Sarita Shrivastva

Trastuzumab, a humanized monoclonal antibody, significantly improves outcomes in HER2-neu positive breast cancer. The incidence of cardiotoxicity with trastuzumab is approximately 8 to 10%. This study was designed to analyze the incidence and risk factors associated with trastuzumab-related cardiotoxicity in real-world settings. This was a single institutional retrospective analysis of the incidence of trastuzumab-related cardiotoxicity in nonmetastatic HER2-positive, invasive breast cancer from January 2013 to December 2018. Trastuzumab-related cardiotoxicity was defined as symptomatic heart failure or asymptomatic decline in left ventricular ejection fraction (LVEF) by more than or equal to 10% or LVEF less than 50%. Risk factors analyzed were higher body mass index (≥30 kg/m2), history of diabetes, hypertension, cardiac disease, left-sided radiotherapy (RT), and prior exposure to anthracyclines. Out of the 246 patients diagnosed with early stage HER2-positive breast cancer, 117 (47.5%) received trastuzumab and constituted the study population. Trastuzumab-related cardiotoxicity was seen in a total of 16 (13.6%) patients. Eleven (9.4%) patients had an asymptomatic decline, while symptomatic LV dysfunction was seen in five (4.2%) patients. The median baseline ejection fraction was 65% (range, 56–72). The median time to development of cardiotoxicity was 18.5 weeks (range, 3–52) and the median trastuzumab cycle for cardiotoxicity was 6 (range, 2–16). Ten (62.5%) patients were rechallenged with trastuzumab following which one patient developed an asymptomatic decline in ejection fraction and one patient developed symptomatic heart failure. Cardiac-related mortality was seen in one (0.85%) patient. Left-sided RT to chest (p = 0.012) and presence of more than or equal to two risk factors (p = 0.01) had significant impact on incidence of cardiotoxicity. Approximately 14% developed trastuzumab-related cardiotoxicity that was slightly higher compared with that seen in clinical trials. Left-sided RT to chest and presence of two or more risk factors had significant impact on development of cardiotoxicity.

11038 Background: Social media has profoundly impacted our professional lives. Quick access to reliable sources of information and engaging with like-minded experts certainly aids in professional development. The purpose of this study is to assess the perception of oncology experts towards social media based education and to develop a platform based on their feedbacks for constructive engagement of the professionals and to improve educational outcomes. Methods: Based on Kirkpatrick 4 level model, 15 questions were designed for oncology experts. We collected responses through online surveys and by distributing the questionnaires at oncology events. Based on the results obtained, we developed a customised social media application for oncologists in android version. User experience design was done in InVision Studio and Model View Presenter (MVP) design pattern was used in software development. Beta testing of the application was done with 50 experts and questionnaire was given to them at the end of beta testing period to compare the technical advantages of our mobile application with their currently preferred social media platform for oncology based education. Results: Among 311 responders, medical oncologists, radiation oncologists, surgical oncologists, hemato oncologists and oncopathologists constituted 45%, 29%, 16%, 7% and 3% respectively. Only 14% clearly denied that social media has improved educational outcomes. Eighty seven percent felt that they lack adequate knowledge in other areas of expertise and 67% of the oncologists were not well informed about the latest oncology updates. Only 60% could actively engage in interdiscliplinary collaboration due to reasons unspecified. When asked about the best way to learn a topic of interest, majority opined it through peer discussion with experts pertaining to that topic of interest. The two major problems faced by experts while seeking social media based education is academic discussions being unorganised and non-academic discussions unwelcomed. After considering these feedbacks, a mobile application in android version was developed. At the end of beta testing, 96% reported a technical advantage of our customised application over their preferred social media based oncology education. Conclusions: A minimum viable product has been developed after considering the feedbacks received from oncologists of various sub-specialities. Such a customised social media application is more appealing when easily applicable across low and middle income countries and in a manner that allows addition of local language options without changing the application software.