43P Usefulness of the Framingham risk score to predict cardiotoxicity in breast cancer patients

Introduction: Cardiotoxicity is a well-known risk in breast cancer patients treated with anthracyclines and trastuzumab. Ezaz et al. developed a clinical risk score (CRS) to risk stratify these patients. Despite evidence that African American (AA) race is a significant risk factor for cardiotoxicity, no study has assessed the impact of AA race on this CRS. Here we assess the discrimination ability of the Ezaz et al. CRS with the addition of AA race. Methods: This is a retrospective cohort utilizing a registry of 118 patients with stage I-IV breast cancer treated with anthracyclines and/or trastuzumab. Patients without baseline echocardiography data or with baseline LVEF < 50% were excluded. The CRS from Ezaz et al. consisting of age, adjuvant chemotherapy, coronary artery disease, atrial fibrillation or flutter, diabetes mellitus, hypertension, and renal failure was calculated with the addition of AA race. Cardiotoxicity was defined by an LVEF decline of ≥ 10% to LVEF < 53% from baseline. Results: In our 118 patient cohort, the mean age was 59 years, 23 (20%) AA patients, 65 (55%) patients considered low risk (scores of 0-3) and 53 (45%) considered moderate to high risk (scores ≥4). After a follow up of 3 months to 5 years, 14 (12%) patients developed cardiotoxicity. Table 1 lists the CRS changes in statistical characteristics and predictability with the addition of AA race. In comparing the models, the AUC c-statistic increased from 0.609 to 0.642 (95% CI 0.47-0.75, 95% CI 0.49-0.79 respectively; P value = 0.56) with the addition of AA race ( Figure 1 ). Conclusions: In this study, the Ezaz et al. CRS demonstrated improved discrimination and sensitivity with the addition of AA race. This study suggests AA race improves the predictive ability of the Ezaz et al. CRS. Given the limited size of our study, we promote that this should be hypothesis-driving and encourage further investigation on the path to develop an important risk stratification tool.

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Immune-related gene based prognostic signature for the risk stratification analysis of breast cancer

Current Bioinformatics ◽

10.2174/1574893616666211005110732 ◽

2021 ◽

Vol 16 ◽

Author(s):

Dongqing Su ◽

Qianzi Lu ◽

Yi Pan ◽

Yao Yu ◽

Shiyuan Wang ◽

...

Keyword(s):

Breast Cancer ◽

Regression Analysis ◽

Cancer Patients ◽

Risk Score ◽

Cox Regression ◽

Enrichment Analysis ◽

Gene Set Enrichment Analysis ◽

Breast Cancer Patients ◽

Cox Regression Analysis ◽

Score Model

Background: Breast cancer has plagued women for many years and caused many deaths around the world. Method: In this study, based on the weighted correlation network analysis, univariate Cox regression analysis and least absolute shrinkage and selection operator, 12 immune-related genes were selected to construct the risk score for breast cancer patients. The multivariable Cox regression analysis, gene set enrichment analysis and nomogram were also conducted in this study. Results: Good results were obtained in the survival analysis, enrichment analysis, multivariable Cox regression analysis and immune-related feature analysis. When the risk score model was applied in 22 breast cancer cohorts, the univariate Cox regression analysis demonstrated that the risk score model was significantly associated with overall survival in most of the breast cancer cohorts. Conclusion: Based on these results, we could conclude that the proposed risk score model may be a promising method, and may improve the treatment stratification of breast cancer patients in the future work.

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A risk score model predictive of the presence of additional disease in the axilla in early-breast cancer patients with one or two metastatic sentinel lymph nodes

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2014.03.005 ◽

2014 ◽

Vol 40 (7) ◽

pp. 835-842 ◽

Cited By ~ 6

Author(s):

G. Canavese ◽

P. Bruzzi ◽

A. Catturich ◽

C. Vecchio ◽

D. Tomei ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Cancer Patients ◽

Early Breast Cancer ◽

Risk Score ◽

Sentinel Lymph Nodes ◽

Breast Cancer Patients ◽

Score Model

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Risk Score For Venous Thromboembolism (VTE) In Ambulatory Patients: Impact Of Cancer Type and Risk Score On VTE Incidence, Early Mortality and Progression-Free Survival

Blood ◽

10.1182/blood.v122.21.3597.3597 ◽

2013 ◽

Vol 122 (21) ◽

pp. 3597-3597

Author(s):

Nicole M. Kuderer ◽

Alok A. Khorana ◽

Charles Francis ◽

Eva Culakova ◽

Gary H. Lyman

Keyword(s):

Breast Cancer ◽

High Risk ◽

Cancer Patients ◽

Risk Score ◽

Progression Free Survival ◽

Early Mortality ◽

Breast Cancer Patients ◽

All Cause Mortality ◽

Cancer Types ◽

Risk Categories

Abstract Background While ambulatory patients receiving cancer chemotherapy are at increased risk for venous thromboembolism (VTE), current guidelines do not recommend routine thromboprophylaxis with a few notable exceptions (Lyman, Khorana et al, J Clin Oncol 2013). A previously validated VTE risk score for cancer outpatients stratifies patients into low (0), intermediate (1-2), or high (>=3) risk categories (Khorana, Kuderer et al, Blood 2008). Understanding cancer types at greatest risk for VTE as well as early mortality and progression based on the risk score provides key clinical understanding. Methods A prospective cohort study was conducted of consenting solid tumor and lymphoma patients initiating a new chemotherapy regimen at 115 randomly selected US oncology practices between 2002 – 2006 by the ANC Study Group. VTE incidence, progression-free survival (PFS), and all-cause mortality over the first 120 days (early mortality) of ambulatory chemotherapy were estimated based on the method of Kaplan and Meier. Results Among 4,458 patients initiating a new chemotherapy regimen, 93 (2.1%) developed a symptomatic VTE within 120 days of chemotherapy. The risk of VTE across cancer types increased from 0.6%, to 1.8% to 6.6% in low-, intermediate- and high-risk categories, respectively. The risk of VTE among low risk patients was 1% or less across all cancer types. However, the risk of VTE was highest among intermediate- and high-risk categories in patients with breast, colorectal, and lung cancer, reaching 16% for high risk breast cancer patients. Early all-cause mortality occurred in 136 patients (3.1%) and also increased with increasing risk score from 0.8% to 3.4% to 6.4% in low-, intermediate- and high-risk categories, respectively. The risk of early mortality was 2.1% or less in low risk patients across all cancer types. However, the risk of early mortality was highest among high-risk category patients, reaching 23% and 14% in colorectal cancer patients and pancreatic or gastric cancer patients, respectively. PFS decreased from 92% to 82% to 72% across the three risk categories, with lowest rates of PFS among colorectal (52%) and lung cancer (52%) patients. Conclusions VTE incidence and all-cause mortality increase and PFS correspondingly decreases with increasing VTE risk score across major solid tumors. Interestingly, while breast cancer is not considered a high risk tumor for VTE, breast cancer patients with a risk score of >=3 had the highest VTE incidence compared to other major solid tumor types. Among patients with a risk score of >=3, gastrointestinal cancer patients had the greatest risk of early mortality and correspondingly, the lowest PFS compared to other major solid tumors. These findings also suggest that both the mortality risk as well as the VTE risk are only partially influenced by tumor type. Funding: 1KM1-CA156687-01 (NK), ASCO Young Investigator Award (NK), NHLBI-1R01HL095109 (all), ANC Study Group (GL), and K23 CA120587 (AK). Disclosures: No relevant conflicts of interest to declare.

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