Article

Key clinical point: A structured Very Low Energy Diet intervention was associated with decrease in cytokines and leptins and increase in adipokines along with significant weight loss in patients with psoriatic arthritis (PsA) and obesity, highlighting the anti-inflammatory effect of weight loss in PsA.

Major finding: At month 6, along with significant weight loss, serum levels of interleukin-23 and leptin decreased significantly, whereas that of total adiponectin and high-molecular-weight adiponectin increased significantly in patients with PsA and control individuals (P < .001 for all). The change in body mass index correlated positively with reduction in serum interleukin-23 (P < .001) and improvement in PsA disease activity (P  =  .003).

Study details: Findings are from a prospective interventional weight loss study that included patients with PsA and obesity (n = 41) and matched control individuals without rheumatic disease or psoriasis (n = 39) who were on the Very Low Energy Diet (640 kcal/day) intervention.

Disclosures: This study was financed by grants from Swedish state and other sources, and open access funding was provided by the University of Gothenburg. The authors declared no conflicts of interest.

Source: Landgren AJ et al. Serum IL-23 significantly decreased in obese patients with psoriatic arthritis six months after a structured weight loss intervention. Arthritis Res Ther. 2023;25:131 (Jul 27). doi: 10.1186/s13075-023-03105-8

Key clinical point: A structured Very Low Energy Diet intervention was associated with decrease in cytokines and leptins and increase in adipokines along with significant weight loss in patients with psoriatic arthritis (PsA) and obesity, highlighting the anti-inflammatory effect of weight loss in PsA.

Major finding: At month 6, along with significant weight loss, serum levels of interleukin-23 and leptin decreased significantly, whereas that of total adiponectin and high-molecular-weight adiponectin increased significantly in patients with PsA and control individuals (P < .001 for all). The change in body mass index correlated positively with reduction in serum interleukin-23 (P < .001) and improvement in PsA disease activity (P  =  .003).

Study details: Findings are from a prospective interventional weight loss study that included patients with PsA and obesity (n = 41) and matched control individuals without rheumatic disease or psoriasis (n = 39) who were on the Very Low Energy Diet (640 kcal/day) intervention.

Disclosures: This study was financed by grants from Swedish state and other sources, and open access funding was provided by the University of Gothenburg. The authors declared no conflicts of interest.

Source: Landgren AJ et al. Serum IL-23 significantly decreased in obese patients with psoriatic arthritis six months after a structured weight loss intervention. Arthritis Res Ther. 2023;25:131 (Jul 27). doi: 10.1186/s13075-023-03105-8

Key clinical point: A structured Very Low Energy Diet intervention was associated with decrease in cytokines and leptins and increase in adipokines along with significant weight loss in patients with psoriatic arthritis (PsA) and obesity, highlighting the anti-inflammatory effect of weight loss in PsA.

Major finding: At month 6, along with significant weight loss, serum levels of interleukin-23 and leptin decreased significantly, whereas that of total adiponectin and high-molecular-weight adiponectin increased significantly in patients with PsA and control individuals (P < .001 for all). The change in body mass index correlated positively with reduction in serum interleukin-23 (P < .001) and improvement in PsA disease activity (P  =  .003).

Study details: Findings are from a prospective interventional weight loss study that included patients with PsA and obesity (n = 41) and matched control individuals without rheumatic disease or psoriasis (n = 39) who were on the Very Low Energy Diet (640 kcal/day) intervention.

Disclosures: This study was financed by grants from Swedish state and other sources, and open access funding was provided by the University of Gothenburg. The authors declared no conflicts of interest.

Source: Landgren AJ et al. Serum IL-23 significantly decreased in obese patients with psoriatic arthritis six months after a structured weight loss intervention. Arthritis Res Ther. 2023;25:131 (Jul 27). doi: 10.1186/s13075-023-03105-8

Key clinical point: Children and young people with juvenile psoriatic arthritis (JPsA) have poorer well-being than other subsets of juvenile idiopathic arthritis (JIA), with having psoriasis at JPsA diagnosis linked with more depressive symptoms.

Major finding: Children with JPsA vs other JIA categories had 2.35-times higher odds of having persistently poor well-being scores despite improvements in joint counts and physician global scores (P  =  .013), and children with psoriasis at JPsA diagnosis scored, on average, 10 points higher on the baseline Moods and Feelings Questionnaire (co-efficient 9.77; P  =  .039).

Study details: This study evaluated 1653 children and young people with JIA who were recruited to the Childhood Arthritis Prospective Study, of whom 111 had JPsA at diagnosis.

Disclosures: This study was funded by the Cecil King Memorial Fund and other sources. The authors declared no conflicts of interest.

Source: Low JM et al for the CAPS Principal Investigators. The impact of psoriasis on wellbeing and clinical outcomes in juvenile psoriatic arthritis. Rheumatology (Oxford). 2023 (Jul 19). doi: 10.1093/rheumatology/kead370

Key clinical point: Children and young people with juvenile psoriatic arthritis (JPsA) have poorer well-being than other subsets of juvenile idiopathic arthritis (JIA), with having psoriasis at JPsA diagnosis linked with more depressive symptoms.

Major finding: Children with JPsA vs other JIA categories had 2.35-times higher odds of having persistently poor well-being scores despite improvements in joint counts and physician global scores (P  =  .013), and children with psoriasis at JPsA diagnosis scored, on average, 10 points higher on the baseline Moods and Feelings Questionnaire (co-efficient 9.77; P  =  .039).

Study details: This study evaluated 1653 children and young people with JIA who were recruited to the Childhood Arthritis Prospective Study, of whom 111 had JPsA at diagnosis.

Disclosures: This study was funded by the Cecil King Memorial Fund and other sources. The authors declared no conflicts of interest.

Source: Low JM et al for the CAPS Principal Investigators. The impact of psoriasis on wellbeing and clinical outcomes in juvenile psoriatic arthritis. Rheumatology (Oxford). 2023 (Jul 19). doi: 10.1093/rheumatology/kead370

Key clinical point: Children and young people with juvenile psoriatic arthritis (JPsA) have poorer well-being than other subsets of juvenile idiopathic arthritis (JIA), with having psoriasis at JPsA diagnosis linked with more depressive symptoms.

Major finding: Children with JPsA vs other JIA categories had 2.35-times higher odds of having persistently poor well-being scores despite improvements in joint counts and physician global scores (P  =  .013), and children with psoriasis at JPsA diagnosis scored, on average, 10 points higher on the baseline Moods and Feelings Questionnaire (co-efficient 9.77; P  =  .039).

Study details: This study evaluated 1653 children and young people with JIA who were recruited to the Childhood Arthritis Prospective Study, of whom 111 had JPsA at diagnosis.

Disclosures: This study was funded by the Cecil King Memorial Fund and other sources. The authors declared no conflicts of interest.

Source: Low JM et al for the CAPS Principal Investigators. The impact of psoriasis on wellbeing and clinical outcomes in juvenile psoriatic arthritis. Rheumatology (Oxford). 2023 (Jul 19). doi: 10.1093/rheumatology/kead370

Key clinical point: Whole blood DNA methylation patterns measured before the onset of musculoskeletal symptoms can help distinguish patients with psoriasis who will develop psoriatic arthritis (PsA) from those who will not.

Major finding: The model based on 36 highly relevant methylation markers across 15 genes and intergenic regions (false discovery rate-adjusted P < .05; minimum change in methylation of 0.05) could identify patients with psoriasis who developed PsA from those who did not with an area under the receiver operating characteristic curve of 0.964.

Study details: Findings are from a nested case-control study including patients with psoriasis who later developed PsA (n = 58) matched with patients who did not develop PsA (n = 59).

Disclosures: This study was partly supported by an Early Career Research Grant awarded to RA Pollock from the National Psoriasis Foundation. The authors declared no conflicts of interest.

Source: Cruz-Correa OF et al. Prediction of psoriatic arthritis in patients with psoriasis using DNA methylation profiles. Arthritis Rheumatol. 2023 (Jul 18). doi: 10.1002/art.42654

Key clinical point: Whole blood DNA methylation patterns measured before the onset of musculoskeletal symptoms can help distinguish patients with psoriasis who will develop psoriatic arthritis (PsA) from those who will not.

Major finding: The model based on 36 highly relevant methylation markers across 15 genes and intergenic regions (false discovery rate-adjusted P < .05; minimum change in methylation of 0.05) could identify patients with psoriasis who developed PsA from those who did not with an area under the receiver operating characteristic curve of 0.964.

Study details: Findings are from a nested case-control study including patients with psoriasis who later developed PsA (n = 58) matched with patients who did not develop PsA (n = 59).

Disclosures: This study was partly supported by an Early Career Research Grant awarded to RA Pollock from the National Psoriasis Foundation. The authors declared no conflicts of interest.

Source: Cruz-Correa OF et al. Prediction of psoriatic arthritis in patients with psoriasis using DNA methylation profiles. Arthritis Rheumatol. 2023 (Jul 18). doi: 10.1002/art.42654

Key clinical point: Whole blood DNA methylation patterns measured before the onset of musculoskeletal symptoms can help distinguish patients with psoriasis who will develop psoriatic arthritis (PsA) from those who will not.

Major finding: The model based on 36 highly relevant methylation markers across 15 genes and intergenic regions (false discovery rate-adjusted P < .05; minimum change in methylation of 0.05) could identify patients with psoriasis who developed PsA from those who did not with an area under the receiver operating characteristic curve of 0.964.

Study details: Findings are from a nested case-control study including patients with psoriasis who later developed PsA (n = 58) matched with patients who did not develop PsA (n = 59).

Disclosures: This study was partly supported by an Early Career Research Grant awarded to RA Pollock from the National Psoriasis Foundation. The authors declared no conflicts of interest.

Source: Cruz-Correa OF et al. Prediction of psoriatic arthritis in patients with psoriasis using DNA methylation profiles. Arthritis Rheumatol. 2023 (Jul 18). doi: 10.1002/art.42654

Key clinical point: Association of body mass index (BMI) with cardiometabolic risk score (CRS) and obesity-related protein score (OPS) and the relation between CRS and OPS in postmenopausal women indicated that weight control for the reduction of cardiometabolic risks may also help prevent breast cancer (BC).

Major finding: A 1-kg/m² increase in BMI per year increased CRS in both premenopausal (0.057 units; P = .025) and postmenopausal women (0.054 units; P = .033) and increased OPS by 0.588 units (P = .001) in postmenopausal women. A significant association was also observed between CRS and OPS in post-menopausal women (β 0.281, P = .034).

Study details: This longitudinal study included 444 healthy women age 35-64 years.

Disclosures: This study was funded by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Xu B et al. Temporal relationships between BMI and obesity-related predictors of cardiometabolic and breast cancer risk in a longitudinal cohort. Sci Rep. 2023;13:12361 (Jul 31). doi: 10.1038/s41598-023-39387-w

Key clinical point: Association of body mass index (BMI) with cardiometabolic risk score (CRS) and obesity-related protein score (OPS) and the relation between CRS and OPS in postmenopausal women indicated that weight control for the reduction of cardiometabolic risks may also help prevent breast cancer (BC).

Major finding: A 1-kg/m² increase in BMI per year increased CRS in both premenopausal (0.057 units; P = .025) and postmenopausal women (0.054 units; P = .033) and increased OPS by 0.588 units (P = .001) in postmenopausal women. A significant association was also observed between CRS and OPS in post-menopausal women (β 0.281, P = .034).

Study details: This longitudinal study included 444 healthy women age 35-64 years.

Disclosures: This study was funded by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Xu B et al. Temporal relationships between BMI and obesity-related predictors of cardiometabolic and breast cancer risk in a longitudinal cohort. Sci Rep. 2023;13:12361 (Jul 31). doi: 10.1038/s41598-023-39387-w

Key clinical point: Association of body mass index (BMI) with cardiometabolic risk score (CRS) and obesity-related protein score (OPS) and the relation between CRS and OPS in postmenopausal women indicated that weight control for the reduction of cardiometabolic risks may also help prevent breast cancer (BC).

Major finding: A 1-kg/m² increase in BMI per year increased CRS in both premenopausal (0.057 units; P = .025) and postmenopausal women (0.054 units; P = .033) and increased OPS by 0.588 units (P = .001) in postmenopausal women. A significant association was also observed between CRS and OPS in post-menopausal women (β 0.281, P = .034).

Study details: This longitudinal study included 444 healthy women age 35-64 years.

Disclosures: This study was funded by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Xu B et al. Temporal relationships between BMI and obesity-related predictors of cardiometabolic and breast cancer risk in a longitudinal cohort. Sci Rep. 2023;13:12361 (Jul 31). doi: 10.1038/s41598-023-39387-w

Key clinical point: Women, particularly post-menopausal women, with diabetes mellitus (DM) faced a higher risk of developing different subtypes of breast cancer (BC).

Major finding: Women with DM had a 20% greater risk of developing BC (risk ratio [RR] 1.20; 95% CI 1.11-1.29), with the risk persisting only in postmenopausal women (RR 1.12; 95% CI 1.07-1.17). The risk of estrogen receptor-negative BC (RR 1.16; 95% CI 1.04-1.30) and triple-negative BC (RR 1.41; 95% CI 1.01-1.96) subtypes increased in patients with DM.

Study details: This meta-analysis of 70 cohort and case-control studies included premenopausal and postmenopausal women with or without DM who developed BC.

Disclosures: JM Chan received funding from the Cancer League Foundation. RE Graff, the corresponding author, declared being supported by a Young Investigator Award from the Prostate Cancer Foundation.

Source: Xiong F et al. Diabetes and incidence of breast cancer and its molecular subtypes: A systematic review and meta-analysis. Diabetes Metab Res Rev. 2023;e3709 (Aug 7). doi: 10.1002/dmrr.3709

Key clinical point: Women, particularly post-menopausal women, with diabetes mellitus (DM) faced a higher risk of developing different subtypes of breast cancer (BC).

Major finding: Women with DM had a 20% greater risk of developing BC (risk ratio [RR] 1.20; 95% CI 1.11-1.29), with the risk persisting only in postmenopausal women (RR 1.12; 95% CI 1.07-1.17). The risk of estrogen receptor-negative BC (RR 1.16; 95% CI 1.04-1.30) and triple-negative BC (RR 1.41; 95% CI 1.01-1.96) subtypes increased in patients with DM.

Study details: This meta-analysis of 70 cohort and case-control studies included premenopausal and postmenopausal women with or without DM who developed BC.

Disclosures: JM Chan received funding from the Cancer League Foundation. RE Graff, the corresponding author, declared being supported by a Young Investigator Award from the Prostate Cancer Foundation.

Source: Xiong F et al. Diabetes and incidence of breast cancer and its molecular subtypes: A systematic review and meta-analysis. Diabetes Metab Res Rev. 2023;e3709 (Aug 7). doi: 10.1002/dmrr.3709

Key clinical point: Women, particularly post-menopausal women, with diabetes mellitus (DM) faced a higher risk of developing different subtypes of breast cancer (BC).

Major finding: Women with DM had a 20% greater risk of developing BC (risk ratio [RR] 1.20; 95% CI 1.11-1.29), with the risk persisting only in postmenopausal women (RR 1.12; 95% CI 1.07-1.17). The risk of estrogen receptor-negative BC (RR 1.16; 95% CI 1.04-1.30) and triple-negative BC (RR 1.41; 95% CI 1.01-1.96) subtypes increased in patients with DM.

Study details: This meta-analysis of 70 cohort and case-control studies included premenopausal and postmenopausal women with or without DM who developed BC.

Disclosures: JM Chan received funding from the Cancer League Foundation. RE Graff, the corresponding author, declared being supported by a Young Investigator Award from the Prostate Cancer Foundation.

Source: Xiong F et al. Diabetes and incidence of breast cancer and its molecular subtypes: A systematic review and meta-analysis. Diabetes Metab Res Rev. 2023;e3709 (Aug 7). doi: 10.1002/dmrr.3709

Key clinical point: Use of metformin reduced the incidence of paclitaxel-induced peripheral neuropathy in patients with breast cancer (BC).

Major finding: A significantly lower proportion of patients receiving metformin vs placebo had grade 2 paclitaxel-induced peripheral neuropathy (36.1% vs 67.6%; P = .007).

Study details: This parallel-group trial included 73 patients with BC who were randomly assigned to receive either metformin or placebo 1 week before initiating treatment with paclitaxel.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Bakry HM et al. Efficacy of metformin in prevention of paclitaxel-induced peripheral neuropathy in breast cancer patients: A randomized controlled trial. Front Pharmacol. 2023;14:1181312 (Jul 31). doi: 10.3389/fphar.2023.1181312

Key clinical point: Use of metformin reduced the incidence of paclitaxel-induced peripheral neuropathy in patients with breast cancer (BC).

Major finding: A significantly lower proportion of patients receiving metformin vs placebo had grade 2 paclitaxel-induced peripheral neuropathy (36.1% vs 67.6%; P = .007).

Study details: This parallel-group trial included 73 patients with BC who were randomly assigned to receive either metformin or placebo 1 week before initiating treatment with paclitaxel.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Bakry HM et al. Efficacy of metformin in prevention of paclitaxel-induced peripheral neuropathy in breast cancer patients: A randomized controlled trial. Front Pharmacol. 2023;14:1181312 (Jul 31). doi: 10.3389/fphar.2023.1181312

Key clinical point: Use of metformin reduced the incidence of paclitaxel-induced peripheral neuropathy in patients with breast cancer (BC).

Major finding: A significantly lower proportion of patients receiving metformin vs placebo had grade 2 paclitaxel-induced peripheral neuropathy (36.1% vs 67.6%; P = .007).

Study details: This parallel-group trial included 73 patients with BC who were randomly assigned to receive either metformin or placebo 1 week before initiating treatment with paclitaxel.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Bakry HM et al. Efficacy of metformin in prevention of paclitaxel-induced peripheral neuropathy in breast cancer patients: A randomized controlled trial. Front Pharmacol. 2023;14:1181312 (Jul 31). doi: 10.3389/fphar.2023.1181312

Key clinical point: In postmenopausal women with estrogen receptor-positive (ER+) human epidermal growth factor receptor 2-positive (HER2+) advanced or metastatic breast cancer (BC), 500 mg fulvestrant (F500) with or without anti-HER2 therapy prolonged the time to treatment failure (TTF) in first- and second-line settings and improved the overall survival (OS) outcomes in those who received chemotherapy-free initial systemic therapy and required longer time to chemotherapy (TTC).

Major finding: F500 improved TTF in the first- and second-line vs third- or later-lines of therapy (6.6 vs 3.7 months; P = .014) and OS in patients who received chemotherapy-free initial systemic therapy and had TTC ≥ 3 years vs < 3 years (hazard ratio 0.32; P = .001).

Study details: This study analyzed 94 postmenopausal women with ER+/HER2+ advanced or metastatic BC from the SAFARI study who received F500 with or without anti-HER2 therapy.

Disclosures: This study was sponsored by Japan Breast Cancer Research Group and AstraZeneca. Several authors declared ties with various sources, including the funding agencies.

Source: Masuyama M et al. Fulvestrant with or without anti-HER2 therapy in patients in a postmenopausal hormonal state and with ER-positive HER2-positive advanced or metastatic breast cancer: A subgroup analysis of data from the Safari study (JBCRG-C06). Cancer Med. 2023 (Aug 1). doi: 10.1002/cam4.6390

Key clinical point: In postmenopausal women with estrogen receptor-positive (ER+) human epidermal growth factor receptor 2-positive (HER2+) advanced or metastatic breast cancer (BC), 500 mg fulvestrant (F500) with or without anti-HER2 therapy prolonged the time to treatment failure (TTF) in first- and second-line settings and improved the overall survival (OS) outcomes in those who received chemotherapy-free initial systemic therapy and required longer time to chemotherapy (TTC).

Major finding: F500 improved TTF in the first- and second-line vs third- or later-lines of therapy (6.6 vs 3.7 months; P = .014) and OS in patients who received chemotherapy-free initial systemic therapy and had TTC ≥ 3 years vs < 3 years (hazard ratio 0.32; P = .001).

Study details: This study analyzed 94 postmenopausal women with ER+/HER2+ advanced or metastatic BC from the SAFARI study who received F500 with or without anti-HER2 therapy.

Disclosures: This study was sponsored by Japan Breast Cancer Research Group and AstraZeneca. Several authors declared ties with various sources, including the funding agencies.

Source: Masuyama M et al. Fulvestrant with or without anti-HER2 therapy in patients in a postmenopausal hormonal state and with ER-positive HER2-positive advanced or metastatic breast cancer: A subgroup analysis of data from the Safari study (JBCRG-C06). Cancer Med. 2023 (Aug 1). doi: 10.1002/cam4.6390

Key clinical point: In postmenopausal women with estrogen receptor-positive (ER+) human epidermal growth factor receptor 2-positive (HER2+) advanced or metastatic breast cancer (BC), 500 mg fulvestrant (F500) with or without anti-HER2 therapy prolonged the time to treatment failure (TTF) in first- and second-line settings and improved the overall survival (OS) outcomes in those who received chemotherapy-free initial systemic therapy and required longer time to chemotherapy (TTC).

Major finding: F500 improved TTF in the first- and second-line vs third- or later-lines of therapy (6.6 vs 3.7 months; P = .014) and OS in patients who received chemotherapy-free initial systemic therapy and had TTC ≥ 3 years vs < 3 years (hazard ratio 0.32; P = .001).

Study details: This study analyzed 94 postmenopausal women with ER+/HER2+ advanced or metastatic BC from the SAFARI study who received F500 with or without anti-HER2 therapy.

Disclosures: This study was sponsored by Japan Breast Cancer Research Group and AstraZeneca. Several authors declared ties with various sources, including the funding agencies.

Source: Masuyama M et al. Fulvestrant with or without anti-HER2 therapy in patients in a postmenopausal hormonal state and with ER-positive HER2-positive advanced or metastatic breast cancer: A subgroup analysis of data from the Safari study (JBCRG-C06). Cancer Med. 2023 (Aug 1). doi: 10.1002/cam4.6390

Key clinical point: Adjuvant radiotherapy (RT) following breast-conserving surgery (BCS) improved survival outcomes in women age ≥ 70 years with T1-2N0 estrogen receptor-negative (ER−) breast cancer (BC); however, patients age ≥ 80 years or those with T1mic+T1a, T1b tumors did not benefit from it.

Major finding: Overall survival (hazard ratio [HR] 0.62; P < .001) and BC-specific survival (HR 0.71; P = .002) improved significantly in patients who received vs did not receive adjuvant RT. Patients age ≥ 80 years (P = .056) or with clinical stage T1mic+T1a (P = .543) or T1b (P = .329) tumors did not show improvement in OS after receiving RT.

Study details: This study included 4201 women with T1-2N0 ER− BC (from the Surveillance, Epidemiology, and End Results [SEER] study) who were age ≥ 70 years and underwent BCS, of which 2811 women received adjuvant RT.

Disclosures: This study was supported by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Chen C et al. The effect of adjuvant radiotherapy after breast-conserving surgery in elderly women with T1-2N0 estrogen receptor-negative breast cancer. PLoS One. 2023;18(8):e0288078 (Aug 3). doi: 10.1371/journal.pone.0288078

Key clinical point: Adjuvant radiotherapy (RT) following breast-conserving surgery (BCS) improved survival outcomes in women age ≥ 70 years with T1-2N0 estrogen receptor-negative (ER−) breast cancer (BC); however, patients age ≥ 80 years or those with T1mic+T1a, T1b tumors did not benefit from it.

Major finding: Overall survival (hazard ratio [HR] 0.62; P < .001) and BC-specific survival (HR 0.71; P = .002) improved significantly in patients who received vs did not receive adjuvant RT. Patients age ≥ 80 years (P = .056) or with clinical stage T1mic+T1a (P = .543) or T1b (P = .329) tumors did not show improvement in OS after receiving RT.

Study details: This study included 4201 women with T1-2N0 ER− BC (from the Surveillance, Epidemiology, and End Results [SEER] study) who were age ≥ 70 years and underwent BCS, of which 2811 women received adjuvant RT.

Disclosures: This study was supported by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Chen C et al. The effect of adjuvant radiotherapy after breast-conserving surgery in elderly women with T1-2N0 estrogen receptor-negative breast cancer. PLoS One. 2023;18(8):e0288078 (Aug 3). doi: 10.1371/journal.pone.0288078

Key clinical point: Adjuvant radiotherapy (RT) following breast-conserving surgery (BCS) improved survival outcomes in women age ≥ 70 years with T1-2N0 estrogen receptor-negative (ER−) breast cancer (BC); however, patients age ≥ 80 years or those with T1mic+T1a, T1b tumors did not benefit from it.

Major finding: Overall survival (hazard ratio [HR] 0.62; P < .001) and BC-specific survival (HR 0.71; P = .002) improved significantly in patients who received vs did not receive adjuvant RT. Patients age ≥ 80 years (P = .056) or with clinical stage T1mic+T1a (P = .543) or T1b (P = .329) tumors did not show improvement in OS after receiving RT.

Study details: This study included 4201 women with T1-2N0 ER− BC (from the Surveillance, Epidemiology, and End Results [SEER] study) who were age ≥ 70 years and underwent BCS, of which 2811 women received adjuvant RT.

Disclosures: This study was supported by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Chen C et al. The effect of adjuvant radiotherapy after breast-conserving surgery in elderly women with T1-2N0 estrogen receptor-negative breast cancer. PLoS One. 2023;18(8):e0288078 (Aug 3). doi: 10.1371/journal.pone.0288078

Key clinical point: Decreased levels of plasma apolipoprotein M (APOM) were associated with worsened mortality outcomes in patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor-2 negative (HER2−) metastatic breast cancer (BC).

Major finding: Mean baseline plasma APOM levels were significantly lower in patients who had deceased vs survived during the 24-month follow-up period (42.7 vs 52.2 µg/mL; P = .003), and the doubling of plasma APOM levels was associated with an improvement in the overall survival outcomes (adjusted hazard ratio 0.23; P = .001).

Study details: This study measured APOM plasma levels in 75 patients with ER+/HER2− metastatic BC.

Disclosures: This study was partly sponsored by the European Regional Development fund. The authors declared no conflicts of interest.

Source: Muendlein A et al. Plasma apolipoprotein M predicts overall survival in metastatic breast cancer patients. Breast Cancer Res Treat. 2023 (Jul 25). doi: 10.1007/s10549-023-07045-4

Key clinical point: Decreased levels of plasma apolipoprotein M (APOM) were associated with worsened mortality outcomes in patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor-2 negative (HER2−) metastatic breast cancer (BC).

Major finding: Mean baseline plasma APOM levels were significantly lower in patients who had deceased vs survived during the 24-month follow-up period (42.7 vs 52.2 µg/mL; P = .003), and the doubling of plasma APOM levels was associated with an improvement in the overall survival outcomes (adjusted hazard ratio 0.23; P = .001).

Study details: This study measured APOM plasma levels in 75 patients with ER+/HER2− metastatic BC.

Disclosures: This study was partly sponsored by the European Regional Development fund. The authors declared no conflicts of interest.

Source: Muendlein A et al. Plasma apolipoprotein M predicts overall survival in metastatic breast cancer patients. Breast Cancer Res Treat. 2023 (Jul 25). doi: 10.1007/s10549-023-07045-4

Key clinical point: Decreased levels of plasma apolipoprotein M (APOM) were associated with worsened mortality outcomes in patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor-2 negative (HER2−) metastatic breast cancer (BC).

Major finding: Mean baseline plasma APOM levels were significantly lower in patients who had deceased vs survived during the 24-month follow-up period (42.7 vs 52.2 µg/mL; P = .003), and the doubling of plasma APOM levels was associated with an improvement in the overall survival outcomes (adjusted hazard ratio 0.23; P = .001).

Study details: This study measured APOM plasma levels in 75 patients with ER+/HER2− metastatic BC.

Disclosures: This study was partly sponsored by the European Regional Development fund. The authors declared no conflicts of interest.

Source: Muendlein A et al. Plasma apolipoprotein M predicts overall survival in metastatic breast cancer patients. Breast Cancer Res Treat. 2023 (Jul 25). doi: 10.1007/s10549-023-07045-4

Key clinical point: Omission of axillary lymph node dissection (ALND) was associated with lymph node understaging but had no impact on systemic therapy recommendations in patients with clinically node-positive breast cancer (cN+ BC).

Major finding: A higher proportion of patients undergoing ALND vs receiving axillary radiotherapy (ART) were detected with ≥ 4 positive nodes (58.9% vs 33.8%). ALND was not associated with the proportion of patients receiving adjuvant chemotherapy after upfront surgery (adjusted odds ratio [aOR] 0.72; 95% CI 0.19-2.67) or systemic therapy after neoadjuvant chemotherapy (aOR 0.86; 95% CI 0.43-1.70).

Study details: Findings are from a prospective, observational cohort study including 500 patients with cN+ BC who underwent tailored axillary surgery and were randomly assigned to undergo ALND or receive ART.

Disclosures: This study was supported by the Swiss State Secretariat for Education, Research and Innovation, and other sources. Some authors declared receiving grants, personal fees, speaker fees, patient fees or having other ties with various sources including the funding source.

Source: Weber WP et al and the TAXIS Study Writing Group . Association of axillary dissection with systemic therapy in patients with clinically node-positive breast cancer. JAMA Surg. 2023 (Jul 19). doi: 10.1001/jamasurg.2023.2840

Key clinical point: Omission of axillary lymph node dissection (ALND) was associated with lymph node understaging but had no impact on systemic therapy recommendations in patients with clinically node-positive breast cancer (cN+ BC).

Major finding: A higher proportion of patients undergoing ALND vs receiving axillary radiotherapy (ART) were detected with ≥ 4 positive nodes (58.9% vs 33.8%). ALND was not associated with the proportion of patients receiving adjuvant chemotherapy after upfront surgery (adjusted odds ratio [aOR] 0.72; 95% CI 0.19-2.67) or systemic therapy after neoadjuvant chemotherapy (aOR 0.86; 95% CI 0.43-1.70).

Study details: Findings are from a prospective, observational cohort study including 500 patients with cN+ BC who underwent tailored axillary surgery and were randomly assigned to undergo ALND or receive ART.

Disclosures: This study was supported by the Swiss State Secretariat for Education, Research and Innovation, and other sources. Some authors declared receiving grants, personal fees, speaker fees, patient fees or having other ties with various sources including the funding source.

Source: Weber WP et al and the TAXIS Study Writing Group . Association of axillary dissection with systemic therapy in patients with clinically node-positive breast cancer. JAMA Surg. 2023 (Jul 19). doi: 10.1001/jamasurg.2023.2840

Key clinical point: Omission of axillary lymph node dissection (ALND) was associated with lymph node understaging but had no impact on systemic therapy recommendations in patients with clinically node-positive breast cancer (cN+ BC).

Major finding: A higher proportion of patients undergoing ALND vs receiving axillary radiotherapy (ART) were detected with ≥ 4 positive nodes (58.9% vs 33.8%). ALND was not associated with the proportion of patients receiving adjuvant chemotherapy after upfront surgery (adjusted odds ratio [aOR] 0.72; 95% CI 0.19-2.67) or systemic therapy after neoadjuvant chemotherapy (aOR 0.86; 95% CI 0.43-1.70).

Study details: Findings are from a prospective, observational cohort study including 500 patients with cN+ BC who underwent tailored axillary surgery and were randomly assigned to undergo ALND or receive ART.

Disclosures: This study was supported by the Swiss State Secretariat for Education, Research and Innovation, and other sources. Some authors declared receiving grants, personal fees, speaker fees, patient fees or having other ties with various sources including the funding source.

Source: Weber WP et al and the TAXIS Study Writing Group . Association of axillary dissection with systemic therapy in patients with clinically node-positive breast cancer. JAMA Surg. 2023 (Jul 19). doi: 10.1001/jamasurg.2023.2840