Tamoxifen treatment is important assistant for estrogen‐receptor‐positive breast cancer (BRCA) after resection. This study aimed to identify signatures for predicting the prognosis of patients with BRCA after tamoxifen treatment. Data of gene‐specific DNA methylation (DM), as well as the corresponding clinical data for the patients with BRCA, were obtained from The Cancer Genome Atlas and followed by systematic bioinformatics analyses. After mapping these DM CPG sites onto genes, we finally obtained 352 relapse‐free survival (RFS) associated DM genes, with which 61,776 gene pairs were combined, including 1,614 gene pairs related to RFS. An 11 gene‐pair signature was identified to cluster the 189 patients with BRCA into the surgical low‐risk group (136 patients) and high‐risk group (53 patients). Then, we further identified a tamoxifen‐predictive signature that could classify surgical high‐risk patients with significant differences on RFS. Combining surgical‐only prognostic signature and tamoxifen‐predictive signature, patients were clustered into surgical‐only low‐risk group, tamoxifen nonbenefit group, and tamoxifen benefit group. In conclusion, we identified that the gene pair PDHA2–APRT could serve as a potential prognostic biomarker for patients with BRCA after tamoxifen treatment.

Background The aim of this study was to assess the prognosis of breast cancer patients with distant metastasis after surgery of the primary tumor and provide new understanding of treatment for these patients. Methods We retrospectively analyzed 8922 primary metastatic breast cancer (PMBC) patients from Surveillance, Epidemiology, and End Results (SEER) Database. The patients' clinical and pathological characteristics were investigated. Overall survival (OS) and breast cancer-specific survival (BCSS) were calculated by Kaplan-Meier method. Independent risk factors associated with disease special mortality were identified by Cox regression analysis. Results A total of 8922 PMBC patients from SEER database were identified, while 1724 (19.3%) of them received surgery therapy (ST) and 7198 (80.1%) patients were identified as no surgery therapy group (NST). Patients' underwent ST had dramatically increased OS (P<0.001) and BCSS (P<0.001) compared with those in NST group. And the result figured out that the patients with 1 or 2 distant metastatic sites might benefit most from local surgery, while the prognosis of patients with 3 or more showed no significant difference (p= 0.073 for OS, p= 0.091 for BCSS). Furthermore, no differences were found in the survival rates between different surgical procedure groups (p= 0.886 for OS, p= 0.943 for BCSS). PMBC patients with ST tented to have increased OS (hazard ratio [HR] = 0.642; 95% confidence interval [CI], 0.583-0.707, p < 0.001) and BCSS (HR = 0.649; 95% CI, 0.587-0.718, p < 0.001), while age, grade, T stage, breast subtype, radiation, the number of metastatic site were also independent prognostic factors. Conclusions The current study demonstrated the survival benefit of ST in PMBC patients, especially those has 1 or 2 distant metastatic sites. Enlarged surgical range could not prolong survival. However, a large randomized clinical trial to validate the efficacy of ST in PMBC is essential in the future. Key words: primary metastatic breast cancer; SEER Database; survival; surgery Citation Format: Zhao Y, Sun H, Yang X, Zhao Y, Chen M, Jin W. Local surgery improves survival in patients with primary metastatic breast cancer: A population-based study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-28.

Background:Given the lack of evidence for survival benefit in patients with metastatic renal cell carcinoma from the addition of radiation therapy to tyrosine kinase inhibitor therapy, this Bayesian network meta-analysis aimed to evaluate survival outcomes in patients receiving radiation therapy plus tyrosine kinase inhibitor therapy.Methods:The preferred reporting items for systematic reviews and meta-analyses reporting guidelines were followed to conduct this study. The electronic databases of PubMed, Cochrane Library, EMBASE, and Web of Science were searched from the inception to August 2021. All phase III clinical trials that reported the outcomes of tyrosine kinase inhibitor with radiation therapy compared with those of tyrosine kinase inhibitor or radiation therapy alone for patients with metastatic renal cell carcinoma were considered eligible for inclusion in this meta-analysis. Overall survival as the primary outcome of interest, and adverse events as secondary outcome of interest were recorded for meta-analysis.Results:A Bayesian network meta-analysis is an appropriate statistical method to compare all treatment options by statistically simulating the estimated results of a comprehensive trial, and to compare treatments by common and associated comparators. In addition, Bayesian network meta-analysis can produce ranking probabilities of treatments, which may contribute to clinicians’ clinical decision-making.