Qualitative data was collected from Mexican-American (MA) and Puerto Rican (PR) breast cancer survivors to gain their perspectives on the relevant issues surrounding breast cancer survivorship and exercise. Six focus groups, a total of 31 participants were convened (three in Puerto Rico and three in Texas). Responses were analyzed and compared between the Mexican-American and Puerto Rican groups. Follow-up sessions were conducted at the sites to review the initial results and to validate a culturally adapted exercise intervention trial. A total of 900 responses were catalogued into 27 codes. Both groups had similar descriptions of exercise and barriers to exercise. Both groups expressed lack of information regarding their exercise capabilities. The groups differed in their responses to perceived safety in their community and how to deliver a culturally adapted exercise intervention in their community. We found important cultural differences and similarities in relevant factors of exercise and breast cancer survivorship.

Background Axicabtagene ciloleucel (axi-cel) is an autologous CD19-specific CAR T-cell therapy product that was FDA approved for the treatment of adult patients with relapsed or refractory large B-cell lymphoma after at least two lines of systemic therapy. In the pivotal ZUMA-1 study, the best overall response (ORR) and complete response (CR) rates observed in 108 patients treated with axi-cel were 82% and 58%, respectively. At a median follow-up of 15.4 months, 42% of the patients remain in ongoing response (Neelapu et al. N Eng J Med 2017). Analysis of efficacy outcomes in patients <65 years (N=81) and ³65 years (N=27) showed that the ORR and ongoing response at 12 months were comparable between the two subgroups (Neelapu et al. N Eng J Med 2017). Whether the safety is also comparable between the two subgroups is unknown. Here, we report safety outcomes in elderly patients (³65 years) with large B-cell lymphoma treated with axi-cel at our institution. Methods We retrospectively analyzed and reviewed the data from patients treated with axi-cel at our institution. Patients had a diagnosis of relapsed or refractory diffuse large B-cell lymphoma (DLBCL), primary mediastinal B-cell lymphoma (PMBCL), high-grade B-cell lymphoma (HGBCL), and transformed follicular lymphoma (TFL). Patients were treated with conditioning chemotherapy with cyclophosphamide and fludarabine for 3 days followed by axi-cel infusion after 2 days of rest at a dose of 2 x 106 CAR+ T cells/kg body weight. Patients were monitored for toxicities for at least 7 days in the hospital after CAR T infusion and those who had at least 30 days of follow-up after axi-cel were considered to be evaluable for safety. Cytokine release syndrome (CRS) and neurological toxicity termed as CAR-related encephalopathy syndrome (CRES) were graded according to the CARTOX grading system (Neelapu et al. Nat Rev Clin Oncol 2018). Results A total of 61 patients with relapsed or refractory large B-cell lymphoma who received axi-cel at our institution were included. Of these, 44 (72%) patients were <65 years of age and 17 (28%) patients were ³65 years of age. The baseline characteristics of the patients are summarized in Table 1. ORR and CR rates at Day 30 were comparable between the two groups. CRS was common in both groups and was observed in 83% and 91% of the patients in the older and younger age groups, respectively. But most CRS events were grade 1-2. Grade 3 or higher CRS was observed in 18% vs. 11% in the older vs. younger age groups (P=0.67). One patient with a history of autoimmune disease in the elderly group died of hemophagocytic lymphohistiocytosis (HLH). CRES was observed in 58% and 71% of the patients in the older and younger age groups, respectively. Grade 3 or higher CRES was observed in 29% vs. 39% in the older vs. younger age groups (P=0.58). Median hospitalization period for axi-cel CAR T-cell therapy was comparable between the two groups. Conclusions Our results suggest that response rates are comparable between the elderly and younger age groups at day 30 after axi-cel therapy. Importantly, toxicities due to CRS and/or CRES after axi-cel CD19 CAR T cell therapy are comparable between the elderly (³65 years) and younger (<65 years) patients with relapsed or refractory large B-cell lymphoma. Table 1 Table 1. Disclosures Nastoupil: Merck: Honoraria, Research Funding; Janssen: Research Funding; Juno: Honoraria; Novartis: Honoraria; Genentech: Honoraria, Research Funding; TG Therappeutics: Research Funding; Karus: Research Funding; Celgene: Honoraria, Research Funding; Spectrum: Honoraria; Gilead: Honoraria. Fowler:Pharmacyclics: Consultancy, Research Funding; Janssen: Consultancy, Research Funding. Samaniego:ADC Therapeutics: Research Funding. Wang:Kite Pharma: Research Funding; Acerta Pharma: Honoraria, Research Funding; Novartis: Research Funding; Juno: Research Funding; Pharmacyclics: Honoraria, Research Funding; Dava Oncology: Honoraria; AstraZeneca: Consultancy, Research Funding; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; MoreHealth: Consultancy; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding. Westin:Kite Pharma: Membership on an entity's Board of Directors or advisory committees; Apotex: Membership on an entity's Board of Directors or advisory committees; Novartis Pharmaceuticals Corporation: Membership on an entity's Board of Directors or advisory committees; Celgen: Membership on an entity's Board of Directors or advisory committees.

Breast cancer is the leading cause of cancer death among Hispanic women. Certain dietary factors have been associated with the risk of breast cancer recurrence, but data in Hispanic survivors is scarce. Objective to examine dietary patterns and diet quality in two groups of Hispanic breast cancer survivors. Methods 23 Mexican American (MA) and 22 Puerto Rican (PR) female breast cancer survivors completed a culturally adapted validated food frequency questionnaire. Intake was standardized per 1,000 kcal and compared to US Dietary Guidelines and the DASH-style diet adherence score was calculated. Results Overweight/obese was 70% in MA and 91% in PR. PR consumed diets rich in fruit/100% fruit juices and beans, while MA diets were high in vegetables, beans, and total grains. Both groups consumed high amounts of starchy vegetables, refined grains, animal protein and calories from solid fats and added sugars but low intakes of whole grains, dairy products and nuts and seeds. DASH scores were relatively low. Conclusion MA and PR female breast cancer survivors have different dietary patterns but both groups had relatively low diet quality. These groups could benefit from culturally tailored interventions to improve diet quality, which could potentially reduce cancer recurrence.

PurposePhysical activity (PA) has a myriad of benefits for breast cancer survivors, including a reduced risk of cancer recurrence. Latinas are less physically active than are women in the general population and little is known about Latina breast cancer survivors’ levels of PA or their beliefs related to PA. We conducted a survey of 50 Puerto Rican (PR), 50 Mexican-American (MA) and 50 non-Hispanic white (NHW) breast cancer survivors to investigate similarities and differences in PA and social cognitive theory (SCT) constructs associated with PA.Methods We collected information on current PA using the Godin Leisure Time Exercise Questionnaire (GLTEQ); comorbidities; anthropometric measures of body mass index [BMI (kg/m2)] and waist-to-hip (W:H) ratio; and SCT measures, including exercise self-efficacy, exercise barriers self-efficacy, modeling and social support from friends and family. Descriptive statistics, one-way analysis of variance of differences between groups and regression models of the predictors of PA were performed.ResultsSurvivors from the three groups were similar in age (M = 56.8, SD = 11.0), BMI (M = 29.0, SD = 5.7) and co-morbidity (M = 2.09, SD = 1.69). Survivors differed in PA (p < 0.001), self-efficacy (p = 0.05), modeling (p = 0.03) and social support from family (p = 0.05). Social support from family member and exercise barriers self-efficacy were predictors of PA.Conclusions Consistent with published studies, Hispanic breast cancer survivors self-report that they are less physically active than are non-Hispanic whites. SCT variables associated with PA differ among Hispanic subgroups and non-Hispanic whites. Further research is warranted in order to understand determinants of physical activity for specific ethnic breast cancer survivors.

Purpose: Among the plethora of benefits of moderate to vigorous levels of physical activity for breast cancer survivors is a link to reduced risk for cancer recurrence. However, after the experience of cancer, many breast cancer survivors who were not previously active will stay inactive; and, those who were active do not return to their previous level of activity. Latinas are among the least physically active segments of the U.S. population. Utilizing a Social Cognitive Theory (SCT) based model as a guide, we conducted a cross sectional survey to investigate similarities and differences in SCT variables associated with current level of physical activity in Puerto Rican, Mexican-American and non-Hispanic white breast cancer survivors. The results reported here are being used to culturally adapt an exercise intervention specific for Mexican-American and Puerto Rican breast cancer survivors. Methods: A total of 150 breast cancer survivors completed an interviewer-guided survey. Fifty Puerto-Rican (PR) participants completed the survey in San Juan Puerto Rico in the Oncologic Hospital. Fifty Mexican-American (MA) and fifty non-Hispanic (NHW) white breast cancer survivors completed the survey in the Breast Clinic at the University of Texas M. D. Anderson Cancer Center. The survey included information on: current physical activity (Godin Leisure Time Exercise Scale, [GLTES]); current health status; and, anthropometric measures of BMI (kg/m2) with hip and waist circumferences (W:H). SCT measures included: exercise self-efficacy (ESE), barriers self-efficacy (BSE), modeling (MOD), social support from friends (SSFR), and social support from family (SSFA). Descriptive statistics, one-way analysis of variance and correlation analyses were conducted for the three groups. Results: Participants were similar in age (M=56.75, SD=11.0), BMI (M=29.0, SD=5.7) and level of co-morbidity (M=1.63, SD=1.42). There were differences in GLTES score (p&lt;.001) with the PR group having the lowest level (M=14.0, SD=19.1), MA lower level (M=33.5, SD=18.8) and NHW highest levels (M=43.7, SD=27.6) of activity. SCT variables that differed between groups were ESE (p=.05), MOD (p=.034) and SSAF (p=.052). SCT variables associated with current physical activity differed between the three groups: for NHW BSE (r=.58, p&lt;.001) and SSFA (r=.26, p=.01); for PR ESE (r=.58, p&lt;.001), BSE (r=.58, p&lt;.001); and, for MA MOD (r=.41, p=.003) were associated with current physical activity. Conclusions: Consistent with current literature, Hispanic breast cancer survivors indicate that they are less physically active than non-Hispanic whites. Variables associated with current physical activity differ between Hispanic breast cancer survivor groups and non-Hispanic whites. Further research to understand culturally specific variables of exercise behaviors for ethnic breast cancer survivors are warranted in order to develop culturally competent interventions that can result in increased physical activity. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B57.