Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline

PURPOSE: To develop guideline recommendations concerning optimal neoadjuvant therapy for breast cancer. METHODS: ASCO convened an Expert Panel to conduct a systematic review of the literature on neoadjuvant therapy for breast cancer and provide recommended care options. RESULTS: A total of 41 articles met eligibility criteria and form the evidentiary basis for the guideline recommendations. RECOMMENDATIONS: Patients undergoing neoadjuvant therapy should be managed by a multidisciplinary care team. Appropriate candidates for neoadjuvant therapy include patients with inflammatory breast cancer and those in whom residual disease may prompt a change in therapy. Neoadjuvant therapy can also be used to reduce the extent of local therapy or reduce delays in initiating therapy. Although tumor histology, grade, stage, and estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2) expression should routinely be used to guide clinical decisions, there is insufficient evidence to support the use of other markers or genomic profiles. Patients with triple-negative breast cancer (TNBC) who have clinically node-positive and/or at least T1c disease should be offered an anthracycline- and taxane-containing regimen; those with cT1a or cT1bN0 TNBC should not routinely be offered neoadjuvant therapy. Carboplatin may be offered to patients with TNBC to increase pathologic complete response. There is currently insufficient evidence to support adding immune checkpoint inhibitors to standard chemotherapy. In patients with hormone receptor (HR)-positive (HR-positive), HER2-negative tumors, neoadjuvant chemotherapy can be used when a treatment decision can be made without surgical information. Among postmenopausal patients with HR-positive, HER2-negative disease, hormone therapy can be used to downstage disease. Patients with node-positive or high-risk node-negative, HER2-positive disease should be offered neoadjuvant therapy in combination with anti-HER2-positive therapy. Patients with T1aN0 and T1bN0, HER2-positive disease should not be routinely offered neoadjuvant therapy.Additional information is available at www.asco.org/breast-cancer-guidelines

Truncating Variants in NAA15 Are Associated with Variable Levels of Intellectual Disability, Autism Spectrum Disorder, and Congenital Anomalies

Genetics of disease, diagnosis and treatmen

Dudley Knox Library Survey of Distance Learning Students

Two files: Report and presentation (with findings and background data).How can the Naval Postgraduate School's (NPS) Dudley Knox Library (DKL) better serve the needs of distance learning students? The Fall 2011 NPS Survey Research Methods class (OA4109) devised, conducted and analyzed results of a survey of distance learning students on behalf of DKL. The study succeeded in meeting three objectives: 1) Evaluate the need for library services; 2) Determine if needs vary among various distance learning curricula; and 3) Solicit feedback on the usability of the DKL website

Mixed-Mode Decohesion Elements for Analyses of Progressive Delamination

A new 8-node decohesion element with mixed- mode capability is proposed and demonstrated. The element is used at the interface between solid finite elements to model the initiation and propagation of delamination. A single displacement-based damage parameter is used in a strain softening law to track the damage state of the interface. The method can be used in conjunction with conventional material degradation procedures to account for inplane and intra-laminar damage modes. The accuracy of the predictions is evaluated in single mode delamination tests, in the mixed-mode bending test, and in a structural configuration consisting of the alebonding of a stifleher flange from its skin