Breast cancer is a prominent cause of cancer diagnosis and death in women globally, with over 90% of deaths being attributed to complications that arise from metastasis. One of the common locations for breast cancer metastasis is the lung, which is associated with significant morbidity and mortality. Curative treatments for metastatic breast cancer patients are not available and the molecular mechanisms that underlie lung metastasis are not fully understood. In order to better treat these patients, identifying events that occur both prior to and during metastatic spread to the lung is essential. Several studies have demonstrated that breast cancer-derived extracellular vesicles secreted from the primary breast tumor play a key role in establishing the lung pre-metastatic niche to support colonization of metastatic tumor cells. In this review, we summarize recent work supporting the influence of extracellular vesicles on stromal components of the lung to construct the pre-metastatic niche and support metastasis. Furthermore, we discuss the potential clinical applications of utilizing extracellular vesicles for diagnosis and treatment. Together, this review highlights the dynamic nature of extracellular vesicles, their roles in breast cancer metastasis to the lung, and their value as potential biomarkers and therapeutics for cancer prevention.
e12522 Background: CDK4/6 inhibitors provide effective treatment options for patients with HR-positive, HER2-negative breast cancer (BC), but adherence and persistence can be challenging. To address this gap, a global educational activity was developed that consisted of a 2-hour live streaming virtual meeting with interactive workshops and a 45-minute online enduring activity. The objective of this study was to assess the educational impact of the online enduring educational activity. Methods: To assess educational impact a repeated-pairs pre-/post-assessment study design using 3 knowledge/competence questions, in which everyone served as their own control. A paired samples t-test assessed mean differences in average number of correct responses pre- to post-assessment, and a McNemar’s test assessed significance of improvement in single questions from pre- to post-assessment. P values < .05 are statistically significant. Confidence was also assessed using a pre/post confidence question. The activity launched on June 4, 2021, and data was collected till March 30, 2022. Results: 80 oncologists from outside the US (OUS) and 69 oncologists from the US who answered all the assessment questions were included in the analysis. Each question assessed a learning objective. All three knowledge/competence learning objectives showed a significant improvement in the OUS oncologist group, and 2 of the 3 showed a significant improvement in the US group. Conclusions: This online enduring activity resulted in a significant improvement of oncologists’ knowledge and competence related to clinical evidence for the use of CDK4/6i, managing adverse events associated with CDK4/6i and monitoring patients on CDK4/6i. Confidence of oncologists in counselling patients on the importance of adherence to CDK 4/6 inhibitor therapy also improved in 29% of OUS oncologists and 33% of US oncologists. However, there is still a need for education in a significant percentage of both OUS and US oncologists on this topic. [Table: see text]
e12509 Background: Hormone receptor positive breast cancer (HR+ BC) is often diagnosed in the early, curable, stage. Emerging treatment options make it important to educate clinicians on how to identify patients eligible for these options and increase their understanding of the clinical data associated with therapies in HR+/HER2- early breast cancer (EBC). The study objective was to assess the impact of 2 educational activities on HR+/HER2- EBC on oncologists’ knowledge, competence, and confidence related to risk of recurrence and clinical data. Methods: Two online continuing medical education activities were launched in 2021 covering a range of topics focused on identification of patients at high risk of recurrence and the latest clinical trial data for CDK4/6 inhibitors (CDK4/6i) in HR+/HER2- EBC. Educational impact was assessed using a repeated pair design, with knowledge/competence and confidence questions pre- and post-education. Confidence was assessed on a Likert-type scale ranging from not confident to very confident. Questions were designed to assess if certain learning objectives (LOs), covering identified educational gaps, were met. Data was collected from 06/14/2021 to 01/31/2022. Statistical significance was assessed using McNemar’s test ( P < .05 level). Results: 5,544 learners participated in these 2 activities, including 727 oncologists. The LOs were grouped in 3 themes that assessed oncologists’ knowledge/competence and confidence related to identifying patients with HR+/HER2- EBC at high risk of recurrence and understanding the clinical trial data investigating CDK4/6i in this setting. Two themes showed a significant improvement. The number of oncologist learners assessed per theme differed from 228 to 260. Conclusions: Participation in text- and video-based activities resulted in a significant improvement of oncologists’ knowledge, competence, and confidence related to CDK4/6i clinical data and treatment eligibility for patients with HR+/HER2- EBC. Baseline knowledge regarding the identification of high risk of recurrence in HR+/HER2-EBC was high (89% correct responses pre-education) in comparison that of clinical trial data and confidence in identification of patients eligible for adjuvant therapy (54% and 21% respectively). This finding could be reflective of clinicians having a high-level knowledge and competence related to risk stratification prior to the developments that occurred secondary to the approval of CDK4/6i in the adjuvant setting. With these new developments additional education around this topic will be required.[Table: see text]
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