Investigations into potential targets of iniparib and its Breast cancer was the most common diagnosis (n=67; 21.5%). In total, 2,187 deaths (1,122 from breast cancer) were observed through December 31, 2010. In the $50 (USD) arm, 16 of 57 eligible patients participated (28.1%) and they invited 38 relatives: 18 relatives enrolled and 17 ordered testing.Cascade genetic testing in families with hereditary cancer syndromes accrued through a population-based cancer registry can be achieved through an online platform that offers genetic risk education and low-cost testing to relatives. Wang, A., Aragaki, A., Tang, J., Kurian, A. W., et al, Lymphopenia after adjuvant radiotherapy to predict poor survival in triple-negative breast cancer. Compared to NL White women with high-education/high-nSES, higher all-cause mortality was observed among NL White women with high-education/low-nSES [hazard ratio (HR) (95% confidence interval) 1.24 (1.08-1.43)], and African American women with low-nSES, regardless of education [high education HR 1.24 (1.03-1.49); low-education HR 1.19 (0.99-1.44)]. Kurian, A. W., Friese, C. R., Bondarenko, I. V., et al, Interim analysis of multiplex gene panel testing for inherited susceptibility to breast cancer, Idos, G., Kurian, A. W., McDonnell, K. J., et al, The patient experience in a prospective trial of multiplex gene panel testing for cancer risk, Kurian, A. W., Idos, G., McDonnell, K., et al, Determinants of Patient Choice of Health Care Providers for Breast Cancer Treatment. [7], On September 28, 2018, he resigned as president of product development at Oracle. abnormal breast duct cytology in women with a high inherited breast cancer risk. Odds of excellent pQoC were lower among the following: college-educated Hispanic women (aOR (CI) = 0.09 (0.02-0.47)) and API women regardless of education (aORs 0.50) vs. college-educated White women, women reporting low and moderate levels of discrimination (aORs 0.44) vs. none, and women reporting any clinician mistrust (aOR (CI) = 0.50 (0.29-0.88)) vs. none. Women with pathogenic variants in BRCA1 and BRCA2 are at high risk of developing breast and ovarian cancers. We report lavage of fluid-yielding and non-fluid-yielding ducts in women at high inherited breast cancer risk.A pilot breast cancer screening study including ductal lavage was conducted in 75 women at high inherited risk, 56 (74.7%) of whom had BRCA1/2 mutations. Ho, W. K., Tan, M. M., Mavaddat, N. n., Tai, M. C., Mariapun, S. n., Li, J. n., Ho, P. J., Dennis, J. n., Tyrer, J. P., Bolla, M. K., Michailidou, K. n., Wang, Q. n., Kang, D. n., Choi, J. Y., Jamaris, S. n., Shu, X. O., Yoon, S. Y., Park, S. K., Kim, S. W., Shen, C. Y., Yu, J. C., Tan, E. Y., Chan, P. M., Muir, K. n., Lophatananon, A. n., Wu, A. H., Stram, D. O., Matsuo, K. n., Ito, H. n., Chan, C. W., Ngeow, J. n., Yong, W. S., Lim, S. H., Lim, G. H., Kwong, A. n., Chan, T. L., Tan, S. M., Seah, J. n., John, E. M., Kurian, A. W., Koh, W. P., Khor, C. C., Iwasaki, M. n., Yamaji, T. n., Tan, K. M., Tan, K. T., Spinelli, J. J., Aronson, K. J., Hasan, S. N., Rahmat, K. n., Vijayananthan, A. n., Sim, X. n., Pharoah, P. D., Zheng, W. n., Dunning, A. M., Simard, J. n., van Dam, R. M., Yip, C. H., Taib, N. A., Hartman, M. n., Easton, D. F., Teo, S. H., Antoniou, A. C. A case of a trans-masculine patient receiving testosterone with a history of estrogen receptor-positive breast cancer. Kwong, A., Ng, E. K., Law, F. B., Wong, L. P., To, M. Y., Cheung, M. T., Wong, H. N., Chan, V. W., Kurian, A., West, D. W., Ford, J. M., Ma, E. S. Genetic/familial high-risk assessment: breast and ovarian. Life expectancy gains from delaying prophylactic surgery by 5 to 10 years range from 1 to 9.9 years for BRCA1 and 0.5 to 4.2 years for BRCA2 mutation carriers. View details for DOI 10.1093/jamia/ocw161. PM at age 25 instead of age 40 offers minimal incremental benefit (1% to 2%); substituting screening for PM yields a similarly minimal decrement in survival (2% to 3%).Although PM at age 25 plus PO at age 40 years maximizes survival probability, substituting mammography plus MRI screening for PM seems to offer comparable survival. Roberts, M. C., Kurian, A. W., Petkov, V. I. Breast cancer molecular subtypes defined by joint hormone receptor (HR, estrogen receptor [ER] and/or progesterone receptor [PR]) and HER2 status were assessed. Approximately 1% to 3% of all gastric cancers are associated with families exhibiting an autosomal dominant pattern of susceptibility. Dr. Kurians research focuses on cancer genetics, precision oncology and the quality of cancer care at the population level. The education level was high among both cases and controls. Good sleepers were older than bad sleepers (p, View details for DOI 10.1016/j.sleep.2022.07.002. Afghahi, A., Timms, K. M., Vinayak, S., Jensen, K. C., Kurian, A. W., Carlson, R. W., Chang, P., Schackmann, E. A., Hartman, A., Ford, J. M., Telli, M. L. Unsupervised clustering of quantitative image phenotypes reveals breast cancer subtypes with distinct prognoses and molecular pathways. New strategies for cancer genetic risk assessment include multiplex sequencing panels of 5 to more than 100 genes (in which rare mutations are often associated with at least two times the average risk of developing breast cancer) and panels of common single-nucleotide polymorphisms (SNPs), combinations of which are generally associated with more modest cancer risks (more than twofold). Blood samples, which were collected at entry, were analyzed for BRCA1 promoter methylation by massive parallel sequencing. We adapted the model into an online tool to support shared decision making.We compared strategies on cancer incidence and survival to age 70 years; for example, PO plus PM at age 25 years optimizes both outcomes (incidence, 4% to 11%; survival, 80% to 83%), whereas PO at age 40 years plus MRI screening offers less effective prevention, yet similar survival (incidence, 36% to 57%; survival, 74% to 80%). Kurian, A. W., Abrahamse, P., Ward, K., Hamilton, A. S., Deapen, D., Katz, S. J. Abstract P3-07-01: Breast cancer-specific mortality (BCSM) in patients age 50 years or younger with node-positive (N+) breast cancer (BC) treated based on the 21-gene assay in clinical practice. Limited studies have investigated racial/ethnic survival disparities for breast cancer (BC) defined by estrogen receptor (ER) and progesterone receptor (PR) status in a multiethnic population.Using multivariable Cox proportional hazards models, we assessed associations of race/ethnicity with ER/PR-specific BC mortality in 10,366 Californian women diagnosed with BC from 1993-2009. There is growing concern about overtreatment of breast cancer as outcomes have improved over time. Positive coverage started November 30, 2015, with 1 payer and increased to 33 (48%) as of April 1, 2019. View details for DOI 10.1016/j.cancergencyto.2007.08.009, View details for Web of Science ID 000251478000001, View details for Web of Science ID 000250506100043. Keegan, T. H., Kurian, A. W., Gali, K., Tao, L., Lichtensztajn, D. Y., Hershman, D. L., Habel, L. A., Caan, B. J., Gomez, S. L. Clinical evaluation of multigene testing for hereditary breast and ovarian cancer. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of Stage IV versus Stage I-III breast cancer; Cox proportional hazards regression was used to assess relative hazard (RH) of mortality.Five percent of invasive breast cancer was metastatic at diagnosis. View details for DOI 10.1093/jncics/pky062. She is also a clinically active oncologist, treating patients diagnosed with breast cancer. Prevention of cancer in transplant recipients is of utmost importance, given the risks of treating malignancy in an immunosuppressed patient. Compared with cisgender heterosexual patients, those from SGM groups experienced a delay in time from symptom onset to diagnosis (median time to diagnosis, 34 vs 64 days; multivariable adjusted hazard ratio, 0.65; 95% CI, 0.42-0.99; P=.04), were more likely to decline an oncologist-recommended treatment modality (35 [38%] vs 18 [20%]; multivariable adjusted odds ratio, 2.27; 95% CI, 1.09-4.74; P=.03), and were more likely to experience a breast cancer recurrence (multivariable adjusted hazard ratio, 3.07; 95% CI, 1.56-6.03; P=.001).This study found that among patients with breast cancer, those from SGM groups experienced delayed diagnosis, with faster recurrence at a 3-fold higher rate compared with cisgender heterosexual patients. We sought to evaluate the association between overestimation of risk of distant recurrence of breast cancer and key patient-reported outcomes, including quality of life and worry.We surveyed a weighted random sample of newly diagnosed patients with early-stage breast cancer identified through SEER registries of Los Angeles County & Georgia (2013-14) ~2months after surgery (N=2578, RR=71%). View details for PubMedCentralID PMC8140787. Mantz, A. All gains were reduced with less than 100% treatment completion.The extension of endocrine therapy from 5 to 10years modestly improved lifetime breast cancer outcomes, but in some women, treatment-related adverse events may outweigh benefits. These findings emphasize the need to address challenges in personalized communication about genetic testing. Silvestri, V. n., Leslie, G. n., Barnes, D. R., Agnarsson, B. [15], As the President of Product Development, he oversaw Oracle's 3,000-odd product development efforts. Giving chemotherapy after surgery may kill any tumor cells that remain after surgery Most (86%; 95% CI, 84% to 88%) tested respondents were very satisfied with their testing decision, versus 34% (95% CI, 27% to 41%) of untested respondents. (HER2-positive), locally advanced or metastatic breast cancer. However, only one half (50.6%) of those not tested received any discussion about genetics. Drawing on the experiences of 21 breast cancer survivors, this paper explores three ways in which fundamental cultural and structural characteristics of the cancer care system in the USA may prevent breast cancer survivors from addressing their sexual health concerns, including: (1) when patients discussed sexual health with their providers, their providers approached sexuality as primarily physical, while participants experienced complex, multidimensional sexual health concerns; (2) specialisation within cancer care services made it difficult for patients to identify the appropriate provider to address their concerns; and (3) the structure of cancer care literally disconnects patients from the healthcare system at the time when sexual side effects commonly emerged. Relative to screening with mammography alone, the cost per QALY gained by adding MRI from ages 35 to 54 years is 55,420 dollars for BRCA1 mutation carriers, 130,695 dollars for BRCA2 mutation carriers, and 98,454 dollars for BRCA2 mutation carriers who have mammographically dense breasts.Breast MRI screening is more cost-effective for BRCA1 than BRCA2 mutation carriers. hydrochloride, cyclophosphamide, and paclitaxel are more effective with or without To estimate the value of cancer care and to compare value among episodes of care, a transparent, reproducible, and standardized cost computation methodology is needed. I lead epidemiologic studies of cancer risk factors, clinical trials of novel approaches to cancer risk reduction, and decision analyses of strategies to optimize cancer outcomes. In a separate model, the odds ratios were 1.21 (95% CI, 0.54 to 2.68) and 0.90 (95% CI, 0.50 to 1.62) for pathogenic variant and variant of uncertain significance, respectively, versus a negative test (the reference group).Compared with BRCA1/2 testing alone, multigene panel testing was not associated with increased cancer worry after diagnosis of breast cancer. B., Dakhil, S. R., Manola, J., Ford, J. M. Chemotherapy (CTX) treatment patterns for early-stage breast cancer (ESBC): Changing use of anthracyclines (A). We compared breast cancer incidence and proportion of newly diagnosed patients receiving pre-operative systemic therapy pre-COVID, in the first 2 months of the COVID pandemic and in the later part of the COVID pandemic.Average monthly breast cancer incidence was 19.3 (95% CI 19.1-19.5) cases per 100,000 women and men pre-COVID, 11.6 (95% CI 10.8-12.4) per 100,000 in April-May 2020, and 19.7 (95% CI 19.3-20.1) per 100,000 in June 2020-February 2021. Utilization of a multigene panel should also be considered, given the additional non-Lynch germline mutation identified in this cohort. However, little is known about the context of such testing or its impact on treatment. Women are more likely to experience worse cancer-related financial outcomes than men. B., Cristofanilli, M., Kurian, A. W., Ford, J. M., Balch, A., Watkins, J., Phillips, K. A. Macrophages Promote Circulating Tumor Cell-Mediated Local Recurrence following Radiotherapy in Immunosuppressed Patients. Thomas Kurian is an Indian-American business executive and Chief Executive Officer of Google Cloud since 2019. For more information, please contact Pei-Jen Chang, 650-725-0866. Clinical impact of multi-gene panel testing for hereditary breast and ovarian cancer risk assessment. The MA-PRS is a combination of three ancestry-specific PRSs on the basis of genetic ancestral composition. Surveys were sent approximately 2 months after surgery. Google Cloud CEO Thomas Kurian says large-scale organizational changes and investments over the past year are paying off in the sales trenches for the No. Participants carried an average of 2.1 variants of uncertain significance among 42 genes.Among women testing negative for BRCA1/2 mutations, multiple-gene sequencing identified 16 potentially pathogenic mutations in other genes (11.4%; 95% CI, 7.0% to 17.7%), of which 15 (10.6%; 95% CI, 6.5% to 16.9%) prompted consideration of a change in care, enabling early detection of a precancerous colon polyp. Large-scale analysis of real-world evidence is often limited to structured data fields that do not contain reliable information on recurrence status and disease sites. Reproductive longevity is essential for fertility and influences healthy ageing in women1,2, but insights into its underlying biological mechanisms and treatments to preserve it are limited. Risk stratification with a 20% risk threshold was compared between CRS and Tyrer-Cuzick in an independent clinical cohort (N = 32,576).Simulation studies confirmed that the Fixed-Stratified method produced accurate risk estimation across patients with different family history. PRSs were generated using a clumping and thresholding method, lasso penalized regression, an Empirical Bayes approach, a Bayesian polygenic prediction approach, or linear combinations of multiple PRSs. Multicenter Prospective Cohort Study of the Diagnostic Yield and Patient Experience of Multiplex Gene Panel Testing For Hereditary Cancer Risk. Sorscher and A.B. Idos, G., Kurian, A. W., Ricker, C., Sturgeon, D., Culver, J., Kingham, K., Koff, R., Chun, N. M., Rowe-Teeter, C., Lowstuter, K., Hartman, A., Allen, B., Kidd, J., Mills, M., Ma, C., Hong, C., McDonnell, K., Ladabaum, U., Ford, J. M., Gruber, S. B. Secondary analyses examined associations by race/ethnicity, age at primary breast cancer diagnosis, menopausal status, and tumor estrogen receptor (ER) status.Germline BRCA1, BRCA2, and CHEK2 PV carriers with breast cancer were at significantly elevated risk (hazard ratio > 1.9) of CBC, whereas only the PALB2 PV carriers with ER-negative breast cancer had elevated risks (hazard ratio, 2.9). A total of 637 women developing incident TNBC and 511 women developing incident HGSOC were matched with cancer-free controls (1841 and 2982, respectively) in a nested case-control design. We searched key electronic databases to identify studies evaluating hereditary cancer cascade testing. View details for Web of Science ID 000687070800036, View details for Web of Science ID 000708120605272, View details for DOI 10.1200/JCO.2021.39.15_suppl.e12507, View details for Web of Science ID 000708120300008, View details for Web of Science ID 000708120605242, View details for Web of Science ID 000708120605258, View details for DOI 10.1200/JCO.2021.39.15_suppl.6562, View details for Web of Science ID 000708120604016, View details for Web of Science ID 000648922701433, View details for Web of Science ID 000639219800501, View details for Web of Science ID 000639219800075, View details for Web of Science ID 000648922700539. CTCs that met stringent criteria for further analysis were obtained from 70% (14/20) of primary and 70% (21/30) of metastatic breast cancer patients; none were captured from patients with non-epithelial cancer (n = 20) or healthy subjects (n = 25). Karimi, Y., Blayney, D. W., Kurian, A. W., Rubin, D., Banerjee, I. bevacizumab. Google Cloud has grown briskly during Thomas Kurian's tenure. Racial/ethnic disparities in breast cancer survival are well documented, but the influence of health care institutions is unclear. Drugs used in chemotherapy, such as doxorubicin hydrochloride, cyclophosphamide, and All statistical tests were 2-sided. Wallner, L. P., Li, Y., McLeod, M., Gargaro, J., Kurian, A. W., Jagsi, R., Radhakrishnan, A., Hamilton, A. S., Ward, K. C., Hawley, S. T., Katz, S. J. View details for DOI 10.1158/1055-9965.EPI-12-0149. George Kurian was appointed CEO of $5.5 billion storage company NetApp about a year ago after a fast, meteoric rise at the company. These results will guide a larger study of the tool's impact on clinical decisions. Fifty-two percent (n=162) reported impact of COVID-19 on 1 or more aspects of social determinants of health with disproportionate impact among those with advanced cancer stages compared with earlier stages.CONCLUSIONS: COVID-19 impacted the care and well-being of patients with cancer and this impact was more pronounced among people with advanced cancer stages. Idos, G., Kurian, A. W., Ricker, C., Sturgeon, D., Culver, J., Kingham, K., Koff, R., Chun, N. M., Rowe-Teeter, C., Kidd, J., Evans, B., Brown, K., Mills, M., Ma, C., Hong, C., McDonnell, K., Ladabaum, U., Ford, J. M., Gruber, S. B. Computing the cost of care per day of breast cancer survivor care. (Am J Public Health. Ductal lavage was attempted in any duct identifiable with a catheter.Ducts were successfully catheterized in 60 of 75 patients (80%). Kurian, A. W., Canchola, A. J., Gomez, S. L. Prevalence of Lynch syndrome in women with mismatch repair-deficient ovarian cancer. Ricker, C., Koff, R., Qu, C., Culver, J. O., Sturgeon, D., Lowstuter, K., Hong, C. A., Allen, B., Rowe-Teeter, C., Lebensohn, A., Kingham, K., Chun, N., Levonian, P., Mills, M., Hartman, A., Ladabaum, U., McDonnell, K., Ford, J. M., Gruber, S., Kurian, A. W., Idos, G. Dynamic Strategy for Personalized Medicine: An Application to Metastatic Breast Cancer. We examined patient reports of cancer worry by test type and results in 1,063 women who linked to a genetic test and reported undergoing testing.More than half of the sample (n = 640; 60.2%) received BRCA1/2-only testing versus 423 patients (39.8%) who had a multigene panel. For Asian Americans, no associations were seen. () RSNA, 2017 Online supplemental material is available for this article. Wang, A., Wakelee, H. A., Aragaki, A. K., Tang, J. Y., Kurian, A. W., Manson, J. E., Stefanick, M. L. Equivalent survival after nipple-sparing compared to non-nipple-sparing mastectomy: data from California, 1988-2013. clinical exam or radiology will be randomized to either neoadjuvant treatment with Nipple-sparing mastectomy, which may improve cosmesis, body image, and sexual function in comparison to non-nipple-sparing mastectomy, is increasingly used to treat early-stage breast cancer; however, long-term survival data are lacking. We investigate the relevance of the major histocompatibility complex region in breast cancer susceptibility, using imputed class I and II HLA alleles, in 25,484 women of Asian ancestry.A total of 12,901 breast cancer cases and 12,583 controls from 12 case-control studies were included in our pooled analysis. Younger women were more likely to report some type of counseling, controlling for other factors: odds ratio, 4.5 (95% CI, 2.6 to 8.0); 1.9 (95% CI, 1.1 to 3.3); and 1.5 (95% CI, 1.0 to 2.3) for women younger than 50 years of age, 50 to 59 years of age, and 60 to 69 years of age versus those 70 years of age and older. View details for PubMedID 35723570, View details for DOI 10.1093/jncics/pkac045. Modeled outcomes were cancer incidence, tumor features that shape treatment recommendations, overall survival, and cause-specific mortality. Resulting regression model approximations include indicators for missingness, interactions, or other functions of the missingness not at random missingness model and observed data. [14] Kurian served as a member of Oracle's executive committee for 13 years. To quantify the potential benefit, we estimated reductions in absolute cancer-related deaths that could occur if cancers diagnosed after metastasis (stage IV) were instead diagnosed at earlier stages.We obtained stage-specific incidence and survival data from the Surveillance, Epidemiology, and End Results Program for 17 cancer types for all persons diagnosed ages 50 to 79 years in 18 geographic regions between 2006 and 2015. View details for DOI 10.1200/CCI.19.00034. All you need to know about Thomas Kurian, Google Cloud's new CEO and Silicon Valley success story. B., Zhou, R., Kozlov, A., DeMartini, W., Chen, S., Okamoto, S., Ikeda, D. M., Mattonen, S. A., Napel, S., Alkim, E., Sledge, G. W., Kurian, A. W., Liu, M., Telli, M. L., Itakura, H. Harnessing artificial intelligence to automate delineation of volumetric breast cancers from magnetic resonance imaging to improve tumor characterization. One-third (35.9%) of oncologists treated >50 new breast cancer patients annually; mean years in practice was 15.8. Linked Community and University data sets revealed that patients treated at both institutions received substantially more interventions (mastectomy: 55.8%; chemotherapy: 47.2%; magnetic resonance imaging: 38.9%; and genetic testing: 10.9% [P < .001 for each 3-way institutional comparison]).Data linkage identified 16% of patients who were treated in 2 health care systems and who, despite comparable prognostic factors, received far more intensive treatment than others. For more information, please contact Pei-Jen Chang, 650-725-0866. Thereafter, genome-wide association studies (GWAS) have accumulated data for hundreds of thousands of subjects. Conclusion: Nab-paclitaxel and paclitaxel monotherapy showed similar efficacy, suggesting their interchangeability as 1L treatments for mTNBC. The practice of genetic testing for hereditary breast and/or ovarian cancer (HBOC) is rapidly evolving owing to the recent introduction of multigene panels. In BCAC, increasing PRS313 was associated with lower grade, hormone receptor-positive status, and smaller tumor size. Hodan, R. n., Kingham, K. n., Cotter, K. n., Folkins, A. K., Kurian, A. W., Ford, J. M., Longacre, T. n. Racial/ethnic disparities in survival after breast cancer diagnosis by estrogen and progesterone receptor status: A pooled analysis. Imaging revealed multiple bilateral breast masses and right axillary adenopathy, and core needle biopsies showed invasive ductal carcinoma in both the right and left breast. Some mutations are unique to one family and others are recurrent; the spectrum of BRCA1/BRCA2 mutations varies depending on the geographical origins, populations or ethnic groups. Using electronic health records (EHRs) and biomolecular data, we sought to discover drug pairs with synergistic repurposing potential. pharmacokinetic (PK) cohort of the study (cohort A) in postmenopausal women with metastatic Patient regret and prophylactic surgery use were low, and patients appropriately encouraged relatives to be tested for clinically relevant results. The absolute benefits would increase to 4.8%-5.5% if the RS was 26+. Adjusting for baseline-model variables decreased disparity primarily by reducing the hazard ratio for African Americans to 1.13 (0.96 - 1.33). Kurian, A. W., Ward, K. C., Abrahamse, P. n., Bondarenko, I. n., Hamilton, A. S., Deapen, D. n., Morrow, M. n., Berek, J. S., Hofer, T. P., Katz, S. J. Recurrence status and disease sites massive parallel sequencing clinical impact of multi-gene panel testing for hereditary risk. 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