Use of a Urine Anastrozole Assay to Determine Treatment Discontinuation Among Women With Hormone-Sensitive Breast Cancer: A Pilot Study

Purpose: Multiple studies have shown that adherence to adjuvant hormonal therapy in women with breast cancer is suboptimal. Measurements of compliance with self-report, pill counts, and/or pharmacy records are susceptible to bias. We assessed the feasibility of using a urine anastrozole assay as an objective biomarker of nonadherence to anastrozole treatment. Patients and Methods: We recruited consecutive postmenopausal women, age ≥ 18 years, with hormone-sensitive nonmetastatic breast cancer who were prescribed anastrozole at least 3 months before enrollment. Each completed a short survey to gather information on demographics, anastrozole compliance history, and self-reported medication history, tumor characteristics, and treatment received. A single, random 15-mL urine sample was collected and tested for the presence of anastrozole using a previously validated assay. Patients were told they were part of a study to determine if anastrozole could be detected in the urine. Results: Among 96 participants, mean age was 63.7 years (range, 51 to 70 years). The population was diverse, with 56.5% white, 57.6% US born, 59.8% unemployed, and 56.6% college educated. Prior treatment included chemotherapy (50%) and/or radiotherapy (58.7%). Mean duration of anastrozole treatment was 2.2 years (standard deviation, 1.6). Four participants reported nonadherence and declined to submit urine samples, and two had no detectable level of anastrozole (six of 96; 6.3%). Detectable levels among adherent women ranged from 49.3 to 632.8 ng/mL. Conclusion: We demonstrated that collection of urine to measure anastrozole levels is feasible and reliable. Identifying biomarkers to measure adherence is critical for studies investigating interventions to improve hormonal therapy compliance

Methods to Standardize a Multicenter Acupuncture Trial Protocol to Reduce Aromatase Inhibitor-related Joint Symptoms in Breast Cancer Patients

AbstractRobust methods are needed to efficiently conduct large, multisite, randomized, controlled clinical trials of acupuncture protocols. The Southwest Oncology Group (SWOG) S1200 trial is a randomized, controlled (i.e., sham-controlled and waitlist-controlled) trial of a standardized acupuncture protocol for treating aromatase inhibitor (AI)-associated arthralgias in early-stage breast cancer patients (n = 228). The primary objective of this study was to determine whether true acupuncture administered twice weekly for 6 weeks, as compared to sham acupuncture or a waitlist control, reduced AI-associated joint pain at 6 weeks as assessed by patient reports. The study was conducted at 11 institutions across the United States. The true acupuncture protocol was developed using a consensus-based process. The true acupuncture and the sham acupuncture protocols each consisted of 12 sessions administered for 6 weeks, followed by one weekly session for 6 weeks. The true acupuncture protocol used standardized protocol points, and the standardized acupoints were tailored to a patient's joint symptoms. The similarly standardized sham acupuncture protocol utilized superficial needling of nonacupoints. Standardized methods were developed to train and monitor acupuncturists and included online and in-person training, study manuals, monthly phone calls, and remote quality assurance monitoring throughout the study period. The research staff similarly received online and in-person training and monthly phone calls

Association between body mass index and response to duloxetine for aromatase inhibitor‐associated musculoskeletal symptoms in SWOG S1202

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149517/1/cncr32024.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149517/2/cncr32024_am.pd

Vitamin D-related gene polymorphisms, plasma 25-hydroxyvitamin D, and breast cancer risk

Studies of vitamin D pathway genetic variants in relation to cancer risk have been inconsistent. We examined associations between vitamin D-related genetic polymorphisms, plasma 25-hydroxyvitamin D [25(OH)D], and breast cancer risk

Genetic polymorphisms in DNA repair and oxidative stress pathways may modify the association between body size and postmenopausal breast cancer

Obesity is associated with increased bioavailability of estrogen, hyperinsulemia and chronic inflammation, all of which may promote tumor growth. Given DNA repair and oxidative stress pathways may work together with these mechanisms to influence carcinogenesis, we hypothesized that genetic variation in these pathways may modify the obesity-postmenopausal breast cancer association

Genetic variation in multiple biologic pathways, flavonoid intake, and breast cancer

We previously reported an inverse association between flavonoid intake and breast cancer incidence, which has been confirmed by others; but no studies have considered simultaneously potential interactions of flavonoids with multiple genetic polymorphisms involved in biologically-relevant pathways (oxidative stress, carcinogen metabolism, DNA repair, and one-carbon metabolism)

EHT-HOPS pipeline for millimeter VLBI data reduction

We present the design and implementation of an automated data calibration and reduction pipeline for very-long-baseline interferometric (VLBI) observations taken at millimeter wavelengths. These short radio-wavelengths provide the best imaging resolution available from ground-based VLBI networks such as the Event Horizon Telescope (EHT) and the Global Millimeter VLBI Array (GMVA), but require specialized processing due to the strong effects from atmospheric opacity and turbulence as well as the heterogeneous nature of existing global arrays. The pipeline builds upon a calibration suite (HOPS) originally designed for precision geodetic VLBI. To support the reduction of data for astronomical observations, we have developed an additional framework for global phase and amplitude calibration which provides output in a standard data format for astronomical imaging and analysis. We test the pipeline on observations taken at 3.5 mm (86 GHz) by the GMVA joined by the phased Atacama Large Millimeter/submillimeter Array in April 2017, and demonstrate the benefits from the specialized processing of high frequency VLBI data with respect to classical analysis techniques