The Salt Lake Regional Medical Center is a 158-bed hospital in Salt Lake City, Utah.Salt Lake Regional Medical Center was formerly known as Holy Cross Hospital, which was one of the few Catholic hospitals in Utah for over a century. The hospital was sold by the Sisters of the Holy Cross in 1994 to the for-profit, HealthTrust and renamed. Due to antitrust concerns raised by the Federal Trade Commission, the hospital was sold to Champion Healthcare Corporation in 1995. The facility changed hands again in 1998 when Champion merged with Paracelsus Healthcare Corporation. It was operated by Iasis Healthcare from 2001 until September 2017, when Iasis Healthcare was acquired by Steward Health Care.
A perimenopausal woman presented with a slowly enlarging right axillary mass initially suspected to be a sebaceous cyst. An incisional biopsy revealed high-grade invasive ductal carcinoma arising from accessory axillary breast tissue. Imaging showed no orthotopic breast lesion and staging was cT1N0M0. She underwent axillary lumpectomy and sentinel lymph node biopsy, confirming pT1bN0M0 invasive carcinoma. Adjuvant therapy included whole breast radiation, hormonal therapy with anastrozole and goserelin. At 2 years, she remains disease-free. This case highlights the diagnostic challenge of accessory axillary breast cancer (AABC), a rare entity often missed on routine imaging. Early recognition and application of standard breast cancer treatment protocols can result in excellent outcomes. Clinicians should maintain a high index of suspicion for AABC in axillary masses, especially in patients with no primary breast findings on imaging to ensure timely diagnosis and appropriate management.
Lung cancer remains the leading cause of cancer mortality worldwide. Immune checkpoint inhibitors (ICI) targeting PD-1/PD-L1 have significantly improved outcomes in a subset of patients. OncoPrism, a clinical test employing a multidimensional predictive RNA-based immune biomarker, was evaluated for predicting immune checkpoint inhibitor benefit in non-small cell lung cancer (NSCLC) patients. This study evaluated OncoPrism in 1487 patients across four NSCLC cohorts: one PD-L1 inhibitor cohort (n = 195), one PD-1 inhibitor cohort (n = 89), and two non-ICI cohorts (n = 193 and n = 1010). In the PD-L1 inhibitor cohort, OncoPrism predicted progression-free survival (p < 0.0001) and overall survival (p = 0.043). In the PD-1 inhibitor cohort, an observational clinical trial, PREDAPT, enrolling patients from 17 healthcare systems, OncoPrism predicted overall response rate (p = 0.008), progression-free survival (p = 0.004), and overall survival (p = 0.011). PD-L1 Tumor Proportion Score (TPS) was not predictive of response, progression-free survival, or overall survival. OncoPrism did not predict overall survival across two non-ICI NSCLC cohorts (p = 0.54, p = 0.73), suggesting the test is specifically predictive of ICI benefit rather than being prognostic with more limited clinical utility. Overall, the data show OncoPrism high patients have two to three-fold greater overall response rate, progression-free survival, and overall survival compared to those in other OncoPrism groups. These results underscore the impact of OncoPrism to address the current unmet need for ICI response prediction in NSCLC. This trial was registered with ClinicalTrials.gov, number NCT04510129, on 10 August 2020.
