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9560 Background: This abstract uses the National Institute on Aging/Alzheimer’s (NIA/AA) criteria to report the prevalence of MCI in a cohort of breast cancer survivors who received adjuvant chemot...

e18024 Background: Little is known about how specific comorbidities affect outcomes among adults receiving intensive therapy for AML. Our goal was to characterize comorbidities by age and investiga...

9516 Background: Breast cancer survivors report long term cognitive and quality of life effects due to cancer and chemotherapy. Cognitive enhancers (donepezil) could be a treatment option. We condu...

e18002 Background: The hypomethylating agents, azacitidine and decitabine, have emerged as an alternative to initial and salvage therapy in patients with AML. Little is known about how AML responds to hypomethylating agents after standard therapy and the use of these agents in the treatment of AML is currently evolving. Methods: We retrospectively examined 76 consecutive AML patients ≥60 years old treated with hypomethylating agents at Wake Forest from 2002-2009 as either 1st-line therapy (n=35), salvage (n=28) or consolidation (n=13). We collected data on age, gender, race, Charleston Comorbidity index (CCI), cytogenetics, type of treatment, Complete Remission (CR), Complete Remission with incomplete count recovery (CRi), and survival. Statistical analysis was performed using Kaplan-Meier estimates and cox proportional hazards models. Results: In the front line setting 11.4% of patients received azacitidine (AZA), 34.3% received 5 days of decitabine (5DD) and 54.3% received 10 days (10DD). In the salvage cohort 3.6% received AZA, 42.8% received 5DD and 53.6% received 10DD. In the consolidation cohort 18.2% received AZA and 81.8% received 5DD. Response rates (CR+CRi) were reduced in the salvage cohort compared to frontline (3.6% versus 25.7%, p=0.033). Despite the reduced response rate, overall survival in the two cohorts was similar when survival was calculated from time of hypomethylating agent (8.2 [CI 4.8-10.3] vs. 3.1 [CI 1.9-12.0] months, p = 0.2967). In the salvage cohort overall survival from the time of relapse was similar to the overall survival of those treated in 1st consolidation (18.3 [CI 15.1 -23.5] vs. 13.7 [CI 8.0 – 21.6] months, p= 0.3346). This suggests that hypomethylating agents given in first remission did not improve survival over patients who received them only after relapse. Comorbidity burden (by the CCI) showed a non-significant trend with prognosis (p= 0.0667). Conclusions: These data suggest prior cytotoxic therapy decreases marrow response rates to hypomethylating agents but not survival. Furthermore, use of hypomethylating agents for consolidation did not result in an increase in median overall survival when compared to their use in salvage.

1034 Background: Triple-negative breast cancers (TNBC) comprise 15% of breast cancers and lack ER, PR, and HER2 expression. TNBC is biologically aggressive with high rates of recurrence, but little is known about the prognosis of small (≤1cm) TNBCs compared to similarly sized breast cancers with other receptor profiles. The role of adjuvant chemotherapy for TNBC that is ≤1cm remains unclear. Methods: Electronic medical records of all women aged ≥ 18 years with ≤1 cm, node negative, invasive breast cancer from 1997-2007 diagnosed or treated at Vanderbilt or Wake Forest were reviewed. Tumor grade, receptor status, treatment details, and follow up and recurrence information were tabulated. Rates of local and distant recurrence among three different receptor subtype categories, ER+ or PR+, HER2 negative; ER-/PR-, HER2 negative; or any ER/PR, HER2 positive were compared using chi-square tests. Results: 437 women with ≤1cm breast tumors were identified. Women with TNBC not given chemotherapy were more likely to have distant recurrence at 9% compared to 2% for ER+ or PR+, HER2 negative and 4% for any ER/PR, HER2 positive. There were no recurrences among the 14 women with ≤1cm TNBC who received chemotherapy. Conclusions: Based on our two institution review, women with ≤1 cm TNBC are at an increased risk for distant recurrence compared to other subtypes when not treated with adjuvant chemotherapy. Further studies to determine the benefit of adjuvant chemotherapy in this population are needed. [Table: see text]

e19576 Background: Late effects of cancer treatment are the occurrence of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). The communication of potential risk will influence a patie...

1120 Background: The active form of vitamin D (1,25(OH)2D) affects proliferation, apoptosis, and angiogenesis and is a potential therapy for breast cancer. However, the use of active vitamin D is limited by hypercalcemia. Analogs of 1,25(OH)2D that are less calcemic have been developed for the treatment of hyperparathyroidism of kidney disease. In preclinical studies, 1,25(OH)2D analogs improved on the clinical efficacy of taxanes. Methods: We sought to determine the safety of dose titration of the 1,25(OH)2D analog, paricalcitol (19-nor-1,25-Dihydroxyvitamin D2), in combination with a taxane or ixabepilone in the treatment of women with metastatic breast cancer (MBC). Feasibility was defined as 8 weeks of continuous therapy of paricalcitol in the first 3 months. Serum calcium was monitored weekly until a steady dose was achieved. If the serum calcium was < 8.9 mg/dl then the dose was increased by one tablet (1 µg), if 9-11.4 mg/dl the dose maintained, and at higher levels the dose was held. Results: We e...