118P Real-world treatment patterns and clinical outcomes among high risk, early stage HER2-negative breast cancer (BC) patients in Alberta, Canada
Bibliographic record
Abstract
Data are needed to improve the current understanding of the epidemiology and clinical management of high-risk early stage HER2- BC patients. This study was a retrospective longitudinal cohort study using real-world, population-level data from Alberta, Canada. All individuals newly diagnosed with high-risk, stage II/III HER2- BC in Alberta, Canada between 2013-2019 were included. Data on treatment, laboratory results and pathology findings were collected through electronic health records and administrative databases. High-risk BC was defined as receipt of adjuvant systemic therapy within 120 days of surgery as well as the presence of the following characteristics: 1) For triple-negative BC (TNBC): tumor 2+ cm (AJCC T2 or greater) or axillary lymph node (LN) involvement; 2) For hormone-receptor positive (HR+/HER2-): four or more positive LNs. Treatment eras were separated into pre/post 2016. Overall survival (OS) was defined as the date of diagnosis to death from any cause or last known contact. The annual cumulative incidence of early-stage, high-risk, HER2- BC ranged from 6% to 9%. Individuals with TNBC were more likely to be younger, have grade 3 histology, stage II BC, and receive systemic therapy at a community centre (p < 0.05) when compared with HR+/HER2- BC. Germline BRCA testing was not widely conducted in this patient population, with an estimated 14% of patients diagnosed in 2010-2017 being tested at some point post-diagnosis. Neoadjuvant systemic therapy was given to 37% of patients with high-risk BC. The 5-year OS from initiation of adjuvant systemic therapy (for patients who received adjuvant systemic therapy) or date of surgery (for patients who did not receive adjuvant systemic therapy) was 77% (95% CI: 75 to 79). OS was significantly worse among patients who were older, had grade 3 histology, stage III BC, or had LN involvement (p < 0.05). OS among patients with TNBC between 2016-2019 who initiated adjuvant capecitabine was markedly worse than that of the overall cohort (2-year OS: 70% vs. 89%). Outcomes analyses in this population suggest a continued unmet clinical need. Additional analyses into the indications for use of systemic therapies are underway.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: yes | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: yes | Observational | low |
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.000 | 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, unvalidatedLabeled directly by 2 models reading the full record.
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".