Citations

CRA1008 The full, final text of this abstract will be available at abstract.asco.org at 7:30 AM (EDT) on Monday, June, 3, 2013, and in the Annual Meeting Proceedings online supplement to the June 20, 2013, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Monday edition of ASCO Daily News.

660 Background: Patients (pts) with MBC previously treated with an anthracycline, a taxane and capecitabine have very limited treatment options. Ixabepilone is the first semi-synthetic analog in a new class of cytotoxic agents, the epothilones. It has shown activity in breast and other tumors. Methods: This single-arm Phase II trial was designed to assess the objective response rate (ORR) of ixabepilone in MBC pts resistant to an anthracycline, a taxane and capecitabine. Pts had to be resistant to each regimen as defined by progression within 8 wks in the metastatic setting or recurrence within 6 months (mo) of adjuvant anthracycline/taxane. Capecitabine must have been given in the metastatic setting. Response was assessed by an independent radiology review committee (IRRC; primary analysis) and by each investigator per RECIST. Ixabepilone was administered IV at 40 mg/m2 over 3 h every 3 wks. Results: A total of 126 pts were treated: median age 51 yrs (range 30–78), Karnofsky PS range 70–100% and 70% pts had baseline liver metastases. 88% pts had received ≥2 prior metastatic regimens. 113 pts were response evaluable (had target disease by IRRC and met eligibility criteria for prior therapy). Median duration of response was 5.3 mo. Stable disease (SD) was the best response in 50% pts and 14% pts had SD ≥6 mo duration. Median PFS was 3.1 mo. Pts received a median of 4 cycles (range 1–16). The most common Grade 3/4 treatment-related adverse events were sensory peripheral neuropathy (14%), fatigue (10%), myalgia (7%), and stomatitis (6%). The neuropathy was cumulative and reversible. Time to resolution (to Grade 1 or baseline) for Grade 3/4 neuropathy was 5.4 wks by Kaplan-Meier analysis. Grade 3/4 neutropenia and thrombocytopenia occurred in 54% and 7% of pts, respectively. Febrile neutropenia was reported in 3% pts. Conclusions: Ixabepilone demonstrates promising clinical activity and a manageable safety profile in patients highly resistant to standard chemotherapy. [Table: see text] [Table: see text]

AbstractBackgroundFew large studies have assessed spironolactone treatment of adult female acne.ObjectivesTo explore the role of spironolactone in the treatment of adult female acne.MethodsWe performed a retrospective case series assessing the efficacy of spironolactone treatment of a cohort of women evaluated at Mayo Clinic in Rochester, Minnesota, from 2007 through 2017.ResultsIn total, 395 patients (median age, 32 years) received a median spironolactone dose of 100 mg daily. Approximately two‐thirds of patients (66.1%) had a complete response; 85.1% had a complete response or a partial response greater than 50%. Median times to initial response and maximum response were 3 and 5 months. Efficacy was observed across all severity subtypes of acne, including those with papulopustular and nodulocystic acne. Patients received long‐term treatment with spironolactone (median duration, 13 months) and had few adverse effects.ConclusionsSpironolactone is a safe and effective treatment of acne for women.

Abstract Background Acral melanoma is the most common subtype of melanoma in Chinese patients and one of the least common in Caucasian patients. It has been unclear if outcomes differ between Chinese and Caucasian patients diagnosed with Acral Melanoma. This study investigated patient characteristics and survival differences between Chinese and Caucasian Acral Melanoma patients. Methods Two large institutional melanoma databases from Fudan University Shanghai Cancer Center (FUSCC) and Mayo Clinic enterprise, were retrospectively reviewed from 2009 to 2015. Clinicopathologic and survival data were collected and analyzed between the two groups. The primary outcome was disease-specific survival (DSS) and was calculated using the Kaplan Meier (KM) method. Results The Chinese group presented with more advanced disease compared with Caucasians: thicker Breslow depth (median 3.0 mm vs. 1.2 mm, p=0.003), more ulcerated disease (66.1% vs 29%; p<0.001), and advanced stages (stage II/III 84.3% vs. 37.1%; p<0.001). No significant difference was identified in terms of age at diagnosis, location, histologic subtypes, or node positive rate. The 5-year DSS rate was 68.4% and 73% (p=0.56) for Chinese and Caucasians, respectively. Male gender, Breslow thickness, ulceration, and positive sentinel lymph nodes predicted worse DSS on multivariate Cox regression analysis. Conclusions There appears to be no difference in stage-stratified survival between Chinese and Caucasians, supporting the implementation of clinical trials of AM that could include both Chinese and Caucasian patients.

Abstract Comparative studies reveal that the ethylenediamine and the trihydroxyindole method when employed as suggested are suitable for assessing sympatho-adrenal activation under various stressful conditions that are accompanied by release of catecholamines into the circulation. Both methods are very accurate in quantitating epinephrine or norepinephrine that has been added to plasma or whole blood, although recovery from blood is less, owing mainly to some association of catecholamines with formed elements, primarily erythrocytes. Use of sodium thiosulfate in the ethylenediamine procedure minimizes association of catecholamines with formed elements. If blood samples are cooled in ice water when collected, association of catecholamines with blood cells can be further reduced. In the trihydroxyindole method, unless tubes containing blood samples are immediately immersed in ice water, a significant amount of catecholamines will disappear from plasma, because of this association of catecholamines with cells.

Background: Gastric cancer is one of the leading causes of cancer-related mortality worldwide, accounting for 8.2% of cancer-related deaths. The purpose of this study was to investigate the geographic and sociodemographic disparities in gastric adenocarcinoma patients. Methods: We conducted a retrospective study in gastric adenocarcinoma patients between 2004 and 2013. Data were obtained from the National Cancer Data Base (NCDB). Univariate and multivariable analyses were performed to evaluate overall survival (OS). Socio-demographic factors, including the location of residence [metro area (MA) or rural area (RA)], gender, race, insurance status, and marital status, were analyzed. Results: A total of 88,246 [RA, N = 12,365; MA, N = 75,881] patients were included. Univariate and multivariable analysis showed that RA had worse OS (univariate HR = 1.08, p < 0.01; multivariate HR = 1.04; p < 0.01) compared to MA. When comparing different racial backgrounds, Native American and African American populations had poorer OS when compared to the white population; however, Asian patients had a better OS (multivariable HR = 0.68, p < 0.01). From a quality of care standpoint, MA patients had fewer median days to surgery (28 vs. 33; p < 0.01) with fewer positive margins (6.3% vs. 6.9%; p < 0.01) when compared to RA patients. When comparing the extent of lymph node dissection, 19.6% of MA patients underwent an extensive dissection (more than or equal to 15 lymph nodes) in comparison to 18.7% patients in RA (p = 0.03). Discussion: This study identifies socio-demographic disparities in gastric adenocarcinoma. Future health policy initiatives should focus on equitable allocation of resources to improve the outcomes.

PURPOSE Despite reported widespread use of dietary supplements during cancer treatment, few empirical data with regard to their safety or efficacy exist. Because of concerns that some supplements, particularly antioxidants, could reduce the cytotoxicity of chemotherapy, we conducted a prospective study ancillary to a therapeutic trial to evaluate associations between supplement use and breast cancer outcomes. METHODS Patients with breast cancer randomly assigned to an intergroup metronomic trial of cyclophosphamide, doxorubicin, and paclitaxel were queried on their use of supplements at registration and during treatment (n =1,134). Cox proportional hazards regression adjusting for clinical and lifestyle variables was used. Recurrence and survival were indexed at 6 months after enrollment using a landmark approach. RESULTS There were indications that use of any antioxidant supplement (vitamins A, C, and E; carotenoids; coenzyme Q10) both before and during treatment was associated with an increased hazard of recurrence (adjusted hazard ratio [adjHR], 1.41; 95% CI, 0.98 to 2.04; P = .06) and, to a lesser extent, death (adjHR, 1.40; 95% CI, 0.90 to 2.18; P = .14). Relationships with individual antioxidants were weaker perhaps because of small numbers. For nonantioxidants, vitamin B12 use both before and during chemotherapy was significantly associated with poorer disease-free survival (adjHR, 1.83; 95% CI, 1.15 to 2.92; P < .01) and overall survival (adjHR, 2.04; 95% CI, 1.22 to 3.40; P < .01). Use of iron during chemotherapy was significantly associated with recurrence (adjHR, 1.79; 95% CI, 1.20 to 2.67; P < .01) as was use both before and during treatment (adjHR, 1.91; 95% CI, 0.98 to 3.70; P = .06). Results were similar for overall survival. Multivitamin use was not associated with survival outcomes. CONCLUSION Associations between survival outcomes and use of antioxidant and other dietary supplements both before and during chemotherapy are consistent with recommendations for caution among patients when considering the use of supplements, other than a multivitamin, during chemotherapy.

BACKGROUND: Prolonged sitting has been shown to increase mortality and obesity. OBJECTIVE: We sought to determine whether physicians would use a treadmill desk, increase their daily physical activity and lose weight. PARTICIPANTS: 20 overweight and obese physicians aged 25 to 70 with Body Mass Index > 25. METHODS: Participants used a treadmill desk, a triaxial accelerometer, and received exercise counseling in a randomized, cross-over trial over 24 weeks. Group 1 received exercise counseling, accelerometer feedback, and a treadmill desk for 12 weeks and then accelerometer only for 12 weeks. Group 2 received an accelerometer without feedback for 12 weeks followed by exercise counseling, accelerometer feedback, and the treadmill desk for 12 weeks. RESULTS: Daily physical activity increased while using the treadmill desk compared to not using the desk by 197 kcal per day (p=0.003). The difference in weight during the two 12 week periods was 1.85 kg (p=0.03). Percent body fat was 1.9% lower while using the treadmill desk (p=0.02). There were no differences in metabolic or well-being measures. CONCLUSIONS: This study suggests that physicians will use a treadmill desk, that it does increase their activity, and that it may help with weight loss. Further studies are warranted.