Overall survival and clinical characteristics in <i>BRCA</i> mutation carriers with stage I/II pancreatic cancer (PC).
Bibliographic record
Abstract
287 Background: BRCA1/2 mutation carriers with PC may have distinct biologic outcomes. We recently described favorable overall survival (OS) in patients with early-stage resected PC. However the prognostic impact of germline (GL) BRCA1/2 mutations in surgically-resected PC cases has not been yet compared with institution-matched controls. Methods: A multi-center, case-control retrospective analysis was performed of patients with surgically-resected, BRCA1/2 mutated PC from years 2001-2012. Non-hereditary PC controls were defined as BRCA negative or absence of a personal and first degree familial history of breast, ovarian or PC. Cases were matched by: age at diagnosis (+/- 5 years), treatment (neoadjuvant vs. adjuvant) and institution. Demographics, clinical history, overall survival (OS) and disease-free survival (DFS) were abstracted from patient records. Statistical comparisons were assessed using χ2and Fisher's exact test and median DFS/OS using Kaplan-Meier method and log-rank testing. Results: 20 patients with GL BRCA1/2 mutation PC were identified and matched (1:2) with 40 non-hereditary controls. Cases were comparable to controls in all tumor and treatment (neoadjuvant vs. adjuvant) related variables except lymphovascular involvement (30.6% vs 64.7%, p= 0.014). However, BRCA cases frequently received neoadjuvant (8/10 vs 6/14)/adjuvant (7/15 vs 3/34) platinum-based treatment. Clinical characteristics of GL BRCA1/2PC cases: BRCA1=3, BRCA2=17. Mean age was 56.7 years (41-78, SD 10.0), 65% (n=13) were female, 55% (n=11) were Jewish, 55% (n=11) had a family history and 95% (n=19) were stage II at resection. We demonstrated no difference in median OS (23.8 vs 25.9 months, p=0.397) and in DFS (13.6 vs 12.6 months, p=0.404) in BRCA1/2 mutation carriers vs controls. BRCA1/2mutation carriers did not experience improved DFS or OS with platinum-based chemotherapy. Conclusions: In this retrospective analysis, the prognosis of surgically-resectable BRCA associated PC is no different than that of sporadic PC from the same institution. The role of DNA damaging agents in this setting is still inconclusive.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".