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  • 1
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 81, No. 4_Supplement ( 2021-02-15), p. OT-03-07-OT-03-07
    Abstract: Background: Overexpression of human epidermal growth factor receptor 2 (HER2) occurs in 15-20% of breast cancers (BC). At the same time, HER2-low tumors (immunohistochemistry 1+ or 2+ with no gene amplification) comprise ~50% of all BC. DS-8201a is an anti-HER2 antibody drug conjugate that has shown very promising response rates both in HER2+ and HER2low BC. However, not all patients respond or benefit to the same extend. Thus, there is a need to identify predictive biomarkers. Here, we hypothesize that by performing several molecular studies in both tissue and plasma samples of those patients participating in the pivotal DESTINY-Breast trials, we will shed more light about the molecular features of HER2+ BC and better characterized the patient population according to their benefit from this promising new anti-HER2 agent. Methods: HER2-PREDICT is a multi-center, observational study within the biomarker program of SOLTI group, which will include patients who will participate, are participating or previously participated in the Daiichi Sankyo INC sponsored phase III trials: DS8201-A-U301 (NCT03523585), -U302 (NCT03529110) and -U303 (NCT03734029). Patients with HER2-positive or HER2-low unresectable and/or metastatic breast cancer may be included in SOLTI-1804 HER2-PREDICT study if randomized to the DS-8201a arm. All patients need to consent for obtaining a fresh tumor biopsy or donating an archival metastatic biopsy. Primary tumors are allowed under SOLTI acceptance. Additionally, patients included before initiating DS-8201a therapy will provide blood samples for biomarker analyses on Cycle 1 Day 1 (C1D1), C2D1 and end of treatment. The primary objectives are (1) to identify an optimal ERBB2 mRNA cut-off point predictive of Ds-8201a response and (2) to evaluate the correlation of baseline ERBB2 mRNA levels (as a continuous variable) with overall response rate (ORR) in the Ds-8201a-treated cohorts. Secondary objectives includes: to evaluate the association of ERBB2 mRNA levels, PAM50 intrinsic subtypes and immune-related genes with ORR, progression-free survival and overall survival; to design a new gene expression signature predictive of Ds-8201a benefit; to correlate early changes in ctDNA with Ds-8201a benefit and to identify acquired somatic mutations of resistance to DS8201a upon progression in plasma samples. Collection of tumor biopsies is an essential part of this study. Pathological analysis includes hematoxylin and eosin (H & E) staining, identification of areas with greater amount of tumor cells and determination of their tumor cell percentage. RNA will be isolated and analyzed at the nCounter (Nanostring Technologies). Molecular intrinsic subtypes will be identified by a research-based version of PAM50. Furthermore, we aim to evaluate 771 additional genes (+5 housekeeping genes) that encompass important genomic signatures and individual genes of importance for breast cancer by means of the nCounter®Breast Cancer 360 Panel. Somatic mutations in PIK3CA, TP53, and additional genes (e.g., GATA3 and ERBB2) will be identified using next-generation sequencing (NGS). Also, a comprehensive NGS gene panel will be performed under the Ion Torrent or Illumina platforms to DNA extracted from FFPE tumor blocks and to circulating tumor DNA (ctDNA) in plasma samples. Current status: Since December 13th, 2019, a total of 10 patients have been included, 5 of them with blood samples. As of today, 13 out of 15 Spanish sites are recruiting patients. Clinical trial identification: NCT04257162 Citation Format: Aleix Prat, Joaquin Gavilá, Sonia Pernas, Josefina Cruz, Cristina Saura, Esteban Nogales, Maria Bermejo, Javier Salvador Bofill, Vanesa Quiroga, Laura Garcia-Estévez, Serafin Morales, Sonia Servitja, Rubén del Toro, Patricia Galván, Núria Chic, Débora Martinez, Fara Brasó-Maristany, Jordi Canes, Laia Paré, Juan M Ferrero-Cafiero, Patricia Villagrasa. Solti-1804 HER2-PREDICT: A biomarker research study of DS8201-A-U301 -U302 and -U303 trials [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr OT-03-07.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2021
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    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 2
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 4_Supplement ( 2022-02-15), p. OT1-12-01-OT1-12-01
    Abstract: Background: Overexpression of human epidermal growth factor receptor 2 (HER2) occurs in 15-20% of breast cancers (BC). At the same time, HER2-low tumors (immunohistochemistry 1+ or 2+ with no gene amplification) comprise ~50% of all BC. Trastuzumab Deruxtecan (T-DXd) is an anti-HER2 antibody drug conjugate that has shown impressive and durable response rates not only in HER2+ and HER2low BC, but also in other cancer subtypes expressing the HER2 receptor. However, not all patients respond or benefit to the same extent. Thus, there is a need to identify predictive biomarkers. Here, we hypothesize that by performing several molecular studies in both tissue and plasma samples of those patients participating in the DESTINY studies receiving T-DXd, we will shed more light on the molecular features of HER2 expressing BC and will better characterize the patient population that benefits benefit from this promising new anti-HER2 agent. Methods: HER2-PREDICT is a multi-center, observational study within the biomarker program of SOLTI group, which will include patients who received T-DXd-only while participating in DESTINY trials. Both HER2-positive and HER2-low unresectable and/or metastatic breast cancer may be included in SOLTI-1804 HER2-PREDICT study (NCT04257162). All patients need to consent to obtain a fresh tumor biopsy or donate an archival metastatic biopsy. Primary tumors may be allowed under SOLTI acceptance. Additionally, for patients included before initiating T-DXd treatment blood samples for biomarker analyses on Cycle 1 Day 1 (C1D1), C2D1 and end of treatment will be obtained. Collection of tumor biopsies is an essential part of this study. Pathological analyses will include hematoxylin and eosin (H & E) staining of formalin-fixed paraffin-embedded (FFPE) tissue, identification of areas with the greater amount of tumor cells and determination of their tumor cell percentage. RNA will be isolated and analyzed using the nCounter platform (Nanostring Technologies). Molecular intrinsic subtypes will be identified by a research-based version of PAM50. Furthermore, we aim to evaluate 771 additional genes (+5 housekeeping genes) that encompass genomic signatures and individual genes of importance in breast cancer by means of the nCounter®Breast Cancer 360 Panel. Somatic mutations in PIK3CA, TP53, and additional genes (e.g., GATA3 and ERBB2) will be identified using next-generation sequencing (NGS) in FFPE tumor blocks and plasma samples. Objectives: The primary objectives are (1) to identify an optimal ERBB2 mRNA cut-off point predictive of T-DXd response and (2) to evaluate the correlation of baseline ERBB2 mRNA levels (as a continuous variable) with overall response rate (ORR). Secondary objectives include: to evaluate the association of ERBB2 mRNA levels, PAM50 intrinsic subtypes and immune-related genes with ORR, progression-free survival (PFS) and overall survival (OS); to design a new gene expression signature predictive of clinical benefit; to evaluate the correlation in early changes in circulating tumor DNA (ctDNA) with ORR, PFS and OS; and to identify acquired somatic mutations of resistance upon progression in plasma samples. The study is active in 13 sites in Spain, and 39 patients have been included in the trial since December 2019 until June 2021. Acknowledgments: We thank Daiichi Sankyo Inc. for their financial support for the study. Citation Format: Aleix Prat, Cristina Saura, Josefina Cruz, Esteban Nogales Fernández, Javier Salvador Bofill, Joaquin Gavilá, Maria José Bermejo-Perez, Vanesa Quiroga, Serafin Morales, Sonia Servitja, Ruben de Toro, Pilar Zamora, Patricia Galván, Nuria Chic, Débora Martínez, Fara Brasó-Maristany, Jordi Canes, Laia Paré, Juan M Ferrero-Cafiero, Tomás Pascual, Sonia Pernas. Solti-1804 HER2-PREDICT: Translational study of tumor samples from breast cancer patients treated with trastuzumab deruxtecan in the metastatic setting [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr OT1-12-01.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 3
    In: Breast Care, S. Karger AG, Vol. 11, No. 2 ( 2016), p. 133-138
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The aim of this project was to provide an expert opinion regarding anti-human epidermal growth factor receptor 2 (HER2) therapy beyond second-line treatment of metastatic breast cancer (mBC). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A group of experts discussed specific issues concerning anti-HER2 therapy in late-line settings in mBC. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Trastuzumab emtansine (T-DM1) or dual HER2 blockade appeared to be good options for HER2-positive mBC after ≥ 2 HER2-targeted therapies. Once an objective response has been achieved with anti-HER2-containing therapy, the anti-HER2 agent can be continued until progression of the disease, unacceptable toxicity or patient decision. mBC treated with ≥ 3 consecutive lines of anti-HER therapy, ≥ 1 being a dual HER2 blockade and with early progression of disease during a fourth or later-line treatment, are clinically resistant to anti-HER therapy. For progression of metastasis in the brain after anti-HER2 therapy, lapatinib and chemotherapy appear to be a good alternative after best local treatment. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Further clinical trials are needed to provide valuable knowledge about the best treatment options in the later settings of mBC.
    Type of Medium: Online Resource
    ISSN: 1661-3791 , 1661-3805
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 2205941-6
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  • 4
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 15_suppl ( 2018-05-20), p. TPS1114-TPS1114
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
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  • 5
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 20 ( 2013-07-10), p. 2593-2599
    Abstract: Adding taxanes to anthracycline-based adjuvant therapy improves survival outcomes of patients with node-positive breast cancer (BC). Currently, however, most patients with BC are node negative at diagnosis. The only pure node-negative study (Spanish Breast Cancer Research Group 9805) reported so far showed a docetaxel benefit but significant toxicity. Here we tested the efficacy and safety of weekly paclitaxel (wP) in node-negative patients, which is yet to be established. Patients and Methods Patients with BC having T1-T3/N0 tumors and at least one high-risk factor for recurrence (according to St. Gallen 1998 criteria) were eligible. After primary surgery, 1,925 patients were randomly assigned to receive fluorouracil, doxorubicin, and cyclophosphamide (FAC) × 6 or FAC × 4 followed by wP × 8 (FAC-wP). The primary end point was disease-free survival (DFS) after a median follow-up of 5 years. Secondary end points included toxicity and overall survival. Results After a median follow-up of 63.3 months, 93% and 90.3% of patients receiving FAC-wP or FAC regimens, respectively, remained disease free (hazard ratio [HR], 0.73; 95% CI, 0.54 to 0.99; log-rank P = .04). Thirty-one patients receiving FAC-wP versus 40 patients receiving FAC died (one and seven from cardiovascular diseases, respectively; HR, 0.79; 95% CI, 0.49 to 1.26; log-rank P = .31). The most relevant grade 3 and 4 adverse events in the FAC-wP versus the FAC arm were febrile neutropenia (2.7% v 3.6%), fatigue (7.9% v 3.4%), and sensory neuropathy (5.5% v 0%). Conclusion For patients with high-risk node-negative BC, the adjuvant FAC-wP regimen was associated with a small but significant improvement in DFS compared with FAC therapy, in addition to manageable toxicity, especially regarding long-term cardiac effects.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
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  • 6
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. e11545-e11545
    Abstract: e11545 Background: NVBO has shown high activity and good safety profile when given as single agent chemotherapy (CT) for MBC. Oral CT formulations allow maintenance of quality of live and minimal interference with a normal lifestyle. Methods: Main inclusion criteria for this retrospective study were: Histologically or citologically confirmed MBC, no more than 1 prior CT line for MBC; prior (neo)adjuvant CT, hormonetherapy or radiotherapy allowed; adequate bone marrow, kidney and liver function. The study protocol was approved by an ethics committee. Data was collected from patients (p) treated between Apr/2006 and Dec/2010 with NVBO 60 mg/m 2 weekly until progression or unacceptable toxicity. 70 patients fulfilled the inclusion criteria. Patient’s characteristics were: Median age, 65 years (range 38-82); 〉 75 years old, 20%; ECOG PS 0-1 in 91% p and PS 2 in 9%; ER+ & /or PR+, 41 p (59%); 〉 2 metastatic sites in 61%; prior (neo)adjuvant CT in 48 p (69%); prior hormonotherapy, 44 p (63%). Measurable disease in 68 p (97%). 1 p received trastuzumab concomitantly. Results: Median number of administrations (a) 11 (range 2-36). 1st/2nd line: 41%/59%. We analyzed 923 a. Dose delayed or reduced due to hematological toxicity in 2.7% a, related non-hematological toxicity in 0.3% a. Dose was reduced in 1% a. Hematological toxicities (%a): neutropenia grade (g) 3, 0.8%; febrile neutropenia 1 p who died due to septic shock after 9 a. Non-hematological toxicities (%a): pain g 3-4, 0.5%; constipation g 3-4, 0.3%; ileus paraliticus g 3, 0.1%; infection g 3, 0.1%; nausea/vomiting g4, 0.1% . 68 p were evaluable for response. 1 CR (1.5%), 19 PR (27.9%) and 16 SD (23.5%) were reported. Objective response (OR) rate 29.4% [CI 95%: 19%-41.7%]. Median progression free survival 4 m [CI 95%, 2.3-5.8] . Median survival has not been reached at the time of analysis. Conclusions: Our findings confirm the consistently produced clinically meaningful efficacy of single agent NVBO for MBC. We observed a favorable safety profile with a particular low incidence of myelosupression and alopecia. We consider that oral vinorelbine is a suitable 1st or 2nd-line treatment for convenient administration in an outpatient environment in selected p with MBC.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2012
    detail.hit.zdb_id: 2005181-5
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  • 7
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 83, No. 5_Supplement ( 2023-03-01), p. OT2-08-02-OT2-08-02
    Abstract: Background Today, there is no clear therapeutic algorithm for patients with metastatic HER2-positive (HER2+) breast cancer (BC) who have progressed to trastuzumab, pertuzumab, tyrosine kinase inhibitors and antibody-drug conjugates (ADC). Among the emerging strategies, the use of immune checkpoint inhibitors in combination therapy is showing promising clinical benefit in the advanced setting of HER2+ BC by overcoming immune resistance and enhancing antitumor cellular immunity. The intrinsic subtypes Basal-like and HER2-enriched (i.e PAM50 non-luminal tumors) represent approximately the 60% of HER2+ BC and are associated with higher expression of immune-related genes, tumor-infiltrating lymphocytes (TILs) presence and high tumor mutational burden (TMB), compared to luminal subtypes. Additionally, immune infiltration and TMB in HER2+ BC are associated with chemo/antiHER2 responsiveness and with potential benefit from anti-PD-1/PD-L1 inhibitors. We hypothesize that combining atezolizumab with trastuzumab and vinorelbine may improve outcomes in HR- or PAM50 non-luminal/HR-positive (HR+) disease within HER2+ MBC. Methods ATREZZO is an open-label, single-arm, Simon 2-stage, multicenter phase II study. The trial will include 55 pre- or post-menopausal female or male patients with unresectable locally advanced or metastatic HR- or PAM50 non-luminal/HR+ HER2+ BC and progressed to trastuzumab-based chemotherapy and anti-HER2 ADC. Prior pertuzumab is allowed, but not required. Treatment consists of atezolizumab IV 1200 mg every 3 weeks combined with trastuzumab and vinorelbine. Patients with stable, progressing, or untreated brain metastasis not requiring immediate local therapy are eligible. The primary objective is to evaluate the Overall Response Rate (ORR) according to RECIST v 1.1 and secondary endpoints include ORR in patients with PD-L1 positive breast cancer, clinical benefit rate, overall survival and progression-free survival. The final recruited population will contain no more than 60 % of patients with PD-L1 negative tumors. Tumor assessments will be performed every 9 weeks. Incidence, duration and severity of adverse events, and further correlative molecular analyses will be also evaluated. An interim analysis will be conducted when 19 patients are evaluable for ORR and if the number of responses is ≥ 3, 36 additional patients will be included. As of July 15th, 2022, 48 patients were screened and 15 were included in sixteen Spanish sites. This study was funded by Roche Farma SA. Trial identification: NCT04759248 Citation Format: Eva Ciruelos, Antonia Perelló, Santiago González-Santiago, Ana López, Francisco Javier Salvador Bofill, Cinta Albacar, Juan Miguel Cejalvo, Santiago Escrivá-de-Romani, Isabel Blancas, Sonia Pernas, Olga Martínez-Sáez, Josefina Cruz, Jose Ponce, Sonia Servitja, Maria-Eva Perez-Lopez, Juan A Guerra, Esther Sanfeliu, Cesar A Rodríguez, Guillermo Villacampa, Lorea Villanueva, Pablo Tolosa, Tomás Pascual, Aleix Prat. SOLTI-1907 ATREZZO: Targeting hormonal receptor negative (HR-) or PAM50 non-luminal disease with atezolizumab in combination with trastuzumab and vinorelbine in HER2-positive metastatic breast cancer (MBC) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT2-08-02.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 8
    In: Anti-Cancer Drugs, Ovid Technologies (Wolters Kluwer Health), Vol. 22, No. 3 ( 2011-03), p. 283-289
    Type of Medium: Online Resource
    ISSN: 0959-4973
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2011
    detail.hit.zdb_id: 2025803-3
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  • 9
    In: Clinical and Translational Oncology, Springer Science and Business Media LLC, Vol. 24, No. 4 ( 2022-04), p. 703-711
    Abstract: Central nervous system (CNS) dissemination is a severe complication in cancer and a leading cause of cancer-related mortality. Brain metastases (BMs) are the most common types of malignant intracranial tumors and are reported in approximately 25% of patients with metastatic cancers. The recent increase in incidence of BMs is due to several factors including better diagnostic assessments and the development of improved systemic therapies that have lower activity on the CNS. However, newer systemic therapies are being developed that can cross the blood–brain barrier giving us additional tools to treat BMs. The guidelines presented here focus on the efficacy of new targeted systemic therapies and immunotherapies on CNS BMs from breast, melanoma, and lung cancers.
    Type of Medium: Online Resource
    ISSN: 1699-3055
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2420460-2
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  • 10
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. 12121-12121
    Abstract: 12121 Background: Prognostic factors for oncologic pts after surgery or curative systemic treatment have been described, including ECOG performance status, tumor staging and malnutrition. However, there is no solid evidence on which combination of variables best predicts mortality after hospitalization of metastatic cancer pts under active systemic treatment. Methods: Prospective multicentric study of pts hospitalized between 2020 and 2022 at the Oncology wards of Vall d’Hebron, Sant Pau and Mar Hospitals [PLANTOLOGY database] in Barcelona, Spain. Clinical factors such as ECOG, comorbidities, tumor characteristics, and laboratory results were collected at admission. Mental status (depression and anxiety) and QOL were assessed through the HADS and EORTC-QLQ30 questionnaires, respectively. Nutritional assessment was performed using the chair and hand grip tests. All variables were analyzed in uni- and multivariable regressions including a machine learning LASSO model to assess predictive discriminators of 30-day mortality after discharge. Missing data was imputed using Multivariate Imputation by Chained Equations. A bootstrap with 1000 iterations was used to validate the model and c-index. Results: Among 1,663 pts, 932 had advanced disease and were under oncologic treatment during the 6 months previous to urgent admission, our target population for model development and validation. Median age was 64 years, 51% had an ECOG 〉 1, median Charlson comorbidity index was 8 and 34% were under treatment in a clinical trial. The most frequent tumor types were lung (25%), colorectal (14%) and breast (12%) cancer. The most relevant factors associated with higher mortality at 30-day after discharge in LASSO model were high Charlson index, low neutrophil count, high LDH, poor ECOG status and progressive disease at admission (all p-values p 〈 0.05). The c-index corrected after bootstrap validation was 0.75. After adding the nutritional assessment, mental health status and QoL (subset of 606 with complete data), the predictive power of the model increased to a c-index corrected after bootstrap validation of 0.81. Our final prognostic model called the PRognostic Oncologic Plantology score (PROP) obtained a sensitivity of 0.75 and a specificity of 0.80 with an overall accuracy of 0.80. Only 10% of “low” PROP score pts (72% of the population) died within 30 days of discharge, as compared to 58% of early mortality in “high” PROP score pts. Conclusions: Our model, including clinical and analytical factors, predicts with accuracy the 30-day mortality of oncologic pts after discharge which is significantly improved with the addition of nutritional assessment and standardized questionnaires of QoL and mental status. The PROP score calculator will be built to help physicians adjust medical interventions for hospitalized cancer pts.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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