Delays in Referral to Multidisciplinary Care for Black Individuals With Sarcoidosis.

Background: Sarcoidosis is a complex granulomatous disease that benefits from multidisciplinary subspecialty expertise. Inequitable access to care contributes to racial disparities in many diseases; however, to our knowledge, no studies have examined racial differences in referral times to Sarcoidosis Centers of Excellence.

Research Question: Is there an association between race and time from sarcoidosis diagnosis to referral to an independently certified, peer-reviewed World Association of Sarcoidosis and Other Granulomatous Disorders Center of Excellence? Does a referral result in a change in sarcoidosis management?

Study Design And Methods: We retrospectively reviewed all 2021 referrals to the Johns Hopkins Sarcoidosis Center of Excellence.

Immunoprofiling at an Institutional Scale Reveals That High Numbers of Intratumoral CD8 and PD-1 Cells Predict Superior Patient Survival Across Major Cancer Types Independent of Major Risk Factors.

Purpose: Retrospective studies have found associations between the number of intratumoral immune cells and patient outcomes for specific cancers treated with targeted therapies. However, the clinical value of routinely quantifying intratumoral immune biomarkers using a digital pathology platform in the pan-cancer setting within an active clinical laboratory has not been established.

Methods: We developed ImmunoProfile, a daily clinical workflow that integrates automated multiplex immunofluorescence tissue staining, digital slide imaging, and machine learning-assisted scoring to quantify intratumoral CD8, PD-1, CD8PD-1, and FOXP3 immune cells and PD-L1 expression in formalin-fixed, paraffin-embedded tissue samples in a standardized and reproducible manner.

Measurement quality metrics to improve absolute microbial cell counting.

Total and viable microbial cell counts are increasingly important for applications including live biotherapeutic products, food safety, and probiotics. In microbiology, cells are quantified using methods such as colony forming unit (CFU), flow cytometry, and polymerase chain reaction (PCR), but different methods measure different aspects of the cells (measurands), and results may not be directly comparable across methods. In the absence of a ground-truth reference material for cell count, one cannot quantify the accuracy of any cell counting method, which limits method performance assessments and comparisons.

The association between young age at metastatic breast cancer diagnosis and overall survival in the EMBRACE study.

The influence of young age at diagnosis on prognosis of patients with metastatic breast cancer (MBC) remains unclear. We examined overall survival (OS) within a single-institution prospective study of patients with de novo or recurrent MBC. Kaplan-Meier curves assessed OS by age (≤35 or ≤40 years as the youngest category) and inferred metastatic tumor subtype.

Case Report: Unlocking opportunities in HER2-targeted antibody-drug conjugates for bulky leptomeningeal metastatic breast cancer.

Leptomeningeal carcinomatosis (LC) is a severe complication of metastatic breast cancer (mBC), with rising incidence. The prognosis for patients with LC has been poor, with a median overall survival of approximately four months. However, recent therapeutic advances, in particular the introduction of trastuzumab deruxtecan have dramatically changed the landscape of CNS metastases and improved outcomes.

Outcomes of subsequent treatment regimens after trastuzumab deruxtecan in patients with metastatic breast cancer.

Background: Most patients with metastatic breast cancer (MBC) are eligible for treatment with trastuzumab deruxtecan (T-DXd). No data are available to guide treatment after exposure to T-DXd.

Methods: We utilized a nationwide electronic health record-derived, deidentified database to review data of patients with MBC who initiated T-DXd between 12/2019 and 9/2023 and who received an additional line of treatment after T-DXd.

The Impact of the Unknown: Patient Experiences With Uncertainty in Sarcoidosis.

Background: Individuals with sarcoidosis face many sources of illness uncertainty, including diagnostic delays, unpredictable therapeutic efficacy and toxicity, and disease-associated morbidity and mortality. Patient perspectives on illness uncertainty in sarcoidosis have not been evaluated critically and offer an opportunity for providers to contextualize and prioritize gaps in care and patient support.

Research Question: How do patients with sarcoidosis describe their lived experiences with the disease and challenges they face in receiving care?

Study Design And Methods: We conducted semistructured qualitative interviews with patients with biopsy-proven pulmonary sarcoidosis receiving treatment for the disease who were seen at a tertiary sarcoidosis center of excellence.

Palazestrant, a novel oral Complete Estrogen Receptor Antagonist (CERAN) and Selective Estrogen Receptor Degrader (SERD), in patients with ER+/HER2- advanced or metastatic breast cancer: phase 1/2 study results.

Background: Endocrine resistance is a major challenge in treating patients with ER+ /HER2- metastatic breast cancer (MBC) necessitating a switch from endocrine therapy to more toxic therapies. Mutations in ESR1 constitute a key mechanism of resistance to endocrine therapy in ER+ /HER2- BC. Therapies that overcome endocrine resistance are needed.

A Randomized Phase 2 Study of Neratinib With or Without Fulvestrant for Patients With HER2-Positive, Estrogen Receptor-Positive Metastatic Breast Cancer.

Background: Most HER2-positive breast cancers co-express estrogen receptor (ER). Given crosstalk between HER2 and ER signaling pathways, dual blockade may be beneficial.

Methods: In this randomized, open-label, phase 2 clinical trial, patients with ER-positive (ER ≥ 10%), HER2-positive metastatic breast cancer were randomized (1:1) to neratinib (240 mg daily) or the same dose of neratinib with fulvestrant.

Accuracy and Reproducibility of ChatGPT Responses to Breast Cancer Tumor Board Patients.

Purpose: We assessed the accuracy and reproducibility of Chat Generative Pre-Trained Transformer's (ChatGPT) recommendations in response to breast cancer patients by comparing generated outputs with consensus expert opinions.

Methods: 362 consecutive breast cancer patients sourced from a weekly international breast cancer webinar series were submitted to a tumor board of renowned experts. The same 362 clinical patients were also prompted to ChatGPT-4.

Patterns of presentation, treatment, and survival among older adults with metastatic breast cancer: Results from a large prospective registry.

Introduction: Older adults with breast cancer experience worse survival than their younger counterparts. However, data are limited on the patterns of presentation, treatment, and outcomes for older patients with metastatic breast cancer (MBC) outside of registry studies and selected clinical trial populations.

Materials And Methods: We identified patients aged ≥60 years from a single, NCI-designated cancer center with MBC diagnosed between 1999 and 2022.

Clinicogenomic Characterization of Inflammatory Breast Cancer.

Purpose: Inflammatory breast cancer (IBC) is a rare and clinically distinct form of breast cancer associated with poor outcomes. The biological mechanisms driving IBC remain poorly understood, partly due to limited large-scale genomic studies that directly compare IBC with non-IBC cases.

Experimental Design: We conducted a retrospective analysis of 140 patients with IBC (68 primary tumors and 72 metastatic tumors) and 2,317 patients with non-IBC (700 primary tumors, 65 local recurrences, and 1,552 metastases).

Nivolumab plus low-dose ipilimumab in hypermutated HER2-negative metastatic breast cancer: a phase II trial (NIMBUS).

In the phase II NIMBUS trial, patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) and high tumor mutational burden (TMB ≥ 9 mut/Mb) received nivolumab (3 mg/kg biweekly) and low-dose ipilimumab (1 mg/kg every 6 weeks) for 2 years or until progression. The primary endpoint was objective response rate (ORR) per RECIST 1.1 criteria.

RANO criteria for response assessment of brain metastases based on amino acid PET imaging.

Novel diagnostic and therapeutic opportunities are needed to improve medical care and outcome of patients with brain metastases, a frequent and severe complication of several cancer types. Currently, magnetic resonance imaging (MRI) is the primary method used for detection, treatment planning and disease monitoring in patients with brain metastases, but this method has limitations. These limitations mean that MRI can inform on lesion size but cannot directly measure the activity or viability of tumor tissue.

Prevalence by therapy line and incidence of breast cancer brain metastases in 18 075 patients.

Importance: Brain metastases portend poor prognosis in patients with metastatic breast cancer (MBC). Designing treatment and prevention clinical trials requires knowledge of brain metastases incidence with each line of therapy.

Objectives: We assessed the prevalence and cumulative incidence of brain metastases in a large MBC patient cohort by subtype and line of therapy, and the impact of HER2-low expression on prevalence.

A Phase II Study of Abemaciclib for Patients with Retinoblastoma-Positive, Metastatic Triple-Negative Breast Cancer.

Purpose: Cyclin-dependent kinase 4/6 inhibitors can significantly extend survival when given in combination with endocrine therapy in patients with hormone receptor-positive metastatic breast cancer. However, their activity has been relatively underexplored in patients with metastatic triple-negative breast cancer (mTNBC).

Patients And Methods: We conducted a single-arm phase II study of abemaciclib monotherapy in patients with Rb-positive mTNBC.

Outcomes and treatment patterns for stage I human epidermal growth factor receptor 2-positive breast cancer in the Surveillance, Epidemiology, and End Results database, 2010-2019.

Background: The risk of recurrence in patients with small, lymph node-negative, human epidermal growth factor receptor 2 (HER2)-positive breast cancers untreated with adjuvant chemotherapy/HER2-directed therapy is uncertain. To investigate this, the authors conducted a retrospective, population-based study of chemotherapy use and breast cancer-specific survival (BCSS) among patients with stage IA HER2-positive breast cancer.

Methods: The authors analyzed Surveillance, Epidemiology, and End Results data from patients diagnosed with stage IA HER2-positive breast cancer from 2010 to 2019.

Factors Associated With Short- and Long-Term Survival in Metastatic HER2-Positive Breast Cancer.

Background: We sought to evaluate prognostic factors in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) and their relationship with short- and long-term overall survival (OS).

Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we evaluated patients with de novo HER2-positive MBC diagnosed from 2010 to 2018. Univariate analyses were performed to determine effect of each variable on OS.

Central Nervous System Metastases in Breast Cancer.

Breast cancer metastasizing to the central nervous system (CNS) encompasses two distinct entities: brain metastases involving the cerebral parenchyma and infiltration of the leptomeningeal space, i.e., leptomeningeal disease.

Cannabidiol for Scan-Related Anxiety in Women With Advanced Breast Cancer: A Randomized Clinical Trial.

Importance: Early evidence from studies outside of oncology has suggested that cannabidiol (CBD) may have anxiolytic effects without neuropsychiatric risks. An understanding of oral CBD in patients with cancer-related anxiety is urgently needed.

Objective: To determine whether a single 400-mg oral dose of a US Food and Drug Administration-approved CBD improves clinical anxiety in an oncologic population.

Race and clinical outcomes in hormone receptor-positive, HER2-negative, node-positive breast cancer in the randomized RxPONDER trial.

Background: The phase III RxPONDER trial has affected treatment for node-positive (1-3), hormone receptor-positive, HER2-negative breast cancer with a 21-gene recurrence score (RS) less than 26. We investigated how these findings apply to different racial and ethnic groups within the trial.

Methods: The trial randomly assigned women to endocrine therapy (ET) or to chemotherapy plus ET.