Abstract PS9-27: Estimation of clinical benefit and economic burden for using a commercial 70-gene signature test for Brazilian breast cancer patients in the public health system

e12526 Background: Luminal B breast cancer is always routinely treated with chemotherapy and endocrine therapy but heterogeneous with respect to sensitivity to treatment, identification of patients who may most benefit remains a matter of controversy. Immune-related genes (IRGs) was found to be associated with the prognosis of breast cancer. The aim of this study is to evaluate the impact of IRGs in predicting the outcome of luminal B breast cancer patients. Methods: According to the Metabric microarray dataset also as a training cohort, 488 luminal B breast cancer patients were selected for generation of immune-related gene signature (IRGS). Another independent dataset (n=250) of patients with complete prognostic information was analyzed as a validation cohort. Prognostic analysis was assessed to test the predictive value of IRGS. Results: A model of prognostic IRGS containing 12 immune-related genes was developed. In both training and validation cohorts, IRGS significantly stratified luminal B breast cancer patients into immune low- and high-risk groups in terms of disease free survival (DFS, HR=4.95, 95% CI=3.22-7.62, P<0.001 in training cohort, HR=2.47, 95% CI=1.29-4.75, P<0.001 in validation cohort). Multivariate analysis revealed IRGS as an independent prognostic factor (HR=4.96, 95% CI=3.00-8.18, P<0.001 in training cohort, HR=2.56, 95% CI=1.28-5.09, P=0.007 in validation cohort). Furthermore, those 12 genes mostly related with response to chemical, and the expression levels of them were completely opposite in patients of immune low- and high-risk groups. Conclusions: The proposed IRGS is a satisfactory prognostic model for estimating DFS of luminal B breast cancer patients. Further studies are needed to assess the clinical effectiveness of this system in predicting prognosis and treatment options for luminal B breast cancer patients. This work was supported by National Natural Science Foundation of China (No. 81602520), Natural Science Foundation of Guangdong Province (No. 2017A030313596).

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Healthcare utilization among breast cancer patients during the COVID-19 outbreak

Palliative & Supportive Care ◽

10.1017/s1478951520000516 ◽

2020 ◽

Vol 18 (4) ◽

pp. 385-391 ◽

Cited By ~ 4

Author(s):

Shiri Shinan-Altman ◽

Inbar Levkovich ◽

Guy Tavori

Keyword(s):

Public Health ◽

Breast Cancer ◽

Health Services ◽

Cancer Patients ◽

Healthcare Professionals ◽

Health Services Utilization ◽

Breast Cancer Patients ◽

Perceived Susceptibility ◽

Services Utilization ◽

Sense Of Mastery

AbstractObjectiveContinuing to utilize healthcare as needed during an epidemic outbreak is significant, in general, and especially for cancer patients. Therefore, this study aimed to explore factors associated with health services utilization among breast cancer patients during the coronavirus disease (COVID-19) outbreak.MethodA cross-sectional online survey was conducted among 151 women with breast cancer. Participants completed measures of perceived health status, perceived susceptibility to COVID-19, anxiety, coping resources, health services utilization (contact with healthcare professionals and cancellation of an appointment to the oncology/hematology clinic), and socio-demographic questionnaires. A multiple hierarchical regression was calculated; contact with healthcare professionals was the dependent variable. In addition, a logistic regression was calculated; cancellation of an appointment to the oncology/hematology clinic because of the COVID-19 was the dependent variable.ResultsBreast cancer patients’ contact with healthcare professionals was lower than their contact prior to the pandemic. A higher extent of contact with healthcare professionals was related to patients’ perception of health as bad/reasonable, lower perceived susceptibility, a lower sense of mastery, and higher social support. In addition, the odds of cancelling an appointment to the oncology/hematology clinic were higher in the presence of additional chronic illnesses and a higher sense of mastery.Significance of resultsThe results could provide public health agencies with a more complete picture of the impact of the COVID-19 epidemic among breast cancer patients. This is significant because, in the event that COVID-19 re-emerges, the findings of the current study could help guide public health officials and possibly prevent the future avoidance of health services’ use among this high-risk population.

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Evaluation of the Quality of Life and Economic Burden with Granulocyte-Colony Stimulating Factor in Chinese Breast Cancer Patients Receiving Docetaxel, Epirubicin and Cyclophosphamide

Annals of Oncology ◽

10.1016/s0923-7534(20)34164-8 ◽

2012 ◽

Vol 23 ◽

pp. ix501

Author(s):

M. He ◽

S. Huang ◽

L. Yu ◽

G. Shi ◽

J. Deng ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Patients ◽

Economic Burden ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

Breast Cancer Patients ◽

Stimulating Factor

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Estimation of Premature Deaths From Lack of Access to Anti-HER2 Therapy for Advanced Breast Cancer in the Brazilian Public Health System

Journal of Global Oncology ◽

10.1200/jgo.2016.005678 ◽

2017 ◽

Vol 3 (3) ◽

pp. 201-207 ◽

Cited By ~ 9

Author(s):

Márcio Debiasi ◽

Tomás Reinert ◽

Rafael Kaliks ◽

Gilberto Amorim ◽

Maira Caleffi ◽

...

Keyword(s):

Public Health ◽

Breast Cancer ◽

Health System ◽

Advanced Breast Cancer ◽

Public Health System ◽

Her2 Positive ◽

The Public ◽

Premature Deaths ◽

Number Of Patients ◽

Positive Breast Cancer

Purpose Patients with human epidermal growth factor receptor 2 (HER2) -positive metastatic tumors treated in the public health system in Brazil do not have access to trastuzumab. This study aimed to estimate the impact of the lack of access to anti-HER2 therapies on the mortality of these patients. Methods On the basis of published data, the number of patients with HER2-positive advanced breast cancer in 2016 who should receive anti-HER2 targeted therapy was estimated. Three different treatment groups were considered for this hypothetical cohort: chemotherapy alone, chemotherapy plus trastuzumab, and chemotherapy plus trastuzumab and pertuzumab. The number of patients alive after 2 years of follow-up was estimated on the basis of the efficacy results of the pivotal trials considering these interventions. Results It was calculated that 2,008 women will be diagnosed with advanced HER2-positive breast cancer in Brazil in 2016. It was estimated that only 808 women would be alive in 2018 if they receive only chemotherapy (which is the treatment offered by the public health system). On the other hand, the bar rises to 1,408 women alive in 2018 if they receive chemotherapy plus trastuzumab and 1,576 women alive in 2018 if they receive the gold standard of chemotherapy plus trastuzumab and pertuzumab. Conclusion Trastuzumab is included in the WHO’s list of essential medications, but the Brazilian public health system does not yet provide this treatment to its population with advanced disease. The introduction of trastuzumab and pertuzumab would have a positive effect, preventing premature deaths in women with metastatic HER2-positive breast cancer in Brazil.

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