half (56.7%) were from single-specialty group practices, 26.6% were from academic practices, and fewer than half (43.3%) had been in practice for 15 or more years.
• In the past year, 56.7% of respondents experienced at least one sharps injury. Of these, 14.7% involved exposure to a blood-borne pathogen, which translated into an annual exposure risk of 7.6% for any given Mohs surgeon.
• The top two types of sharps injuries were self-inflicted suture needlestick (76.5%) and other types of self-inflicted needlestick injuries (26.5%).
• Of respondents who sustained a sharps injury, 44.1% did not report them, while 95% of all survey respondents said they had access to postexposure prophylaxis/protocols at their workplace.
• The researchers determined that the average annual rate of sharps injury was 0.87.

IN PRACTICE:

• “In best practices to prevent sharps injuries, the authors recommend that a standardized sharps handling protocol be developed and disseminated for dermatologic surgeons and their staff,” the researchers wrote.

STUDY DETAILS:

• Faezeh Talebi-Liasi, MD, and Jesse M. Lewin, MD, department of dermatology, Icahn School of Medicine at Mount Sinai, New York, conducted the research. The study was published in Dermatologic Surgery.

LIMITATIONS:

• The study’s cross-sectional observational design and small sample size was skewed toward single-specialty and academic practices.

DISCLOSURES:

• The authors reported having no relevant financial disclosures.

A version of this article appeared on Medscape.com.

TOPLINE:

More than half of Mohs surgeons report at least one sharps injury in the past year, mostly self-inflicted, survey finds.

METHODOLOGY:

• Data on the incidence of sharps injuries among dermatologic surgeons is limited.
• In a cross-sectional analysis of anonymous survey responses from members of the American College of , researchers aimed to determine the incidence and types of sharps injuries among Mohs surgeons.
• The researchers used descriptive statistics for continuous and nominal variables (percentage and frequencies) to report survey data and Fisher exact or chi-square analysis of categorical variables to obtain P values.

TAKEAWAY:

• Of the 60 survey respondents, more than half (56.7%) were from single-specialty group practices, 26.6% were from academic practices, and fewer than half (43.3%) had been in practice for 15 or more years.
• In the past year, 56.7% of respondents experienced at least one sharps injury. Of these, 14.7% involved exposure to a blood-borne pathogen, which translated into an annual exposure risk of 7.6% for any given Mohs surgeon.
• The top two types of sharps injuries were self-inflicted suture needlestick (76.5%) and other types of self-inflicted needlestick injuries (26.5%).
• Of respondents who sustained a sharps injury, 44.1% did not report them, while 95% of all survey respondents said they had access to postexposure prophylaxis/protocols at their workplace.
• The researchers determined that the average annual rate of sharps injury was 0.87.

IN PRACTICE:

• “In best practices to prevent sharps injuries, the authors recommend that a standardized sharps handling protocol be developed and disseminated for dermatologic surgeons and their staff,” the researchers wrote.

STUDY DETAILS:

• Faezeh Talebi-Liasi, MD, and Jesse M. Lewin, MD, department of dermatology, Icahn School of Medicine at Mount Sinai, New York, conducted the research. The study was published in Dermatologic Surgery.

LIMITATIONS:

• The study’s cross-sectional observational design and small sample size was skewed toward single-specialty and academic practices.

DISCLOSURES:

• The authors reported having no relevant financial disclosures.

A version of this article appeared on Medscape.com.

TOPLINE:

More than half of Mohs surgeons report at least one sharps injury in the past year, mostly self-inflicted, survey finds.

METHODOLOGY:

• Data on the incidence of sharps injuries among dermatologic surgeons is limited.
• In a cross-sectional analysis of anonymous survey responses from members of the American College of , researchers aimed to determine the incidence and types of sharps injuries among Mohs surgeons.
• The researchers used descriptive statistics for continuous and nominal variables (percentage and frequencies) to report survey data and Fisher exact or chi-square analysis of categorical variables to obtain P values.

TAKEAWAY:

• Of the 60 survey respondents, more than half (56.7%) were from single-specialty group practices, 26.6% were from academic practices, and fewer than half (43.3%) had been in practice for 15 or more years.
• In the past year, 56.7% of respondents experienced at least one sharps injury. Of these, 14.7% involved exposure to a blood-borne pathogen, which translated into an annual exposure risk of 7.6% for any given Mohs surgeon.
• The top two types of sharps injuries were self-inflicted suture needlestick (76.5%) and other types of self-inflicted needlestick injuries (26.5%).
• Of respondents who sustained a sharps injury, 44.1% did not report them, while 95% of all survey respondents said they had access to postexposure prophylaxis/protocols at their workplace.
• The researchers determined that the average annual rate of sharps injury was 0.87.

IN PRACTICE:

• “In best practices to prevent sharps injuries, the authors recommend that a standardized sharps handling protocol be developed and disseminated for dermatologic surgeons and their staff,” the researchers wrote.

STUDY DETAILS:

• Faezeh Talebi-Liasi, MD, and Jesse M. Lewin, MD, department of dermatology, Icahn School of Medicine at Mount Sinai, New York, conducted the research. The study was published in Dermatologic Surgery.

LIMITATIONS:

• The study’s cross-sectional observational design and small sample size was skewed toward single-specialty and academic practices.

DISCLOSURES:

• The authors reported having no relevant financial disclosures.

A version of this article appeared on Medscape.com.