Pennsylvania Department Of State

10618 Background: Patients assigned male at birth (AMAB) with pathogenic germline variants (PGVs) in BRCA1 or BRCA2 ( BRCA+ ) have a 1-10% lifetime risk of developing breast cancer (BC). NCCN guidelines currently recommend that male BRCA1/2 carriers consider annual mammograms. However, there is minimal data on the mammography among male BRCA1/2 carriers. Methods: We identified a cohort of 489 BRCA + male patients with male gender identity from the electronic health record (EHR) at Penn Medicine who had no prior BC diagnosis. Charts were reviewed to determine indication for and results of mammography episodes between 2008-2024. A mammography episode was defined as all breast imaging studies obtained for a specific reason, i.e. asymptomatic screening or for symptoms within six months. An independent cohort of 1808 BRCA negative AMAB patients with male gender identity and no prior BC diagnosis from the Penn Medicine EHR was analyzed for the true positive rate of BI-RADS 4/5 findings. Results: Of 489 BRCA + individuals, 85 (17%) patients completed at least one mammography episode and 46 (9%) had at least one subsequent mammography episode during the study period. Of 85 BRCA + patients, 71% had BRCA2 PGVs. Of 404 patients who did not complete a mammogram, 270 were at least 50 years old at the time of data abstraction. Of these 270 patients, 50% had no discussion of mammograms in their charts, 8% of patients had a physician ordered mammogram that was not completed by the patient, and 42% had a shared decision-making discussion between the physician and patient indicating a decision against mammography. The first observed and subsequent mammography episodes were ordered for asymptomatic screening in 65% and 83% of 85 BRCA + individuals, respectively. In BRCA neg individuals, 92% of mammography episodes were for symptoms. Nine (11%) and one (2%) BRCA+ individuals were diagnosed with BC after the first observed or subsequent mammography episode, respectively. No breast cancers were identified on mammography episodes among asymptomatic patients. Combining all mammography data, the true positive rate of BI-RADS 4 mammograms was significantly higher in BRCA + vs BRCA neg individuals (71% vs 11%, p=0.0007); whereas the true positive rate of BI-RADS 5 mammograms was similar in BRCA + vs BRCA -neg individuals (100% vs 82%, p=0.54). Hormone receptor status and clinical stage of identified BC were similar between BRCA + and BRCA neg individuals. Conclusions: The majority of male BRCA1/2 carriers in our cohort did not complete mammography. All BC diagnosed in BRCA+ individuals were identified on mammography episodes obtained for symptoms. The true positive rate of a BI-RADS 4 mammogram was significantly higher in BRCA + compared to BRCA neg individuals. Additional data is needed regarding whether mammography identifies asymptomatic BC in male BRCA1/2 carriers and whether mammograms improve clinical outcomes.

BackgroundTFIIIB, an RNA polymerase III specific transcription factor has been found to be deregulated in human cancers with much of the research focused on the TBP, BRF1, and BRF2 subunits. To date, the TFIIIB specific subunit BDP1 has not been investigated in ovarian cancer but has previously been shown to be deregulated in neuroblastoma, breast cancer, and Non‐Hodgkins lymphoma.ResultsUsing in silico analysis of clinically derived platforms, we report a decreased BDP1 expression as a result of deletion in serous ovarian cancer and a correlation with higher and advanced ovarian stages. Further analysis in the context of TP53 mutations, a major contributor to ovarian tumorigenesis, suggests that high BDP1 expression is unfavorable for overall survival and high BDP1 expression occurs in stages 2, 3 and 4 serous ovarian cancer. Additionally, high BDP1 expression is disadvantageous and unfavorable for progression‐free survival. Lastly, BDP1 expression significantly decreased in patients treated with first‐line chemotherapy, platin and taxane, at twelve‐month relapse‐free survival.ConclusionsTaken together with a ROC analysis, the data suggest BDP1 could be of clinical relevance as a predictive biomarker in serous ovarian cancer. Lastly, this study further demonstrates that both the over‐ and under expression of BDP1 warrants further investigation and suggests BDP1 may exhibit dual function in the context of tumorigenesis.

The Midwest Regional Carbon Sequestration Partnership (MRCSP) was founded in 2003 as part of the U.S. Department of Energy’s (DOE’s) Regional Carbon Sequestration Partnership initiative. Since its founding, MRCSP has made significant strides toward making CCUS a viable option for states in the region. The public/private consortium, funded through the DOE Regional Carbon Sequestration Initiative, brings together nearly 40 industry partners and 10 states. Battelle, as the project lead, oversees research, development and operations and coordinates activities among the partners. The incremental, phased approach has built a valuable knowledge base for the industry and paved the way for commercial-scale adoption of CCUS technologies. From 2008 to 2020, MRCSP Phase III focused on the development of large-scale injection projects. This report is part of a series of reports prepared under the Midwestern Regional Carbon Sequestration Partnership (MRCSP) Phase III (Development Phase). These reports summarize and detail the findings of the work conducted under the Phase III project. The MRCSP regional geology Capstone report summarizes the regional characterization of geologic storage subtasks performed under MRCSP Phase III. The regional characterization work was completed by the state geological surveys of Delaware, Indiana, Kentucky, Maryland, New York, Ohio, Pennsylvania, and West Virginia along with Western Michigan University and Rutgers University. Building on the Phases I and II, the Phase III research was focused on key research topics identified in previous MRCSP efforts: [1] Regional Geologic Cross Sections for Potential Storage and Containment Zones; [2] Appalachian Basin: Enhanced Recovery Opportunities; [3] Michigan Basin: Assessment of Enhanced Oil Recovery Using Carbon Dioxide in Silurian Pinnacle Reefs; [4] Mid-Atlantic Coastal Plain and Adjacent Offshore Region: Characterization of Carbon Storage Targets; [5] Ordovician-Cambrian Units: Hierarchical Evaluation of Geologic Carbon Storage Resource Estimates; [6] Upper Silurian to Middle Devonian Strata of Ohio: Structural Characterization of Potential CO2 Reservoirs and Adjacent Strata; [7] Triassic Rift Basins: Preliminary Study of Long-Term CO2 Storage Potential Together, the regional characterization effort developed useful products to support project developers, policy makers and other stakeholders in the MRCSP region seeking to understand where potential storage exists relative to large stationary sources of CO2 emissions.

524 Background: The role of adjuvant therapy after radical cystectomy (RC) is not well-defined for squamous cell carcinoma (SqCC) of the bladder. Several studies suggest limited efficacy for chemo while adjuvant RT improved disease-free survival (DFS) vs. observation in a previous trial. In this study, we report a post-hoc subgroup analysis of SqCC to compare adjuvant therapies. We hypothesized that adjuvant RT would improve DFS vs. chemo for locally advanced bladder cancer (LABC) (≥pT3N0-N+). Methods: A randomized phase III trial was opened to compare adjuvant RT vs. sandwich chemo+RT after RC for LABC at the NCI in Cairo. A 3rd arm, adjuvant chemo, was added later. Bladder cancer patients ≤70 y/o with ≥1 of the following (pT3b/pT4a, grade 3, or pN+) with negative margins after RC were eligible. RT was delivered to the pelvis with 3D conformal RT (45Gy in 1.5Gy BID). Chemo+RT included 2 cycles of gemcitabine/cisplatin before & after RT. Chemo alone included gem/cis x 4. Primary & secondary endpoints were DFS and overall survival (OS). Results: 198 patients were enrolled. 82 (41%) had SqCC & 77 had ≥pT3N0-N+ disease and were analyzed (34 RT, 27 chemo+RT, & 16 chemo). Median age was 53. Median F/U was 20 months (1-127 months). The RT vs chemo arms were well-balanced except for number of nodes removed (mean 12 vs. 9, p=0.05). On univariable analysis, RT was not significantly associated with DFS [HR 0.56 (95%CI 0.26-1.21), p=0.14]. On multivariable analysis, only pN+ was significant. 2-yr DFS was 60% for RT & 43% for chemo (log-rank p=0.13). OS was improved with RT (2-yr OS 71% vs. 43%, p=0.04). There was one death during treatment (chemo-related). There was no significant difference in DFS or OS for RT vs. chemo+RT with 2-yr DFS of 59% & 55% (p=0.65) & 2-yr OS of 67% & 74% (p=0.16). Conclusions: On post-hoc analysis, RT for locally advanced bladder SqCC was associated with significantly improved OS vs. adjuvant chemo. We hypothesize that the inferior OS with chemo was due to increased toxicity & limited efficacy. There was no difference in outcomes for RT vs. chemo+RT. Adjuvant RT should be a standard option for ≥pT3 SqCC of the bladder after RC. Alternative chemo agents for SqCC should be explored. Clinical trial information: NCT01734798.

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351 Background: The role of post-operative chemotherapy after radical cystectomy (RC) is not well-defined. While some retrospective studies have shown a benefit, trials have been under-powered. In a phase III Egyptian trial, we evaluated the benefit of adjuvant chemo in locally advanced bladder cancer (LABC) patients treated with post-operative radiotherapy (PORT). In this study, we report a post-hoc subgroup analysis of patients with urothelial histology. We hypothesized that the addition of adjuvant chemo would improve disease-free survival (DFS) compared to PORT alone for LABC. Methods: A randomized phase III trial was opened to compare PORT vs. sequential chemo+PORT after RC for LABC & accrued from 2002–2008 at the NCI in Cairo. Bladder cancer pts ≤70 with at least one of the following factors (≥pT3b, grade 3, positive nodes) with negative margins after RC plus pelvic node dissection were eligible. RT was delivered using 3-D conformal RT to the pelvis to 45Gy in 1.5Gy BID. Chemo+PORT included 2 cycles of gemcitabine/cisplatin before & after RT. The primary endpoint was DFS. Secondary endpoints included overall survival (OS) & late GI toxicity. Results: 153 pts were enrolled. 53% had urothelial carcinoma (41 chemo+PORT & 40 PORT). In the urothelial cohort, the arms were well-balanced. Median age was 55. Median follow-up was 21 months for chemo+PORT (range 4-127) & 15 months for PORT (range 5-70). There were 2 local failures for PORT & none for chemo+PORT. Two-year DFS for chemo+PORT vs. PORT was 62% (95% CI 53-71%) & 48% (95% CI 39-58%), log-rank p=0.031. Two-year OS was 71% (95% CI 63-80%) & 51% (95% CI 40-61%), log-rank p=0.048. On multivariable analysis, chemo+PORT was a significant predictor of improved DFS (HR 0.42 95% CI 0.21-0.85, p=0.016) and OS (HR 0.45, 95% CI 0.21-0.96, p=0.039). In the entire cohort, late grade ≥3 GI toxicity was observed in 5 chemo+PORT patients (7%) & 6 PORT patients (8%). Conclusions: The addition of adjuvant chemo to PORT improved DFS & OS for LABC after RC with acceptable late GI toxicity. The results suggest a role for adjuvant therapies to address both local & distant disease. Clinical trial information: 01734798.

In the United States, organizations are becoming as diverse as ever, a trend that many organizations believe is important (Avery, McKay, & Valpone, 2013), but one that may lead to lower performance in diverse organizations (Joshi & Roh, 2009). Supporting diversity has been shown to aid in leveraging it (Gonzalez & Denisi, 2009), yet recruiting for just that is yet to be well understood. This study explored how organizational characteristics work to attract White individuals who would likely support diversity initiatives. Using racial identity development, a construct based in Cross’ (1971) and Helms’ (1989; 1990) work, we found support for using organizational characteristics of support for diversity, innovativeness, decisiveness, and rewards orientation to attract potential White allies.

This study investigates multidimensional aspects of process consultation to integrate diverse individuals and groups in post-modern organizations while considering how process consultants deal with challenges across and within cultures. The rapid globalization of recent years has meant that process consultants have more opportunities to work with clients who have multicultural backgrounds. The existing model of process consultation does not consider cultural diversity or the socioemotional dynamics of diverse workgroups. This paper explores process consultants’ verbal and nonverbal behavioral communication patterns based on the cultural mosaic framework. The study contributes to the literature regarding OD interventions and process consultation by suggesting how OD practitioners can support multicultural clients.