Awareness and knowledge of HPV and cervical cancer in female students: A survey (with a cautionary note)

We conducted a survey to explore levels of awareness and knowledge of human papillomavirus (HPV) and cervical cancer in 170 female students and whether mode of data collection (online vs. paper) affected the results. 27% of women named HPV as a cause of cervical cancer with online respondents more likely to do so. 75% of women had heard of HPV. More online respondents had heard of HPV than paper respondents. 127 women reported having heard of HPV, with a mean knowledge score of 2.989 (standard deviation [SD] 1.599). Online respondents scored higher (3.57, SD 1.316) than paper respondents (2.688, SD 1.591). Knowledge and awareness of HPV and its link to cervical cancer appear to have increased which may be related to the HPV vaccination programme. However, there is still a considerable number of women with little to no knowledge of HPV. Online surveys may result in an inflated estimation of awareness and knowledge.

Significance of heat-shock protein-90 as a prognostic indicator in breast-cancer

A human breast cancer cDNA library was screened with a polyclonal antiserum against breast cancer metastasis membranes in order to select genes whose expression may be altered in breast malignancy. Several immunopositive clones have been isolated. One of these, AJ1, was analyzed in detail and found to be expressed at varying levels as a 3.3 kb mRNA in all of the 123 primary breast cancers examined. AJ1 was expressed at lower levels in non-malignant biopsies as compared to malignant tissue (p=0.0008). We found high expression to be associated with lymph node involvement (p=0.059). Comparison between high and low expressing groups showed a significant difference for both overall (p=0.039) and relapse-free (p=0.034) survival at 10 years, with early recurrence and reduced overall survival in high expressors. Thus, AJ1 could be a potentially useful prognostic factor and marker of aggressiveness in breast cancer. Partial sequence analysis of the 620 bp clone showed complete homology with human heat shock protein, HSP 90.

Comparative-study of intramuscular ketorolac tromethamine and morphine in patients experiencing cancer pain

Ketorolac tromethamine administered intramuscularly (i.m.) 10 mg 6-hourly was compared with morphine 10 mg i.m. 6-hourly in a randomised, double-blind, cross-over trial for its analgesic efficacy and safety in 51 patients with moderate to severe cancer pain. There was no overall significant difference between the analgesic effect of the two treatments. 57% of ketorolac- and 74% of morphine-treated patients changed their analgesic. Among these, significantly more patients stopped ketorolac than morphine due to pain (p=0.007) whilst more patients discontinued morphine than ketorolac because of adverse effects (p=0.001), predominantly emesis. Only one patient (2%) stopped ketorolac because of intolerance. Ketorolac shows promise as an effective and well tolerated analgesic for cancer pain and merits further study.

Changes in [18F]Fluorothymidine Pharmacokinetics Following Capecitabine Treatment in Human Breast Cancer Detected by Positron Emission Tomography

Background: Pre-clinical models used by our group have demonstrated that thymidylate synthase (TS) inhibition leads to redistribution of the nucleoside transporter, ENT1, to the cell membrane and hence increases the tissue uptake of [18F]fluorothymidine (FLT).Methods: In this study we assessed, for the first time, the altered pharmacokinetics of FLT in patients following TS inhibition. We analyzed 10 lesions from 6 breast cancer patients by positron emission tomography (PET) before and after treatment with capecitabine.Results: Whereas drug treatment did not alter tumor delivery pharmacokinetic variables or blood flow, tumor FLT retention variables increased with drug treatment in all but one patient. The baseline average standardized uptake value (SUV) at 60 min, rate constant for the net irreversible transfer of radiotracer from plasma to tumor (Ki) and unit impulse response function (IRF) at 60 min were 11.11 x 10-5 m2/ml, 4.38 x 10-2 ml plasma/min/ml tissue and 4.93 x 10-2 /min, respectively. At 1 h after capecitabine, the SUV was 13.55 x 10-5 m2/ml (p=0.004), Ki 7.40 x 10-2 ml plasma/min/ml tissue (p=0.004) and IRF 7.40 x 10-2 /min (p= 0.002).Conclusion: FLT pharmacokinetics did not change in normal tissues suggesting that the effect was largely restricted to tumor (p=0.55). In summary, we have identified FLT-PET retention parameters that could be used in future early clinical studies to measure the pharmacodynamics of TS inhibitors, as well as for identifying patients who are unlikely to benefit from TS inhibition.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5003.

The anatomic localization of circulating tumor cells and the immediate impact of surgery and radiofrequency ablation

e22004

Background: There are few data on the impact of immediate and differing surgical interventions on circulating tumor cells (CTCs), nor their compartmentalization or localization in different anatomic vascular sites. Methods: CTCs from consecutive patients with colorectal liver metastases were quantitated prior to and immediately after open surgery, laparoscopic resection, open radiofrequency ablation (RFA) or percutaneous RFA. For individuals undergoing open surgery, either hepatic resections or open RFA, CTCs were examined in both systemic and portal circulation by measuring CTCs in samples derived from the peripheral vein, an artery, the portal vein and hepatic vein. Results: A total of 29 consecutive patients with colorectal liver metastases were included with a median age of 55 (range 30 - 88 years). CTCs were localized to the hepatic portosystemic macrocirculation with significantly greater numbers than in the systemic vasculature. Surgical procedures led to a statistically significant fall in CTCs at all sites measured (p<0.05). Conversely, RFA, either open or percutaneous was associated with an increase in CTCs. Conclusions: Surgical resection of metastases but not RFA decreases CTC levels. In patients with colorectal liver metastases, CTCs are localized to the hepatic (and probably pulmonary) macrocirculations. This may explain why metastases in sites other than the liver and lungs, are infrequently observed in cancer.

No significant financial relationships to disclose.

Inhibiting nicastrin (NCT) stabilizes expression of e-cadherin and has potential in inducing mesenchymal to epithelial transition in breast cancer (BC)

Abstract #3066

Introduction: NCT is a member of the Gamma Secretase (GS) enzyme complex, responsible for activating multiple substrates (Notch proteins, Her4, E-cadherin , CD44 etc.), implicated in BC development and progression from primary tumour to metastasis. E-cadherin (E-cad) is a key protein regulating cell-to-cell adhesion. Loss of E-cad is a central feature of Epithelial-to-Mesenchymal (EMT) transition enabling cell migration and invasion, while restoration of E-cad expression indicates a less malignant cell phenotype.&#x2028; Materials and Methods: MCF-7 and MDA-MB-231 BC cell lines were used to investigate expression of NCT by Western Blot (WB) and RT-Q-PCR. Paraffin embedded BC tissue samples (n=126), 10 benign breast lesions (fibroadenoma) and 40 normal breast tissue specimens were analysed for NCT expression by Immunohistrochemistry (IHC). NCT was transiently silenced in vitro by siRNA and expression of E-cad, Beta-Catenin, Snail1 were analysed by WB and RT-Q-PCR. A commercially available kit was used to measure GS activity in vitro. Transmitted light microscopy was used to monitor cell motility using a model of a stable NCT knockout (KO) in mouse embryonic fibroblast (MEF) cells.&#x2028; Results: NCT was not expressed or was weakly expressed in normal breast tissue by IHC. Strikingly, NCT was highly expressed only in the myoepithelial layer of all 10 fibroadenomas analysed, while epithelial layer remained negative of weakly NCT positive (+). Breast carcinomas were graded as NCT 1+, 2+ or 3+. NCT siRNA (72 h) resulted in &gt;90% reduction of both NCT mRNA and protein levels, as well as &gt;50% reduction in GS activity in both MDA-MB-231 and MCF-7 cell lines. NCT siRNA did not affect E-cad, Beta-Catenin or Snail1 mRNA levels in these cell lines. However, NCT siRNA resulted in cellular redistribution of E-cad to the cell membrane, as visualized by immunofluorescence, and an increase in E-cad protein levels by WB in MCF-7 cells. The transient NCT silencing at 72 h did not result in change of morphology in MDA-MB-231 cells. Cell motility was, however, reduced by 20%: (0.01 µm/sec in parental MDA-MB-231 vs 0.008 µm/sec in MDA-MB-231 NCT siRNA cells). Stable NCT KO caused a notable change in cell phenotype, converting a spindle like wild type MEFs to rounded epitheloid-like morphology, coupled with a marked increase of E-cad localized to the membrane. Furthermore, cell motility was reduced by 3 fold in NCT KO MEFs (0.008 µm/sec in wild type MEFs vs 0.0025um/sec in the NCT KO MEFs).&#x2028; Conclusion: NCT is up-regulated in BC as compared to normal breast tissue. NCT is strongly expressed only in the myoepithelial cell compartment of breast fibroadenomas, suggesting possible involvement of NCT in EMT. Inhibiting NCT stabilizes E-cadherin protein levels in BC cells, at the post-translational level. Inhibiting NCT in BC may represent a potential strategy to reduce BC invasiveness and metastasis.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3066.