Breast cancer
Intratumor RUFY3 low expression is a predictive biomarker for lymph node metastasis in
elderly breast cancer patients
- Author(s)：
-
Masanori Oshi1,3, Akimitsu Yamada1, Angarita Fernando A3, Aki Kimura1, Shinya Yamamoto2, Kazutaka Narui2,
Edge Stephen B3, Itaru Endo1, Kazuaki Takabe1,3 - Affiliation(s)：
- 1Department of Gastroenterological Surgery, Hospital, Yokohama City University, 2Department of Breast and Thyroid Surgery,, Medical center, Yokohama City University,3Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center
Background: A biomarker that identifies lymph node (LN) metastasis may facilitate decision-making in older patients with early breast cancer. RUFY3 is associated with cancer progression. We evaluate RUFY3 expression level as a biomarker for LN-positive breast cancer in older women, which were determined over 75-year-old.
Methods: Clinical and transcriptomic data of breast cancer patients were obtained from the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC, n=1,903) and The Cancer Genome Atlas (TCGA, n=1,046) Pan-Cancer study cohorts. We analyzed the association between RUFT3 expression and clinicopathological factors.
Results: A total of 510 (METABRIC) and 211 (TCGA) older women were identified. LN-positive breast cancer, which represented 51.4% (METABRIC) and 48.4% (TCGA), demonstrated worse disease-free, disease-specific and overall survival. RUFY3 levels were significantly lower in LN-positive tumors regardless of age. The area under the curve for the receiver operator characteristic curves showed RUFY3 predicted LN metastasis with 67.3% sensitivity, 53.4% specificity, 95%CI=0.58-0.68 in METABRIC, and with 66.7% sensitivity, 54.4% specificity, 95%CI=0.50-0.66, in TCGA. Low RUFY3 enriched oxidative phosphorylation, DNA repair, MYC targets, unfolded protein response, and mtorc1 signaling gene sets by Gene set enrichment analysis. Low RUFY3 was associated with T helper type 1 cell infiltration, and with intratumor heterogeneity and fraction altered score. Low RUFY3 expression was associated with LN-positive breast cancer and with worse disease specific survival amongst older women.
Conclusion: Low RUFY3 expression is associated LN-positive in breast cancer. RUFY3 levels can be used for selection of older breast cancer patients for LN staging.
Real-world treatment patterns of palbociclib among patients with HR+/HER2- advanced breast cancer: An updated analysis of the administrative claims data in Japan
- Author(s)：
- Masataka Sawaki1, Kentaro Nakagawa2, Kanae Togo2, Tetsumi Toyoda3, Thomas Laurent3, Hiroji Iwata1
- Affiliation(s)：
- 1Breast Oncology, Aichi Cancer Center, 2Pfizer Japan Inc., Tokyo, Japan,3Clinical Study Support Inc., Aichi, Japan
Background: Palbociclib (PAL) was approved in 2017 for the treatment of hormone receptor-positive (HR+) /human epidermal growth factor-2-negative (HER2-) metastatic breast cancer (mBC) in Japan. The line of treatment or endocrine therapy (ET) combined with PAL is not indicated in the label for PAL in Japan and the data on the real-world use of PAL in Japan are very limited. Therefore, we conducted this study to describe the real-world treatment patterns of patients treated with PAL in Japan.
Method: This was a retrospective, observational study using claims data of patients prescribed PAL from September 2017 to August 2020 in the DPC hospital-based Medical Data Vision database. The line of treatment for mBC was identified based on the algorithm designed for the claims database.
Results: A total of 927 patients records were identified as the prescription of PAL for HR+/HER2- mBC patients. Overall, the proportions of the patients prescribed PAL in the first-, second-, and third-line treatments were 31.6%, 32.3%, and 13.4%, respectively. The use of PAL as first-line treatment increased from 14.5% (December 2017 to February 2018) to 45.3% (March to May 2020). Fulvestrant was the most common endocrine therapy prescribed with PAL as the first-, second-, and third-line therapy (range: 62.5%-65.6%). The types of the subsequent therapies after the first-line treatment with PAL were as follows: CDK4/6 inhibitor combined therapy, 27.0%; chemotherapy, 25.0%; endocrine monotherapy, 18.2%; mTOR inhibitor combined therapy, 15.5%; other therapies, 14.2%.
Conclusion: This study demonstrated that PAL was prescribed as part of various treatments in Japan, with the use of PAL as first-line treatment increasing from December 2017 to May 2020. Fulvestrant was most commonly combined with PAL, regardless of the treatment line. Sequential use of CDK4/6 inhibitors were observed in one quarter of patients who were prescribed PAL as the first-line treatment in this real-world study.
