Haider, Ali

e13154 Background: Triple-negative breast cancer (TNBC) is a less common but highly aggressive subtype of breast cancer with poor prognosis and limited therapeutic options. Despite advancements in oncology, significant survival disparities persist among racial, histologic, and socio-demographic groups. This study investigates these disparities and identifies factors contributing to unequal outcomes, providing actionable insights for improving care. Methods: Data on TNBC cases from 2000 to 2021 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, encompassing 17 registries and 76,265 patients. Patients were categorized by stage, marital status, age, race, and histology. Kaplan-Meier survival analysis was used to estimate median survival with 95% confidence intervals (CI), and the log-rank test assessed differences across groups. Cox proportional hazards regression determined the magnitude of disparities. A p-value < 0.05 was considered statistically significant. Results: Among the 76,265 patients analyzed, those with distant-stage disease had the poorest median survival (51 months; 95% CI: 46–60), compared to localized-stage patients (128 months; 95% CI: 127–129). The youngest cohort (15–19 years) exhibited the lowest survival (43 months), while individuals aged 80–84 had a median survival of 79 months (95% CI: 76–84). South Asians, particularly Pakistani individuals, had the shortest survival among racial groups (83 months). Single patients had lower survival (116 months) compared to married or divorced individuals. Histologically, median survival was 113 months (95% CI: 103–120) for epithelial neoplasms and 78 months for mucoepidermoid neoplasms. All observed differences were statistically significant (p < 0.05). Conclusions: Localized-stage TNBC, individuals aged 40–44, and patients from White or Black racial groups exhibited better survival outcomes, as did those with cystic, mucinous, or serous histologies compared to epithelial neoplasms. Addressing these disparities through tailored treatment strategies and improved access to care is critical. Limitations of this study include the lack of treatment-level data and the potential influence of unmeasured confounders. Stage Marital Status Age Group at Diagnosis Distant Localized Single Divorced 15-19 40-44 80-84 Median Survival(LCL-UCL) 51(46-60) 128(127-129) 116(114-118) 127(124-129) 43(14-NA) 132(130-135) 79(76-84) Neoplasm Histology Race Epithelial Muco-epidermoid Cystic, Mucinous& Serous Pakistani OtherAsian Black White Median Survival(LCL-UCL) 113 (103-120) 78(63-NA) 142(123-NA) 83 (63-NA) 97(91-108) 123 (121-125) 126 (125-127) LCL= Lower Confidence Limit, UCL= Upper Confidence Limit.

e16237 Background: Alcohol use (AU) and Liver cell carcinoma (LCC) are significant contributors to adult mortality worldwide. Examining trends and disparities in AU and LCC-related deaths is essential for understanding public health challenges and formulating targeted interventions. This study investigates national mortality patterns related to AU and LCC in the United States from 1999 to 2023, emphasizing demographic, geographic, and temporal disparities. Methods: This descriptive analysis used the CDC WONDER database (1999–2023) to identify AU-related deaths (ICD-10 codes E24.4, F10, G32.2, G62.1, G72.1, I42.6, K70, K85.2, K86.0, R78.0, T51, X65, Y15) and LCC (ICD-10 code C22.0) in adults aged 25 and older. Age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were calculated, stratified by gender, race/ethnicity, census region, urban-rural classification, and state. Trends were analyzed using Joinpoint regression to compute annual percent changes (APCs) and 95% confidence intervals (CIs). Statistical significance was set at p < 0.05, and analyses adhered to STROBE guidelines. Results: From 1999 to 2023, a total of 21,007 deaths were attributed to LCC and AU (Men: 18,836 Women: 2,171). AAMRs showed a stable trend from 1999 to 2003 (APC: 0.0; 95% CI: -8.7 to 4.9) but increased significantly from 2003 to 2019 (APC: 6.1; 95% CI: 5.7 to 7.4), stabilizing from 2019 to 2023 (APC: -0.6; 95% CI: -3.2 to 1.3). Men's AAMRs decreased from 1999 to 2003 (APC: -1.1; 95% CI: -10.4 to 3.4), then rose sharply from 2003 to 2019 (APC: 6.1; 95% CI: 5.6 to 7.1). For women, AAMRs increased significantly, particularly between 2013 and 2017 (APC: 12.4; 95% CI: -9.5 to 25.1). Non-Hispanic Black and White populations experienced notable increases in AAMRs, while Hispanic people showed an initial decline followed by an increase post-2004 (APC: 4.7; 95% CI: 3.7 to 7.9). The West had the highest regional AAMR (5.3; 95% CI: 5.2 to 5.5), while the Northeast recorded the lowest (2.1; 95% CI: 2.0 to 2.2). New Mexico had the highest state AAMR (8.4; 95% CI: 7.4 to 9.4), and Mississippi the lowest (1.2; 95% CI: 0.9 to 1.5). AAMRs rose more sharply in non-metropolitan areas from 1999-2020 (APC: 6.6; 95% CI: 5.9 to 7.8) compared to metropolitan regions from 2004 to 2020 (APC: 5.4; 95% CI: 4.9 to 6.5). Conclusions: AU and LCC-related mortality rates have increased significantly since 2003, with distinct gender, racial, and geographic disparities. Men and rural populations faced higher mortality increases, with notable variations across states and regions. These findings underscore the need for focused public health efforts to mitigate these disparities and address the growing burden of LCC and AU-related mortality.

e20097 Background: Malignant Mesothelioma (MMe) is a neoplasm of mesothelium and has a very poor survival rate. Over half the patients of MMe express programmed death-ligand 1 (PD-L1) which binds to the PD-1 receptor on T-cells which in turn suppresses their ability to kill tumors. Pembrolizumab is a PD-1 inhibitor antibody and it has shown efficacy in combating MMe. Our analysis aims to summarize data related to objective response rates (ORR) and adverse effects of Pembrolizumab therapy in MMe patients. Methods: We conducted an online search through PubMed, Cochrane, and Clinicaltrials.gov databases from their inception till January 25, 2024, to identify studies that reported the use of Pembrolizumab in patients with MMe. Data were extracted and analyzed and proportions with their 95% confidence interval have been reported. Onlinemeta v1.0 was used for all analyses. Results: A total of six studies with 549 patients reported the use of Pembrolizumab in patients with MMe. ORR was observed in 36.2% (32.3% - 40.4%; p < 0.01) of patients receiving Pembrolizumab while 20.4% (17.2%- 24.0%; p < 0.01) of patients experienced adverse effects of the therapy. Median survival ranged from 9.5 to 17.3 months whereas progression-free survival ranged from 2.5 to 7.1 months in patients. Conclusions: Pembrolizumab has an ORR and safety profile comparable to other immunotherapies. Further studies are needed to extensively study the drug and its effects in detail in patients with MMe. [Table: see text]

e18073 Background: Selpercatinib is a highly selective RET inhibitor that is used for the treatment of RET-mutant medullary thyroid cancers, but its efficacy and safety is not fully understood. Our objective is to summarize available literature on the safety and efficacy profile of Selpercatinib. Methods: A search was conducted on PubMed, Embase and Cochrane from foundation to 31st January 2024. Patients aged above 18 with Advanced RET-Altered Medullary Thyroid Cancers who received Selpercatinib were identified. Data abstraction was done based on objective response rate, complete response rate, any grade adverse effect (AE) and grade ≥3 AE. Analysis was done using R (v.4.3) and reported as proportions with respective 95% confidence intervals (CI) on forest plots. Results: Four studies were identified that reported the use of Selpercatinib in Advanced RET-Altered Medullary Thyroid Cancers. Our analysis showed that the pooled proportion of objective response rate and complete response rate was 74.8% (95% CI: 70.1% – 79%) and 4.9% (95% CI: 3.1% – 7.7%) respectively. Pooled proportion of patients experiencing any grade AE and grade ≥3 AE was 93.4% (95% CI: 90.4% – 95.6%) and 46.2% (95% CI: 41.1% – 51.3%) respectively. Conclusions: Selpercatinib is a novel RET inhibitor which has potential use against RET-Altered Thyroid Cancers. It has an overall acceptable safety and efficacy profile. However it requires further studies to establish its adverse effects and clinical application. [Table: see text]