Slostad, Jessica

Introduction: Several recent studies have shown a gender disparity in professional doctoral introductions at major medical conferences, with female speakers being less likely to be introduced with a professional title. We sought to examine whether a similar disparity existed at the American Society of Hematology (ASH) Annual Meeting. Methods: In this retrospective observational study, 8 investigators reviewed available presentations from video archives of the 2018 ASH Annual Meeting. Presentations were excluded if gender could not be identified and/or speaker did not have a doctoral degree. We collected data on speaker gender, speaker academic/non-academic rank, speaker geographic location, speaker training status, speaker session type and introducer gender were all collected. A "professional address" was defined as either "Dr. [First and Last Name]" or "Dr. [Last Name]." Descriptive statistics and regression modelling were used to analyze the data. Results:Of the videos reviewed, 645 presentations were eligible for analysis; 380 (59%) speakers were men and 264 (41%) were women. A comparison of male and female speaker cohorts is seen in Table 1. Forty-eight percent of both men and women held a Medical Doctor degree (MD), and the rest were MD/PhD or PhD graduates. Substantially more men (28%) were full professors compared to women (13%). Almost half (47%) of session types for both men and women speakers were designated as "basic science." In an adjusted analysis, more women (N=174, 66%) compared to men (N=225, 59%) received a professional address (P<.01). 43% of women were introduced by a female introducer and 42% of men were introduced by a female introducer (P=.79). In addition, 48 of the introducers (19%) for women and 68 of the introducers (18%) for men had a PhD or MD/PhD. In a logistic regression model adjusting for session type, academic rank, degree, geographic location, trainee status, and gender of introducer, there were no significant gender-based differences in professional introduction [Table 1; Odds Ratio (OR) 0.71, P=.06]. In addition, speakers with MD introducers were more likely to have a professional introduction compared to PhD introducers (OR 2.15, P=.03) regardless of sex. Conclusions: Our study demonstrates that women were at least as likely as men to receive a professional address at the 2018 ASH Annual Meeting. These results differ from previous studies of other professional medical conferences. These findings may reflect the strong presence of PhD graduates as both speakers and introducers. Both forms of bias (gender and degree-based) merit further study and interventions including speaker training to ensure combatting unconscious bias. Disclosures Velazquez: Midatech: Other: Husband owns stock in this company; Portola Pharmaceuticals: Other: Husband owns stock in this company; Corbus Pharmaceuticals: Other: Husband owns stock in this company; Johnson & Johnson: Other: Husband is employed by this company.

Abstract Introduction: Hospitalization-associated VTE attack (incident plus recurrent VTE) rates over the 6-year period, 2005-2010, did not change significantly despite achieving near-universal in-hospital VTE prophylaxis; 75% of these VTE events occurred after hospital discharge with a median of 19.5 days from hospital discharge to VTE. The median durations of hospitalization and in-hospital prophylaxis were 3 days and 70 hours, respectively, suggesting that VTE prophylaxis was inadequate. However, the hospital population that would benefit most from post-hospitalization VTE prophylaxis is uncertain. Our study aim was to test hospital length of stay (LOS) as a potential predictor of post-hospital-discharge incident or recurrent VTE. Methods: Using the resources of the Rochester Epidemiology Project, we identified all unique Olmsted County, MN residents hospitalized at least once at a Rochester, MN Mayo Clinic hospital and all such residents with objectively-diagnosed occurrence of first or recurrent VTE during hospitalization or within 92 days after hospital discharge, 2005-2010. We tested LOS as a potential predictor of post-hospital-discharge VTE (conditional on surviving to hospital discharge free of VTE) using the Anderson-Gill version of Cox regression modeling and adjusting for age, sex, any surgery performed during that hospitalization, and Charlson Comorbidity Index calculated from conditions recorded from 1/1/2005 until the day of hospital discharge. Results: Over the period, 2005-2010, 31,588 unique Olmsted County residents were hospitalized at least once at a Rochester Mayo Clinic hospital. The distribution of LOS was: 1-2 (3.8%), 3 (24.2%), 4 (23.3%), 5 (16.4%), 6 (8.8%), 7-9 (12.4%), 10-19 (8.4%) and 20+ (2.3%). Of the 253 VTE events identified within 92 days post-hospital discharge, 6, 29, 31, 38, 38, 53, 42 and 16 had been hospitalized for 1-2, 3, 4, 5, 6, 7-9, 10-19 and 20+ days, respectively. The hazard ratios (HR) for post-hospital-discharge VTE were similar for hospital LOS ≤4 days; compared to LOS ≤3 days, the HRs were significantly increased for hospital LOS of 5 (HR=1.78), 6 (HR=2.86), 7-9 (HR=2.71), 10-19 (HR=3.16) and 20+ (HR=4.20) days (Table 1). Conclusions: The adjusted hazards of post-hospital discharge VTE for hospital LOS > 4 days were significantly increased 1.8 to 4.2-fold compared to LOS ≤3 days, suggesting that hospital LOS may be useful for identifying hospitalized patients suitable for longer duration VTE (including post-discharge) prophylaxis. Future studies should be aimed at identifying additional predictors of post-hospital-discharge VTE such that extended prophylaxis can be targeted to those patients who would benefit most. Disclosures No relevant conflicts of interest to declare.

239 Background: Pancreatic adenocarcinoma is a rapidly fatal cancer with 5-year overall survival <5%. 5-10% of pancreatic cancers occur in patients with family history of disease, and 5-27% of these familial cancers are BRCA associated, with defects in Homologous Recombination Repair (HRR). In breast and ovarian cancer, BRCA mutations may be associated with increased risk for brain metastasis (BM). BM is rare in pancreatic cancer, but it is suggested HRR deficient pancreatic cancer patients may have an increased risk for BM/LC. Methods: We analyzed 3030 prospectively identified patients with pancreatic cancer and HHR mutation germline sequencing data (BRCA1/2, ATM, PALB2) from the Mayo Clinic Pancreatic Cancer SPORE Registry. We used clinical databases (2000-2018) to assess the presence of BM or leptomeningeal carcinomatosis (LC). Unconditional logistic regression analysis, with Odds Ratio (OR) and 95% Confidence Interval (CI), assessed the association between HRR gene germline mutation carrier status and any BM. Results: Of 3030 total pancreatic cancer patients, 8 were diagnosed with clinically evident BM/LC (0.26%), confirming the very low incidence of this metastasis site (Table). Of these, all had BM, and 4 also had LC present. No patients had LC diagnosed without BM present. 175/3030 (5.8%) patients had a germline HHR gene mutation. Of these, 1 patient was a BRCA2 carrier (0.57% of HRR deficient patients). 7 /2763 (0.25%) patients without germline HRR mutations had BM or LC (p = 0.44, OR 2.26; 95% CI: 0.27, 18.49). Conclusions: To our knowledge, this is the largest review of BRCA-associated pancreatic cancer patients with BM or LC. The incidence of BM is rare at 0.27%, with LC at 0.14%. Limitations include likely underdiagnosis given short clinical course and lack of availability of somatic HRR gene status. Our study suggests HRR germline carrier patients may have an increased risk of BM/LC development compared to non-carriers. Given rarity, larger studies should be explored. [Table: see text]

BACKGROUNDDespite the success of immune checkpoint and targeted therapy, many patients with melanoma ultimately require further treatment. The combination of carboplatin, paclitaxel, and bevacizumab (CPB) has demonstrated promising activity in a single‐arm study. In the current study, the authors performed a randomized phase 2 study to confirm efficacy and to determine whether adding everolimus would increase the activity of the combination.METHODSThrough the North Central Cancer Treatment Group, a total of 149 patients with unresectable AJCC 6th edition stage IV melanoma were randomized from May 2010 to May 2014 to either CPB or CPB with everolimus (CPBE). The primary endpoint was progression‐free survival (PFS), with secondary endpoints of overall survival (OS), response rate, and tolerability.RESULTSThe CPB and CPBE treatment arms were balanced with regard to age (median age: 59 years vs 58 years) and high lactate dehydrogenase (48% vs 51%), but were unbalanced with regard to sex (male sex: 72% vs 55%; P = .03). Overall, there was no difference noted with regard to PFS, with a median PFS of 5.6 months for CPB versus 5.1 months for CPBE (hazard ratio [HR], 1.14; 95% confidence interval [95% CI], 0.81‐1.62 [P = .44]), or for OS, with a median OS of 14.5 months for CPB versus 10.8 months for CPBE (HR, 1.16; 95% CI, 0.84‐1.84). The confirmed response rate was 13% for CPB and 23% for CPBE (P = .13). Toxicity was higher for CPBE compared with CPB (83% for grade 3 + and 14% for grade 4 + vs 63% for grade 3 + and 11% for grade 4+, respectively) (toxicities were graded using the Cancer Therapy Evaluation Program of the National Cancer Institute Common Terminology Criteria for Adverse Events [version 4.0]). Common grade 3 + toxicities were neutropenia, leukopenia, and fatigue, which occurred in both treatment arms with comparable frequency.CONCLUSIONSBoth experimental arms demonstrated activity, with a PFS of >5 months. However, the addition of everolimus to CPB failed to improve outcomes, with increased toxicity noted. These findings replicate the moderate antitumor activity of CPB, with future development possibly in combination with targeted or immunotherapy. Cancer 2018;124:537‐45. © 2017 American Cancer Society.