Genetic variants in MicroRNA biosynthesis pathways and binding sites modify ovarian cancer risk, survival, and treatment response

MicroRNAs (miRNA) play important roles in tumorigenesis. Genetic variations in miRNA processing genes and miRNA binding sites may affect the biogenesis of miRNA and the regulatory effect of miRNAs to their target genes, hence promoting tumorigenesis. This study analyzed 226 single nucleotide polymorphisms (SNP) in miRNA processing genes and miRNA binding sites in 339 ovarian cancer cases and 349 healthy controls to assess association with cancer risk, overall survival, and treatment response. Thirteen polymorphisms were found to have significant association with risk. The most significant were 2 linked SNPs (r(2) = 0.99), rs2740351 and rs7813 in GEMIN4 [odds ratio (OR) = 0.71; 95% confidence interval (CI), 0.57-0.87 and OR = 0.71; 95% CI, 0.57-0.88, respectively]. Unfavorable genotype analysis showed the cumulative effect of these 13 SNPs on risk (P for trend < 0.0001). Potential higher order gene-gene interactions were identified, which categorized patients into different risk groups according to their genotypic signatures. In the clinical outcome study, 24 SNPs exhibited significant association with overall survival and 17 SNPs with treatment response. Notably, patients carrying a rare homozygous genotype of rs1425486 in PDGFC had poorer overall survival [hazard ratio (HR) = 2.69; 95% CI, 1.67-4.33] and worse treatment response (OR = 3.38; 95% CI, 1.39-8.19), compared to carriers of common homozygous and heterozygous genotypes. Unfavorable genotype analyses also showed a strong gene-dosage effect with decreased survival and increased risk of treatment nonresponse in patients with greater number of unfavorable genotypes (P for trend < 0.0001). Taken together, miRNA-related genetic polymorphisms may impact ovarian cancer predisposition and clinical outcome both individually and jointly.

A genome-wide association study identifies susceptibility loci for ovarian cancer at 2q31 and 8q24

Ovarian cancer accounts for more deaths than all other gynecological cancers combined. To identify common low-penetrance ovarian cancer susceptibility genes, we conducted a genome-wide association study of 507,094 SNPs in 1,768 individuals with ovarian cancer (cases) and 2,354 controls, with follow up of 21,955 SNPs in 4,162 cases and 4,810 controls, leading to the identification of a confirmed susceptibility locus at 9p22 (in BNC2). Here, we report on nine additional candidate loci (defined as having P ≤ 10⁻⁴) identified after stratifying cases by histology, which we genotyped in an additional 4,353 cases and 6,021 controls. We confirmed two new susceptibility loci with P ≤ 5 × 10⁻⁸ (8q24, P = 8.0 × 10⁻¹⁵ and 2q31, P = 3.8 × 10⁻¹⁴) and identified two additional loci that approached genome-wide significance (3q25, P = 7.1 × 10⁻⁸ and 17q21, P = 1.4 × 10⁻⁷). The associations of these loci with serous ovarian cancer were generally stronger than with other cancer subtypes. Analysis of HOXD1, MYC, TIPARP and SKAP1 at these loci and of BNC2 at 9p22 supports a functional role for these genes in ovarian cancer development.

Oral poly(ADP-ribose) polymerase inhibitor olaparib in patients with BRCA1 or BRCA2 mutations and recurrent ovarian cancer: a proof-of-concept trial

BACKGROUND

Olaparib is a novel, orally active poly(ADP-ribose) polymerase (PARP) inhibitor that induces synthetic lethality in homozygous BRCA-deficient cells. We aimed to assess the efficacy and safety of olaparib for treatment of advanced ovarian cancer in patients with BRCA1 or BRCA2 mutations.

METHODS

In this international, multicentre, phase 2 study, we enrolled two sequential cohorts of women (aged >or=18 years) with confirmed genetic BRCA1 or BRCA2 mutations, and recurrent, measurable disease. The study was undertaken in 12 centres in Australia, Germany, Spain, Sweden, and the USA. The first cohort (n=33) was given continuous oral olaparib at the maximum tolerated dose of 400 mg twice daily, and the second cohort (n=24) was given continuous oral olaparib at 100 mg twice daily. The primary efficacy endpoint was objective response rate (ORR). This study is registered with ClinicalTrials.gov, number NCT00494442.

FINDINGS

Patients had been given a median of three (range 1-16) previous chemotherapy regimens. ORR was 11 (33%) of 33 patients (95% CI 20-51) in the cohort assigned to olaparib 400 mg twice daily, and three (13%) of 24 (4-31) in the cohort assigned to 100 mg twice daily. In patients given olaparib 400 mg twice daily, the most frequent causally related adverse events were nausea (grade 1 or 2, 14 [42%]; grade 3 or 4, two [6%]), fatigue (grade 1 or 2, ten [30%]; grade 3 or 4, one [3%]), and anaemia (grade 1 or two, five [15%]; grade 3 or 4, one [3%]). The most frequent causally related adverse events in the cohort given 100 mg twice daily were nausea (grade 1 or 2, seven [29%]; grade 3 or 4, two [8%]) and fatigue (grade 1 or 2, nine [38%]; none grade 3 or 4).

INTERPRETATION

Findings from this phase 2 study provide positive proof of concept of the efficacy and tolerability of genetically targeted treatment with olaparib in BRCA-mutated advanced ovarian cancer.

FUNDING

AstraZeneca.

A one-year study to assess the safety and efficacy of the CB1R inverse agonist taranabant in overweight and obese patients with type 2 diabetes

AIM

To evaluate the efficacy and safety of taranabant in overweight and obese patients with type 2 diabetes mellitus (T2DM).

METHODS

This was a multicenter, double-blind, randomized, placebo-controlled study in overweight and obese patients with T2DM (ages > or = 18 and < or = 75 years) with a BMI > or = 27 kg/m(2) and < or = 43 kg/m(2) and HbA1c > or =7.0 and < or = 10.0%, who were either not on an antihyperglycaemic agent or on a stable dose of metformin (> or = 1500 mg/day). After a 2-week placebo run-in, patients were randomized to placebo (N = 156) or taranabant 0.5-mg (N = 155), 1-mg (N = 157), or 2-mg (N = 155) once daily for 52 weeks. Primary efficacy endpoints were changes from baseline in body weight (BW) and HbA1c at Week 36, with results at Week 52 being key secondary endpoints.

RESULTS

In the all-patients-treated population, using a last-observation-carried-forward analysis, reductions in BW were -2.5, -3.7, -4.5 and -5.1 kg at Week 36 and -2.4, -4.0, -4.6 and -5.3 kg at Week 52 in the placebo, 0.5-, 1- and 2-mg groups, respectively (all doses significant vs. placebo at both time points). The proportion of patients who lost > or = 5 and > or = 10% of their baseline BW was significantly greater in the 1- and 2-mg groups vs. placebo at Week 36 and all taranabant groups vs. placebo at Week 52. Reductions in HbA1c were -0.40, -0.47, -0.68 and -0.71% at Week 36 and -0.30, -0.43, -0.65 and -0.64% at Week 52, in the placebo, 0.5-, 1- and 2-mg groups, respectively (1- and 2-mg doses significant vs. placebo at both time points). After 52 weeks, the incidences of adverse experiences classified in the gastrointestinal (diarrhoea, nausea, vomiting), nervous system-related (dizziness, sensory-related), and psychiatric (irritability, depression-related) organ systems were numerically higher or statistically significantly higher in all taranabant groups compared with the placebo group.

CONCLUSIONS

After 36 and 52 weeks, treatment with taranabant at the 1- and 2-mg doses led to clinically significant weight loss and improvement in glycaemic parameters in overweight and obese patients with T2DM that was associated with dose-related increases in adverse experiences. Based on these data and data from other Phase III clinical studies, it was determined that the overall safety and efficacy profile of taranabant did not support further development for the treatment of obesity.

Abstract 2752: Genetic variants in MMPs genes as predisposition factors for ovarian cancer risk and clinical outcome

Ovarian cancer is the leading cause of death resulting from the cancer of female reproductive system. Matrix metalloproteinases (MMPs) are a family of zinc-dependent and structure related endopeptidases that have been implicated in the development and prognosis of cancers including ovarian cancer. In this case control study of 417 ovarian cancer cases and 417 healthy controls, we genotyped a comprehensive panel of 266 potential functional single nucleotide polymorphisms (SNPs) in 23 MMP genes and analyzed their associations with ovarian cancer risk, and overall survival and response to chemotherapy in ovarian cancer cases who received platinum-based chemotherapy with surgery. The analysis was further restricted to 339 Caucasian ovarian cancer cases and 349 Caucasian healthy controls to minimize potential confounding by population stratification. We observed 24 SNPs significantly associated with the risk of ovarian cancer, 4 of which remained significant after adjusting for multiple comparisons using q value at 10% level. The top 3 SNPs were from MMP20 and the most significant association was observed for SNP rs2292730 (OR = 2.03, 95% CI = 1.39 − 2.96, P = 0.0002, recessive model). We then analyzed the cumulative effect of the top four SNPs on ovarian cancer risk by counting the number of unfavorable genotypes in each individual and found a significant gene-dosage effect (P for trend &lt; 0.0001). We applied classification and regression tree (CART) analysis to explore high order gene-gene interaction and identified 4 terminal nodes with differential risk of ovarian cancer (percentage of cases in terminal nodes ranging from 33% to 63%). In survival analysis, there were 42 SNPs significantly associated with overall survival, 34 of which remained significant after adjusting for multiple comparisons using q value at 10% level and 4 of which showed significant association with response to chemotherapy. The most significant association was observed for SNP rs2239008 from MMP1 (HR = 3.10, 95% CI = 1.54 − 6.24, P = 0.0016). We also studied the cumulative effect of the top SNPs on overall survival. Compared to low risk group of individuals with ≤ 11 unfavorable genotypes, patients with 12∼18 and ≥ 19 unfavorable genotypes had significantly increased risk of death (HR = 2.31, 95% CI = 1.51 − 3.51, and HR = 4.06, 95% CI = 2.45 − 6.73, respectively). The median survival times (MST) for patients having ≤ 11, 12∼18 and ≥ 19 unfavorable genotypes were 70.7, 40, and 25 months, respectively (log rank P &lt; 0.0001). Survival tree analysis showed that patients can be differentiated into distinct risk groups based on their genetic profiles. There were 9 terminal nodes identified by the survival tree analysis with MSTs ranging from 18.2 to 151.7 months. In conclusion, our results suggest that genetic variants in MMP pathway genes may modulate the risk and clinical outcomes of ovarian cancer, both individually and jointly.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2752.

Abstract 2834: Genetic variants in TGFβ pathway genes and ovarian cancer risk

The transforming growth factor (TGF) β signaling pathway plays a crucial role in cell proliferation, differentiation, apoptosis, extracellular matrix production and other cellular functions. Dysregulation and genetic variations of major genes in this pathway may be involved in the process of carcinogenesis. In this study, 218 single nucleotide polymorphisms (SNPs) in 21 major genes of TGFβ pathway were genotyped in 339 Caucasian ovarian cancer cases and 349 age, gender, and ethnicity matched controls. We analyzed the association between these SNPs and the risk as well as clinical outcomes of ovarian cancer. In the risk analysis, 16 SNPs were found significantly associated with ovarian risk, among these SNPs, a dose-response effect of increased risk for ovarian cancer with increased unfavorable genotype (UFG: defined as the allele related with increased ovarian risk) was observed (P for trend &lt; 0.0001). Compared with individuals carrying ≤ 6 UFGs, subjects carrying ≥ 9 UFGs conferred a 3.7-fold increased risk of ovarian cancer (ORs =3.71, 95%CI=2.52-5.45, P&lt;0.0001). The most significant individual association was found for INHBC: rs2228225. Patients carrying at least one variant allele of this SNP conferred 63% increased risk for ovarian cancer (OR = 1.63, 95%CI= 1.20-2.22, P=0.0018). Potential high-order gene-gene interactions were identified using the classification and regression tree analysis (CART). Eight terminal nodes were identified representing eight groups of patients with different probability for ovarian cancer (ORs ranging from 2.87 to 6.68). In the analysis of clinical outcomes, 13 SNPs were significantly associated with the risk of death. The top two SNPs were from BMP1. Patients carried rare homozygous genotype of either one of the SNP has a nearly two-fold increased risk for death (rs3857979: HR= 1.80, 95%CI= 1.23- 2.65, P=0.0026; rs4075478: HR=1.89, 95%CI=1.22- 2.91, P=0.004). A cumulative effect was also observed (P for trend &lt; 0.0001). The median survival times decreased from 83.3 months for patients with ≤5UFGs to 26.8 months for those with ≥ 9UFGs (log rank P &lt; 0.0001). Survival tree analysis identified eight terminal nodes representing eight groups of patients with different survival probability. Interestingly, the two BPM1 SNPs that were most significant in survival analysis were also significantly associated with poor response for chemotherapy (rs3857979: OR= 1.90, 95%CI= 1.04-3.48, P=0.0375; rs4075478: HR=2.39, 95%CI=1.17-4.86, P=0.0166), indicating that these two SNPs were predictive markers for response. In conclusion, our result demonstrates that genetic variations within TGFβ pathway may have modulate the risk and clinical outcomes of ovarian cancer.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2834.

Abstract 3593: Genetic variants in NER pathway genes and ovarian cancer risk and outcomes

Nucleotide excision repair (NER) pathway is critical for protecting against damage from carcinogens. In this case-control study, we evaluated the associations between genetic variations in NER pathway and ovarian cancer risk in 339 Caucasian ovarian cancer cases and 349 Caucasian healthy controls. A comprehensive panel of 217 SNPs in 28 NER pathway genes was analyzed to assess their association with ovarian cancer risk. For the cases who received surgery and platinum-based chemotherapy, we also analyzed the association of these SNPs with overall survival and response to chemotherapy. Individually, 12 SNPs were significantly associated with the ovarian cancer risk. The most significant association was observed for SNP rs4150667 from GTF2H1 (OR = 0.64, 95% CI 0.47- 0.86). A strong gene-dosage effect was observed when these top 12 SNPs were combined for unfavorable genotype analysis. Compared to subjects carrying ≤ 2 unfavorable genotypes, individuals carrying 3 (OR = 2.11, 95% CI = 1.32−3.39), 4 (OR = 2.32, 95% CI = 1.47 − 3.66) or ≥ 5 (OR = 4.31, 95% CI = 2.75 − 6.78) unfavorable genotypes exhibited significantly increased risk for ovarian cancer (P for trend &lt; 0.0001). Classification and regression tree (CART) analysis further revealed potential high order gene-gene interaction among the top 12 SNPs and identified 7 terminal nodes with the percentage of ovarian cancer cases in each terminal node range from 27% to 64%. In the clinical outcome study, there were 10 SNPs that exhibited significant association with overall survival. The unfavorable genotype analysis showed the median survival times for individuals carrying ≤3, 4∼7, and ≥ 8 unfavorable genotypes were 83.3, 40.0, and 24.7 months, respectively, indicating a strong gene-dosage effect (P for trend &lt; 0.0001). We also observed significant gene-dosage effect in chemotherapy response. In summary, this pathway-based approach demonstrated that increasing numbers of unfavorable genotypes in the NER predispose susceptible individuals to increased risk of ovarian cancer and affect clinical outcomes in ovarian cancer patients. These findings warrant further replications in independent populations.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3593.

Abstract 4567: Urine biomarkers outperform serum biomarkers in the diagnosis of various human cancers

Background: The measurement of biomarkers present in the bodily fluids of cancer patients represents an important avenue for the development of minimally invasive tests to predict tumorigenesis, disease recurrence, or treatment response. A great deal of work along these lines has already been devoted to blood, given its systemic exposure and extensive availability through tissue banks. However, blood is a dynamic biofluid with a proteome under continuous metabolic and homeostatic regulation. Alternatively, urine represents a biofluid that is inherently quiescent in that all molecular and proteolytic activity is largely complete upon sampling. Additional characteristics of urine including its high level of temperature stability and low-complexity matrix resulting from renal filtration have led many to propose urine as an alternative or companion to blood for biomarker studies.

Methods: We performed an analysis of biomarkers present in the urine and serum of patients diagnosed with ovarian, pancreatic, and breast cancer utilizing multiplexed bead-based immunoassays developed for the Luminex® xMAP® platform. Ovarian and breast cancer patients were compared to matched healthy controls while the pancreatic cancer patients were compared to a group of patients diagnosed with benign pancreatic conditions. Each case/control group was tested for 10-15 biomarkers identified as informative for each cancer type through previous population-based analyses of serum biomarkers.

Results: In our analysis, nearly all of the tested biomarkers were detectable in urine and many of the biomarkers exhibited mean relative differences of greater magnitude in urine versus serum. Our multivariate analysis identified several urine multimarker panels capable of discriminating the cancer from the control groups with high sensitivity and specificity. The use of a 4-biomarker panel comprised of 3 urine biomarkers and one serum biomarker resulted in the discrimination of ovarian cancer patients from healthy controls with a sensitivity of 100% at 95% specificity. For the ovarian and pancreatic cancer comparisons, urine/serum multimarker panels outperformed the best serum biomarker panels identified. A urine 5-biomarker panel was identified in the breast cancer comparison that demonstrated a high discriminatory power in both training and validation sample sets.

Conclusions: Our results support the use of urine biomarkers as alternatives and/or companions to serum biomarkers for the diagnosis of selected human cancers.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4567.

Development of a multimarker assay for early detection of ovarian cancer

PURPOSE

Early detection of ovarian cancer has great promise to improve clinical outcome.

PATIENTS AND METHODS

Ninety-six serum biomarkers were analyzed in sera from healthy women and from patients with ovarian cancer, benign pelvic tumors, and breast, colorectal, and lung cancers, using multiplex xMAP bead-based immunoassays. A Metropolis algorithm with Monte Carlo simulation (MMC) was used for analysis of the data.

RESULTS

A training set, including sera from 139 patients with early-stage ovarian cancer, 149 patients with late-stage ovarian cancer, and 1,102 healthy women, was analyzed with MMC algorithm and cross validation to identify an optimal biomarker panel discriminating early-stage cancer from healthy controls. The four-biomarker panel providing the highest diagnostic power of 86% sensitivity (SN) for early-stage and 93% SN for late-stage ovarian cancer at 98% specificity (SP) was comprised of CA-125, HE4, CEA, and VCAM-1. This model was applied to an independent blinded validation set consisting of sera from 44 patients with early-stage ovarian cancer, 124 patients with late-stage ovarian cancer, and 929 healthy women, providing unbiased estimates of 86% SN for stage I and II and 95% SN for stage III and IV disease at 98% SP. This panel was selective for ovarian cancer showing SN of 33% for benign pelvic disease, SN of 6% for breast cancer, SN of 0% for colorectal cancer, and SN of 36% for lung cancer.

CONCLUSION

A panel of CA-125, HE4, CEA, and VCAM-1, after additional validation, could serve as an initial stage in a screening strategy for epithelial ovarian cancer.

Hemodynamic monitoring in pigs undergoing orthotopic abdominal multivisceral transplantation

Anesthesia for abdominal multivisceral transplantation (MVTx) is challenging. Surgical success depends on hemodynamic stability throughout organ removal from the donor and engraftment in recipients. The aim of the current study was to summarize our experience with anesthetic management including monitoring of hemodynamic changes in pigs during MVTx procedures.

MATERIALS AND METHODS

Ten male pigs were randomly divided into two groups: donors and recipients for five MVTxs. A pulmonary artery catheter (PAC), transesophageal echocardiography (TEE), and pulse indicator continuous cardiac output (PiCCO) were used intraoperatively in recipients to monitor hemodynamic changes.

RESULTS

Two recipients had cardiac arrest and died intraoperatively presumably due to hypovolemia. The data obtained by PAC and TEE from three successful cases showed huge changes in hemodynamics during the stages of organ removal and reperfusion after engraftment. Use of PiCOO in one of those three cases allowed successful fluid management, resulting in stable intraoperative hemodynamics.

CONCLUSION

The anesthetic management for MVTx surgery was improved by PAC, TEE, and PiCOO monitoring.

Node-positive adenocarcinoma of the endometrium: outcome and patterns of recurrence with and without external beam irradiation

OBJECTIVE

To evaluate treatment outcomes and patterns of recurrence in patients with node-positive (International Federation of Obstetrics and Gynecology stage IIIC) adenocarcinoma of the uterus without serous or clear cell differentiation.

METHODS

The records of 71 women who were treated for stage IIIC endometrial adenocarcinoma at our institution between 1984 and 2005 were reviewed. All patients underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy. Fifty patients received definitive pelvic or extended-field radiotherapy with or without systemic therapy (regional RT group). Eighteen received adjuvant systemic platinum-based chemotherapy or hormonal therapy without external beam RT. The median follow-up for patients not dying of disease was 67 months. Survival rates were calculated using the Kaplan-Meier method; differences were assessed using log-rank tests.

RESULTS

Thirty-nine percent (28/71) of patients had involved paraaortic lymph nodes while 61% (43/71) had only pelvic lymph nodes. Five- and 10-year disease-specific survival (DSS) rates were 63% and 54%, respectively; corresponding overall survival rates were 60% and 47%. Grade was strongly associated with DSS (76% vs 46% at 5 years for low-grade vs high-grade tumors, P=0.004). Cervical or adnexal involvement was associated with decreased DSS, but lymph-vascular space invasion, age, race, body mass index, and number and location of positive nodes were not. Five-year pelvic-relapse-free survival (98% vs 61%, P=0.001), DSS (78% vs 39%, P=0.01), and overall survival (73% vs 40%, P=0.03) were significantly better for the regional RT group than the systemic therapy group. In patients treated without regional RT, the most common site of relapse was the pelvis. DSS was not significantly correlated with number of nodes removed in the regional RT group but was in patients treated without regional RT (P=0.001).

CONCLUSIONS

Patients treated without regional RT had a high rate of locoregional recurrence. Patients with stage IIIC endometrial adenocarcinoma who underwent surgical staging followed by external beam irradiation had a high rate of cure. Relapses in patients treated with EBRT primarily occurred in patients with grade 3 cancer who may be most likely to benefit from combined-chemoradiation treatment.

Anti-carbohydrate antibodies of normal sera: findings, surprises and challenges

We have used microchip format glycan array to characterize the individual carbohydrate recognition patterns by antibodies (Ab) in sera of 106 healthy donors. The glycan library included blood group antigens and other most frequent terminal oligosaccharides and their cores of mammalian N- and O-linked glycoproteins and glycolipids, tumor-associated carbohydrate antigens, and common components of bacterial/pathogenic polysaccharides and lipopolysaccharides, totally 205 glycans. The serum Ab interacted with at least 50 normal human glyco-motifs. Apart from expected blood group-, xeno- (heterophil) and infection-related binding activities, we observed a number of new and unexpected features. The surprising, relatively high antibody binding was found to the blood group P(1) and P(k) trisaccharides and H(type 2) trisaccharide. Novel and very high binding activities have been observed towards Galbeta1-3GlcNAc (Le(C)) related glycans, especially 3'-O-Su-Le(C), and towards 4'-O-sulfated lactosamine. Relatively high and uniform Ab binding to GalNAcalpha1-3Gal disaccharide demonstrated absence of correlation with fucosylated blood group A GalNAcalpha1-3(Fucalpha1-2)Gal antigen-similarly to well known relationship between Galalpha1-3Gal and true, fucosylated blood group B Galalpha1-3(Fucalpha1-2)Gal antigen. The binding intensity to Galalpha1-3Galbeta1-4GlcNAc xenoantigen was shown to be rather modest. Absence or very low Ab binding was found against oligosialic acid, sialooligosaccharides except SiaT(n), type 2 backbone glycans such as Le(y), and biantennary N-chain as well as its truncated forms, i.e. without terminal Sia, SiaGal, and SiaGalGlcNAc motifs. We have also found that Ab are capable of recognizing the short inner core typical for glycolipids (-Galbeta1-4Glc) and glycoproteins (-GalNAcalpha) as a fragment of bigger glycans.

A unique case of Hajdu-Cheney syndrome and squamous cell carcinoma of the anus

OBJECTIVE

Hajdu-Cheney syndrome (HCS), first described in 1948 by Hajdu and independently in 1965 by Cheney, is an extremely rare disorder characterized by severe and excessive bone resorption leading to osteoporosis, with a wide range of other systemic complications from connective tissue and bone dysplasia. Currently there are approximately 50 distinct cases reported in the literature. There have been several reports associating polycystic kidneys with HCS and several other connective tissue disorders, suggesting a possibility of a hyperproliferative component to the syndrome. No articles exist in the current literature describing a case of HCS with concurrent carcinoma. Here, we present a case of a 54-year-old nonimmune compromised woman with multiple stigmata of HCS and recently diagnosed anal squamous cell carcinoma.

METHOD

This is a case report of HCS and stage T3N0 squamous cell carcinoma of the anus.

RESULTS

This is the first report of a patient with HCS with malignancy.

CONCLUSIONS

We present a patient with HCS who developed anal squamous cell carcinoma. The mechanism of HCS, which is still unknown, may either make patients more susceptible to carcinoma or may just be a reflection of the normal incidence of anal squamous cell carcinoma given attributable risk factors.

Somatic BRCA status in ovarian tumors

5528

Background: The combined prevalence of BRCA1/2 mutations in germline DNA derived from a population of invasive ovarian cancer patients is up to 15.3%. PARP inhibitor trials are ongoing in patients who carry germline BRCA1/2 mutations. It is important to know whether somatic (non-germline) BRCA changes are present in ovarian tumors, given the predicted sensitivity of BRCA mutation-carrying tumors to PARP inhibitors and other DNA damaging agents. However, a large cohort of ovarian tumor tissues has not been studied to determine the frequency of BRCA deficiency due to additional somatic changes. Methods: BRCA1/2 exons/flanking regions were sequenced in 235 high-grade ovarian cancers and 38 ovarian cancer cell lines. In 112 tumors, we also performed gene expression analysis and copy number arrays with ultradense probe tiling throughout both BRCA genes. Results: For BRCA1, 31 tumors (13.2%) harbored mutations: 23 known deleterious mutations, 1 suspected deleterious mutation, 3 novel indels, 1 novel mis-sense and 3 novel nonsense mutations. For BRCA2, 12/178 sequenced tumors (6.7%) harbored mutations: 8 known deleterious mutations, 1 suspected deleterious mutation and 3 novel indels. Only 3 BRCA1 mutations were detected in 2 cell lines, two known deleterious and 1 a novel 29 base pair deletion. One cell line thus appears to have both a germline and a somatic mutation. BRCA mutation status was associated with a trend to improved progression-free survival (PFS) in univariate analysis (p = 0.17). However, BRCA deficiency (defined by BRCA1/2 gene expression loss (4 tumors) and homozygous deletion (1 tumor) in addition to mutations) was associated with improved PFS in univariate (p = 0.04) and multivariate (p = 0.03) analyses. Conclusions: The frequency of BRCA1/2 mutations in ovarian tumors detected by sequencing regardless of family history is ≈20%, higher than the expected prevalence of germline mutations. In both BRCA1/2 genes, almost 25% of mutations in tumor tissue were novel and not previously seen in germline DNA. We are now sequencing corresponding germline DNA to determine the exact number of these novel mutations that are somatic. Direct analysis of ovarian tumor tissue is likely to expand the number of women with BRCA-deficient tumors beyond that detectable by germline sequencing.

[Table: see text]

Microfluidic assisted synthesis of multi-functional polycaprolactone microcapsules: incorporation of CdTe quantum dots, Fe3O4 superparamagnetic nanoparticles and tamoxifen anticancer drugs

This paper demonstrates a proof-of-concept approach for encapsulating the anticancer drug tamoxifen, Fe3O4 nanoparticles (NPs) and CdTe quantum dots (QDs) into size-controlled polycaprolactone (PCL) microcapsules utilizing microfluidic emulsification, which combined magnetic targeting, fluorescence imaging and drug controlled release properties into one drug delivery system. Cross-linking the composite PCL microcapsules with poly(vinyl alcohol) (PVA) tailored their size, morphology, optical and magnetic properties and drug release behaviors. The flow conditions of the two immiscible solutions were adjusted in order to successfully generate various sizes of polymer droplets. The result showed superparamagnetic and fluorescent properties, and was used as a controlled drug release vehicle. The composite magnetic and fluorescent PCL microcapsules are potential candidates for a smart drug delivery system.