Abstract P2-07-06: Obesity, dyslipidemia, and diabetes as risk factors for trastuzumab-related cardiotoxicity in breast cancer patients
Bibliographic record
Abstract
Abstract Background. Clinical trials have demonstrated an increased risk of cancer treatment related cardiac dysfunction (CTCD) during trastuzumab(H) therapy. Diabetes, dyslipidemia, and obesity are also known risk factors for cardiovascular disease. The primary objective of this study was to evaluate the incidence of asymptomatic drop in left ventricular ejection fraction (AD-LVEF) and symptomatic CTCD (S-CTCD) in women with BC and co-morbidities receiving H, referred to a dedicated cardio-oncology clinic (COC). Methods. This was a retrospective cohort study of women with BC (all stages) referred to The Ottawa Hospital COC between 2008 and 2015, who received chemotherapy (CT) and H. Data collected included: demographics, reason for referral, cardiac testing (MUGA/ECHO) co-morbidities (diabetes, dyslipidemia) and cardiac outcomes. Obesity defined as body mass index > 30. Symptomatic CTCD include SOB, PND, orthopnea, peripheral edema, congestive heart failure. Asymptomatic drop in LVEF defined as decrease of at least 15% from baseline; normal LVEF, or a decrease of at least 10% in LVEF, less than 53%. Results. Chemotherapy (A-CT) followed by H, 62 received H without A-CT. 139 patients with no history diabetes, dyslipidemia, or obesity, referred with AD-LVEF (68%), with S- CTCD (30%), pre-CT assessment (2%). Obesity (O) pre-existing co-morbidity in 63 (26%) patients, (20 (32%) with S-CTCD, 40 (63%) referred with AD-LVEF, 3(5%) referred for pre-CT assessment). Dyslipidemia (L) – 52 (21%); referred with S-CTCD 15; 29%), with AD-LVEF 31 (60%), pre-CT assessment 6 (11). Diabetes (D) – 29 (12%) - (6 (21%) with S-CTCD, 19 (66%) referred with AD-LVEF, 4(13%) referred for pre-CT assessment). Combination of two or three conditions significantly increase incidence of S-CTCD: O+L – 67%, O+D – 69%, O+L+D – 72%. Combination of obesity and other conditions significantly increase incidence of S-CTCD: O+L – 67%(Relative Risk -2.2, p=0,04), O+D – 69% (RR-2.3, p=0,02), O+L+D – 72% (RR-2.4, p=0,08). Conclusion. The combination of two or three co-morbidities significantly increases the incidence of S-CTCD. BC patients experiencing CTCD with pre-existing history of diabetes, dyslipidemia, and obesity may require more proactive strategies for prevention, detection and treatment of cardiotoxicity during trastuzumab-based treatment. Citation Format: Aseyev O, Johnson C, Turek M, Stadnick E, Law A, Gosh N, Dent S. Obesity, dyslipidemia, and diabetes as risk factors for trastuzumab-related cardiotoxicity in breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-07-06.
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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 | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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".