Biomarkers predictive of a response to extended endocrine therapy in breast cancer: a systematic review and meta-analysis.

PURPOSE: Extension of adjuvant endocrine therapy beyond five years confers only modest survival benefit in breast cancer patients and carries risk of toxicities. This systematic review investigates the role of biomarker tests in predicting the clinical response to an extension of endocrine therapy. METHODS: We searched Ovid MEDLINE, Ovid Embase, Global Index Medicus, and the Cochrane Central Register of Controlled Trials using an iterative approach to identify full-text articles related to breast cancer, endocrine therapy, and biomarkers. RESULTS: Of the 1,217 unique reports identified, five studies were deemed eligible. Four investigated the Breast Cancer Index (BCI) assay in three distinct study populations. These studies consistently showed that BCI score was predictive of response to extended endocrine therapy among 1,946 combined patients, who were predominately non-Hispanic white and postmenopausal. CONCLUSIONS: Evidence in the setting of predictive tests for extended endocrine therapy is sparse. Most relevant studies investigated the use of BCI, but these study populations were largely restricted to a single age, race, and ethnicity group. Future studies should evaluate a variety of biomarkers in diverse populations. Without sufficient evidence, physicians and patients face a difficult decision in balancing the benefits and risks of endocrine therapy extension.

Disruption of Library Services Due to Hospital Cyberattack: A Case Study.

Cyberattacks on healthcare organizations increased dramatically in 2020 and 2021. The University of Vermont Medical Center suffered an attack in October 2020, during the second wave of the COVID-19 pandemic. The disruption to hospital computer systems had wide-ranging impacts, including loss of online access to the medical library for nearly three months. Library staff worked to reduce impacts and increase access for hospital employees until full access was restored. This case study offers lessons learned and resources for health sciences libraries planning for a potential cyberattack.