Acquired substrate preference for GAB1 protein bestows transforming activity to ERBB2 kinase lung cancer mutants

Activating mutations in the αC-β4 loop of the ERBB2 kinase domain, such as ERBB2(YVMA) and ERBB2(G776VC), have been identified in human lung cancers and found to drive tumor formation. Here we observe that the docking protein GAB1 is hyper-phosphorylated in carcinomas from transgenic mice and in cell lines expressing these ERBB2 cancer mutants. Using dominant negative GAB1 mutants lacking canonical tyrosine residues for SHP2 and PI3K interactions or lentiviral shRNA that targets GAB1, we demonstrate that GAB1 phosphorylation is required for ERBB2 mutant-induced cell signaling, cell transformation, and tumorigenesis. An enzyme kinetic analysis comparing ERBB2(YVMA) to wild type using physiologically relevant peptide substrates reveals that ERBB2(YVMA) kinase adopts a striking preference for GAB1 phosphorylation sites as evidenced by ∼150-fold increases in the specificity constants (kcat/Km) for several GAB1 peptides, and this change in substrate selectivity was predominantly attributed to the peptide binding affinities as reflected by the apparent Km values. Furthermore, we demonstrate that ERBB2(YVMA) phosphorylates GAB1 protein ∼70-fold faster than wild type ERBB2 in vitro. Notably, the mutation does not significantly alter the Km for ATP or sensitivity to lapatinib, suggesting that, unlike EGFR lung cancer mutants, the ATP binding cleft of the kinase is not significantly changed. Taken together, our results indicate that the acquired substrate preference for GAB1 is critical for the ERBB2 mutant-induced oncogenesis.

Heat shock protein 90 functions to stabilize and activate the testis-specific serine/threonine kinases, a family of kinases essential for male fertility

Spermiogenesis is characterized by a profound morphological differentiation of the haploid spermatid into spermatozoa. The testis-specific serine/threonine kinases (TSSKs) comprise a family of post-meiotic kinases expressed in spermatids, are critical to spermiogenesis, and are required for male fertility in mammals. To explore the role of heat shock protein 90 (HSP90) in regulation of TSSKs, the stability and catalytic activity of epitope-tagged murine TSSKs were assessed in 293T and COS-7 cells. TSSK1, -2, -4, and -6 (small serine/threonine kinase) were all found to associate with HSP90, and pharmacological inhibition of HSP90 function using the highly specific drugs 17-AAG, SNX-5422, or NVP-AUY922 reduced TSSK protein levels in cells. The attenuation of HSP90 function abolished the catalytic activities of TSSK4 and -6 but did not significantly alter the specific activities of TSSK1 and -2. Inhibition of HSP90 resulted in increased TSSK ubiquitination and proteasomal degradation, indicating that HSP90 acts to control ubiquitin-mediated catabolism of the TSSKs. To study HSP90 and TSSKs in germ cells, a mouse primary spermatid culture model was developed and characterized. Using specific antibodies against murine TSSK2 and -6, it was demonstrated that HSP90 inhibition resulted in a marked decrease of the endogenous kinases in spermatids. Together, our findings demonstrate that HSP90 plays a broad and critical role in stabilization and activation of the TSSK family of protein kinases.

Displasia renal em cão da raça Rotweiller

Descreveram-se os achados clínicos e patológicos de um caso de displasia renal em um cão da raça Rotweiller com oito meses de idade. O animal apresentou vômitos, emagrecimento, polidpsia e poliúria. Houve elevação sanguínea de creatinina, cálcio e da fosfatase alcalina. À necropsia, notaram-se os rins diminuídos de tamanho, com estruturas císticas proeminentes sobre a superfície natural do órgão e, ao corte, firmes e com estruturas císticas distribuídas pelo parênquima. Na avaliação histológica, havia glomérulos imaturos, fibroplasia intersticial e dilatação cística tubular.

Epidemic reemergence in adaptive complex networks

The dynamic nature of a system gives rise to dynamical features of epidemic spreading, such as oscillation and bistability. In this paper, by studying the epidemic spreading in growing networks, in which susceptible nodes may adaptively break the connections with infected ones yet avoid being isolated, we reveal a phenomenon, epidemic reemergence, where the number of infected nodes is incubated at a low level for a long time and then erupts for a short time. The process may repeat several times before the infection finally vanishes. Simulation results show that all three factors, namely the network growth, the connection breaking, and the isolation avoidance, are necessary for epidemic reemergence to happen. We present a simple theoretical analysis to explain the process of reemergence in detail. Our study may offer some useful insights, helping explain the phenomenon of repeated epidemic explosions.

A pre-mRNA-associating factor links endogenous siRNAs to chromatin regulation

In plants and fungi, small RNAs silence gene expression in the nucleus by establishing repressive chromatin states. The role of endogenous small RNAs in metazoan nuclei is largely unknown. Here we show that endogenous small interfering RNAs (endo-siRNAs) direct Histone H3 Lysine 9 methylation (H3K9me) in Caenorhabditis elegans. In addition, we report the identification and characterization of nuclear RNAi defective (nrde)-1 and nrde-4. Endo-siRNA–driven H3K9me requires the nuclear RNAi pathway including the Argonaute (Ago) NRDE-3, the conserved nuclear RNAi factor NRDE-2, as well as NRDE-1 and NRDE-4. Small RNAs direct NRDE-1 to associate with the pre-mRNA and chromatin of genes, which have been targeted by RNAi. NRDE-3 and NRDE-2 are required for the association of NRDE-1 with pre-mRNA and chromatin. NRDE-4 is required for NRDE-1/chromatin association, but not NRDE-1/pre-mRNA association. These data establish that NRDE-1 is a novel pre-mRNA and chromatin-associating factor that links small RNAs to H3K9 methylation. In addition, these results demonstrate that endo-siRNAs direct chromatin modifications via the Nrde pathway in C. elegans.

Chromatin consists of DNA and proteins. Chromatin can exist in many different states. The state of chromatin in highly regulated in order to ensure that genes are expressed correctly. RNAs play an important role in the regulation of chromatin. For example, in plants and fungi small RNAs drive the formation of heterochromatin, a repressive chromatin state. Many types of small RNAs have been identified in animal cells, but the functions of these small RNAs are largely unknown. Using the nematode C. elegans as a model system, we identified a small RNA pathway that regulates the state of chromatin. We report the identification of two new factors, termed NRDE-1 and NRDE-4, which act in this nuclear small RNA pathway. NRDE-1 and NRDE-4 link small RNAs to chromatin regulation. Additionally, we show that endogenously expressed small RNAs, termed the endo-siRNAs, direct the post-translational modification of histone proteins, which are core components of chromatin. These results establish a direct connection between small RNAs and chromatin regulation in animals.

Validation study of the Chinese Identification Pain Questionnaire for neuropathic pain

OBJECTIVES

For diagnosing neuropathic pain, a simple 6-item patient-completed identification pain questionnaire has been validated among Caucasians. We aimed to study the validity and reliability of this questionnaire among Hong Kong Chinese patients.

DESIGN

Questionnaire survey.

SETTING

Two pain clinics and two neurology clinics in Hong Kong.

PATIENTS

Patients with either neuropathic pain or nociceptive pain were recruited randomly from the four clinics. The patients completed the questionnaire themselves and the diagnosis of neuropathic pain and nociceptive pain was made by the pain specialists. We determined the optimal cutoff, positive and negative predictive values, sensitivity, specificity, the area under the receiver operating characteristic curve, and test-retest reliability of the translated version.

RESULTS

Among the 92 participants, 60 (65%) had neuropathic pain and 32 (35%) had nociceptive pain. At an optimal cutoff score of 3 or higher, the positive predictive value was 87% while the negative predictive value was 55%, and it correctly classified 71% of cases. The specificity and sensitivity were 81% and 65%, respectively. The area under the curve was 0.78 (P<0.001). Test-retest reliability in the 10 randomly selected patients showed a good intraclass correlation of 0.72.

CONCLUSION

The Chinese Identification Pain Questionnaire is a valid and reliable scale that may be used as an initial diagnostic tool for neuropathic pain among Hong Kong Chinese patients.

Evaluation of applied biosystems MicroSEQ real-time PCR system for detection of Salmonella spp. in food

Real-time PCR methods for detecting foodborne pathogens offer the advantages of simplicity and quick time-to-results compared to traditional culture methods. In this study, the MicroSEQ real-time PCR system was evaluated for detection of Salmonella spp. in 10 different food matrixes following the AOAC Research Institute's Performance Tested Method validation program. In addition, the performance of the MicroSEQ system was evaluated for the detection of Salmonella in peanut butter as a part of the Emergency Response Validation Program sponsored by the AOAC Research Institute. The system was compared to the ISO 6579 reference method using a paired-study design for detecting Salmonella spp. in raw ground beef, raw chicken, raw shrimp, Brie cheese, shell eggs, cantaloupe, chocolate, black pepper, dry infant formula, and dry pet food. For the peanut butter study, the system was compared to the U.S. Food and Drug Administration's Bacteriological Analytical Manual procedures using an unpaired-study design. No significant difference in performance was observed between the MicroSEQ Salmonella spp. detection system and the corresponding reference methods for all 11 food matrixes. The MicroSEQ system detected all Salmonella strains tested, while showing good discrimination against detection of an exclusivity panel of 30 strains, with high accuracy.

Susceptibility to aplastic anemia is associated with HLA-DRB1*1501 in an aboriginal population in Sabah, Malaysia

The incidence of aplastic anemia is reported to be higher in Asia than elsewhere. We studied the frequency of human leukocyte antigen (HLA) DRB1 alleles in aplastic anemia patients from 2 genetically similar aboriginal groups, the Kadazan and the Dusun, and compared them with genetically matched community and hospital controls. HLA-DRB1*15 was significantly higher in the patients compared with controls (p = 0.005), confirming similar findings in Japanese and Caucasian studies. Further testing indicated a significantly higher frequency of HLA-DRB1*1501 in patients compared with controls (p = 0.0004) but no significant difference in the frequency of HLA-DRB1*1502. The high frequency of HLA-DRB1*15 in the Kadazan and Dusun population combined with the wide variety of environmental factors associated with aplastic anemia could be the reason for the elevated incidence of aplastic anemia in the Kadazan and Dusun in Sabah.

Predicting consideration of cosmetic surgery in a college population: a continuum of body image disturbance and the importance of coping strategies

Elective cosmetic surgeries are increasing in the American population with reasons linked to body image disturbance and body dysmorphic disorder (BDD). Little research exists documenting the continuum of body image disturbance and its relationship to seeking surgery. The present research examined data from 544 participants, 55 of whom were diagnosable with BDD. Using assessments for body image disturbance, problematic coping strategies, and BDD symptomatology, results provided evidence for a continuum of body image distress. Logistic regression analysis supported the hypothesis that increased levels of body image disturbance and one type of problematic coping strategy (Appearance Fixing) predicted consideration of cosmetic surgery. Of participants diagnosable with BDD, those who considered cosmetic surgery showed more severe body image disturbance and problematic coping than those who did not consider surgery. These results have implications for pre-surgical assessment as well as psychological interventions rather than invasive medical interventions.

What is the nature of polyps detected by the NHS bowel cancer screening pilots?

AIM

The NHS Bowel Cancer Screening Programme is currently being introduced following three rounds of pilot screening. The study outlines the important characteristics of polyps detected by pilot screening and compares the location of polyps with those of symptomatic cancers to challenge the circumstantial evidence for the adenoma carcinoma pathway.

METHOD

The first 100 patients with screen-detected polyps from University Hospitals Coventry and Warwickshire (UHCW) were identified from the colorectal cancer screening database. Important characteristics of the polyps were identified from the endoscopy reporting system and entered into a database. Polyp location was compared with the location of symptomatic cancers detected in the UHCW colorectal cancer database.

RESULTS

One hundred patients were selected for investigation and 202 polyps were detected. The average age of the patients with polyps was 61 years, 35% were under the age of 60. There were 67% male subjects. The average size of the largest polyp in each of the different patients was 13.5 mm. Eighty-five per cent of polyps were excised. Histology was available for 181 polyps of which 40% were tubulovillous, 33% tubular, 14% metaplastic and 1% villous. Eighty-eight per cent showed low-grade dysplasia and 8% high-grade one. The location of screen-detected polyps was significantly different from that of symptomatic cancers in our database, with proportionally more sigmoid and proportionally less rectal and caecal polyps detected.

CONCLUSION

The study outlines the important characteristics of screen-detected polyps. The significant difference in location of polyps from that of cancer suggests a variation in the malignancy potential of polyps depending on the location.

Randomized Controlled Trial of Clozapine and CBT for First-Episode Psychosis with Enduring Positive Symptoms: A Pilot Study

Here we report the results of a pilot study investigating the relative and combined effects of a 12 week course of clozapine and CBT in first-episode psychosis patients with prominent ongoing positive symptoms following their initial treatment. Patients from our early psychosis service who met the inclusion criteria (n = 48) were randomized to one of four treatment groups: clozapine, clozapine plus CBT, thioridazine, or thioridazine plus CBT. The degree of psychopathology and functionality of all participants was measured at baseline then again at 6, 12 and 24 weeks, and the treatment outcomes for each group determined by statistical analysis. A substantial proportion (52%) of those treated with clozapine achieved symptomatic remission, as compared to 35% of those who were treated with thioridazine. Overall, those who received clozapine responded more rapidly to treatment than those receiving the alternative treatments. Interestingly, during the early treatment phase CBT appeared to reduce the intensity of both positive and negative symptoms and thus the time taken to respond to treatment, as well having as a stabilizing effect over time.

Synthesis of Nanocrystalline Co-W Alloys

Electroplating is one of the most technologically advanced methods to synthesize nanophase materials both as coatings and in bulk form. This paper demonstrates the formulation of a processing “window” for nanocrystalline Co-W alloys using factorial design. The microstructural evolution from polycrystalline to nanocrystalline to amorphous Co-W microstructures is shown for electrodeposits produced from a bath containing cobalt sulphate, sodium tungstate, Rochelle salt and ammonium chloride. The effect of operating variables such as temperature and current density is discussed.

Factors influencing sleep for parents of critically ill hospitalised children: a qualitative analysis

The aim of this study was to describe factors affecting the sleep of parents of critically ill children and to determine strategies used to improve their sleep. One hundred and eighteen parents of 91 children recruited during their child's paediatric intensive care unit stay responded in writing to open-ended questions assessing their experiences with sleep and eliciting ideas for strategies to promote sleep to be used by parents and provided by hospital staff. Patterns and concepts were coded and organised into themes using a qualitative descriptive approach. Seven themes emerged related to influences on and strategies to improve sleep: (1) the child's condition; (2) being at the bedside or not; (3) difficult thoughts and feelings; (4) changes to usual sleep; (5) caring for self and family; (6) the hospital environment and (7) access to sleep locations. Parents described multiple, often competing, demands that affected their ability to achieve sleep, regardless of location. Many more factors that influenced sleep were described than strategies to improve sleep, highlighting the need for nurses to explore with parents the unique barriers and facilitators to sleep they encounter and to develop and rigorously test interventions to improve sleep.

The effectiveness of the '2-week wait' referral service for colorectal cancer

INTRODUCTION

The UK government target expects all suspected cancer patients to be seen within 2 weeks of referral made by general practitioners. This has significant impact on the workload for colorectal surgeons. The aim of this study was to investigate the effectiveness of this colorectal service.

METHOD

A retrospective study of all patients referred to a 2-week wait colorectal clinic over a 12-month period was assessed, documenting diagnosis and staging. Comparison of patients diagnosed with colorectal cancer (CRC) presenting via other routes in the same period was made.

RESULTS

Over the 12-month period, all 1100 patients were seen in the 2-week wait clinic; 938 (85%) patients fulfilled the referral criteria, but only 81 (7.3%) were diagnosed with cancer. Conversely, 136 CRC patients presented to the surgeons via urgent referrals (n = 86), emergency (n = 13), routine colorectal clinic (n = 19) and bowel screening (n = 18). The 2-week cohort had more advanced staging than those referred by standard letter and pilot screening. Cancers in the symptomatic population are predominantly Dukes' B and Dukes' C whereas in pilot screening group predominantly Dukes' A.

CONCLUSION

The effectiveness of 2-week wait referral was poor, confirming its lack of validity. Further work is required to offer primary care stricter inclusion and exclusion referral criteria.

Identification of a novel HSP70-binding cochaperone critical to HSP90-mediated activation of small serine/threonine kinase

We previously reported the identification of small serine/threonine kinase (SSTK) that is expressed in postmeiotic germ cells, associates with HSP90, and is indispensable for male fertility. Sperm from SSTK-null mice cannot fertilize eggs in vitro and are incapable of fusing with eggs that lack zona pellucida. Here, using the yeast two-hybrid screen, we have discovered a novel SSTK-interacting protein (SIP) that is expressed exclusively in testis. The gene encoding SIP is restricted to mammals and encodes a 125-amino acid polypeptide with a predicted tetratricopeptide repeat domain. SIP is co-localized with SSTK in the cytoplasm of spermatids as they undergo restructuring and chromatin condensation, but unlike SSTK, is not retained in the mature sperm. SIP binds to SSTK with high affinity (K(d) ∼10 nM), and the proteins associate with each other when co-expressed in cells. In vitro, SIP inhibited SSTK kinase activity, whereas the presence of SIP in cells resulted in enzymatic activation of SSTK without affecting Akt or MAPK activity. SIP was found to be associated with cellular HSP70, and analyses with purified proteins revealed that SIP directly bound HSP70. Importantly, SSTK recruited SIP onto HSP90, and treatment of cells with the specific HSP90 inhibitor, 17-allylamino-17-demethoxygeldanamycin, completely abolished SSTK catalytic activity. Hence, these findings demonstrate that HSP90 is essential for functional maturation of the kinase and identify SIP as a cochaperone that is critical to the HSP90-mediated activation of SSTK.

Functional and structural diversification of the Anguimorpha lizard venom system

Venom has only been recently discovered to be a basal trait of the Anguimorpha lizards. Consequently, very little is known about the timings of toxin recruitment events, venom protein molecular evolution, or even the relative physical diversifications of the venom system itself. A multidisciplinary approach was used to examine the evolution across the full taxonomical range of this ∼130 million-year-old clade. Analysis of cDNA libraries revealed complex venom transcriptomes. Most notably, three new cardioactive peptide toxin types were discovered (celestoxin, cholecystokinin, and YY peptides). The latter two represent additional examples of convergent use of genes in toxic arsenals, both having previously been documented as components of frog skin defensive chemical secretions. Two other novel venom gland-overexpressed modified versions of other protein frameworks were also recovered from the libraries (epididymal secretory protein and ribonuclease). Lectin, hyaluronidase, and veficolin toxin types were sequenced for the first time from lizard venoms and shown to be homologous to the snake venom forms. In contrast, phylogenetic analyses demonstrated that the lizard natriuretic peptide toxins were recruited independently of the form in snake venoms. The de novo evolution of helokinestatin peptide toxin encoding domains within the lizard venom natriuretic gene was revealed to be exclusive to the helodermatid/anguid subclade. New isoforms were sequenced for cysteine-rich secretory protein, kallikrein, and phospholipase A(2) toxins. Venom gland morphological analysis revealed extensive evolutionary tinkering. Anguid glands are characterized by thin capsules and mixed glands, serous at the bottom of the lobule and mucous toward the apex. Twice, independently this arrangement was segregated into specialized serous protein-secreting glands with thick capsules with the mucous lobules now distinct (Heloderma and the Lanthanotus/Varanus clade). The results obtained highlight the importance of utilizing evolution-based search strategies for biodiscovery and emphasize the largely untapped drug design and development potential of lizard venoms.

Are screen detected colorectal cancers asymptomatic?

OBJECTIVE

Colorectal cancer (CRC) screening aims to detect asymptomatic disease and thus provide the opportunity for early diagnosis and treatment. This study assesses the prevalence of significant symptoms in patients found to have CRC detected through the NHS National Bowel Cancer Screening Programme (NHS NBCSP) pilots.

METHOD

All patients in the NHS NBCSP pilots with a positive faecal occult blood completed a standardized symptomatology questionnaire before colonoscopy. This data was entered into the NHS BCS pilot database, data from the English arm has been analysed retrospectively.

RESULTS

There were 200 patients diagnosed with colorectal cancer. Of these, 28.5% were Dukes A, 35% Dukes B, 31% Dukes C1 and 5.5% Dukes C2. Some 81.5% reported experiencing GI symptoms. Symptoms considered significant included rectal bleeding, change in bowel habit, tenesmus and peri-anal discomfort, reported in 47.7%, 24%%, 36.5% and 15.5% of patients respectively. In addition to this, 27% reported urgency, 20.5% reported abdominal pain and 29% reported upper GI symptoms.

DISCUSSION

This data suggests a high prevalence of significant symptoms amongst patients with screening-detected CRC. It is possible that these patients would have presented via routine colorectal services if the awareness of symptoms of colorectal cancer were increased.

Does the location of screen-detected cancers differ from that seen in the unscreened population?

OBJECTIVE

It is important that screening detects cancers regardless of their location within the colon. The aim of this study was to see if the location of cancers detected by the pilot screening programme differs from that of unscreened cancers.

METHOD

The colorectal cancer dataset of University Hospital Coventry was analysed retrospectively. A 7-year period was used to include all three rounds of the pilot screening. Two groups of patients were selected, those with colorectal cancers detected by the screening programme and those detected outside of screening. The tumour location was compared in the two groups statistically (chi-squared test).

RESULTS

One thousand four hundred-ninety patients were included, 100 of whom were in the screened population and 1390 were in the unscreened population. There was no significant difference in tumour location between the two groups (P = 0.49).

CONCLUSION

This study showed that screen-detected cancers do not differ in their location from unscreened cancers and suggests that faecal occult blood testscreening detects cancer irrespective of location within the colon.

Oral biofilms: emerging concepts in microbial ecology

Oral biofilms develop under a range of different conditions and different environments. This review will discuss emerging concepts in microbial ecology and how they relate to oral biofilm development and the treatment of oral diseases. Clues to how oral biofilms develop may lie in other complex systems, such as interactions between host and gut microbiota, and even in factors that affect biofilm development on leaf surfaces. Most of the conditions under which oral biofilms develop are tightly linked to the overall health and biology of the host. Advances in molecular techniques have led to a greater appreciation of the diversity of human microbiota, the extent of interactions with the human host, and how that relates to inter-individual variation. As a consequence, plaque development may no longer be thought of as a generic process, but rather as a highly individualized process, which has ramifications for the treatment of the diseases it causes.

Novel venom proteins produced by differential domain-expression strategies in beaded lizards and gila monsters (genus Heloderma)

The origin and evolution of venom proteins in helodermatid lizards were investigated by multidisciplinary techniques. Our analyses elucidated novel toxin types resultant from three unique domain-expression processes: 1) The first full-length sequences of lethal toxin isoforms (helofensins) revealed this toxin type to be constructed by an ancestral monodomain, monoproduct gene (beta-defensin) that underwent three tandem domain duplications to encode a tetradomain, monoproduct with a possible novel protein fold; 2) an ancestral monodomain gene (encoding a natriuretic peptide) was medially extended to become a pentadomain, pentaproduct through the additional encoding of four tandemly repeated proline-rich peptides (helokinestatins), with the five discrete peptides liberated from each other by posttranslational proteolysis; and 3) an ancestral multidomain, multiproduct gene belonging to the vasoactive intestinal peptide (VIP)/glucagon family being mutated to encode for a monodomain, monoproduct (exendins) followed by duplication and diversification into two variant classes (exendins 1 and 2 and exendins 3 and 4). Bioactivity characterization of exendin and helokinestatin elucidated variable cardioactivity between isoforms within each class. These results highlight the importance of utilizing evolutionary-based search strategies for biodiscovery and the virtually unexplored potential of lizard venoms in drug design and discovery.

Challenges for retrospective cohort studies: A profile of patients who refuse participation or are lost to follow-up

6615

Background: As hematopoietic cell transplantation (HCT) has increasingly become a curative option for many diseases, studying long-term complications has assumed critical importance. A major issue in conducting scientifically rigorous long-term follow up studies with large cohorts is the ability to track patients, and obtain informed consents. High participation rates are critical to avoid selection bias and ensure generalizability. Methods: A mass consenting process was implemented to obtain informed consents from 1056 City of Hope HCT patients transplanted during 1976–2006 who were one+ year survivors and alive in June 2007. This process involved mailing consent forms followed by phone calls. Patients were classified as consented, refused, or lost-to-follow-up (LTFU). Sociodemographic and clinical characteristics indicative of higher risks for refusal or LTFU were identified. Results: Study patients comprised 58% males, and 53% Caucasians. Median age at HCT was 34 years (0.6–73); median age at study initiation was 47 years (6–81); and median time from HCT to study initiation was 10 years (1–30). Primary diagnoses included acute/chronic leukemia (43%), Hodgkin/non-Hodgkin lymphoma (36%), multiple myeloma (9%), and other miscellaneous diagnoses (12%). Fifty percent received allogeneic HCT. At the end of the process, 46% consented, 17% refused, and 37% were LTFU. Compared to consented patients, males, Asians, and younger patients were more likely to refuse consent. Patients LTFU were more likely to have lower SES, a longer time since HCT, in addition to being males, Asians and younger at HCT (Table). Conclusions: This study demonstrates the critical need for maintaining up-to-date contact information on patients after HCT in order to obtain valid long-term follow-up data. It also describes the characteristics of the sub-population that are more likely to refuse or be LTFU, information necessary for planning targeted interventions in long-term follow-up initiatives.

[Table: see text]

No significant financial relationships to disclose.

Clinical and pathological characteristics of Chinese patients with BRCA related breast cancer

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Background: Breast cancers due to underlying germline BRCA1 and BRCA2 mutations are associated with particular pathological features that may differ from sporadic breast cancers. We report clinical and pathologic characteristics of breast cancer in a clinical cohort of high risk Chinese women with BRCA mutations and those without mutations. Methods: 202 high risk women based on their age and family history were recruited from March 2007 to November 2008. Medical information was prospectively collected from the patients and medical records. BRCA1 and BRCA2 mutations were detected using full gene sequencing and multiplex ligation-dependent probe amplification (MLPA). Results: Of the 202 female probands tested, 25 (12.3 %) were BRCA mutation carriers of which 11 (44%) were BRCA1 and 14 (56%) were BRCA2 mutations. Breast cancer risk factors, other than family history, did not differ between carriers and non-carriers. Mutation carriers were more likely to have a familial history of breast cancer (p=0.07) and personal and family history of ovarian cancer (p=0.005; p=0.007). Other cancers found in carriers families included pancreatic, gastric, colon, lung, liver, and nasopharyngeal. 23% of women diagnosed with DCIS had BRCA mutations compared with 11.4% of those with invasive cancers. BRCA related tumors were more likely to be ER, PR and Her-2 negative (Triple negative, TN) (p= 0.006). Overall 9.6% of non-BRCA cancers were TN whereas 25.9% of BRCA cancers were TN. Prevalence of TN in BRCA1 carriers is 71% compared with 13.4% in BRCA2 carriers. BRCA1 mutation related cancers were significantly more likely to be ER negative than BRCA2 and this is only significant in those who are under 40 years of age (p=0.070). Conclusions: We have a high BRCA2 mutation rate in our cohort. BRCA related breast cancer is associated with families with increasing number of first degree relatives with breast and/or ovarian cancers and were higher for DCIS cancers. Prevalence of TN breast cancers was high compared to Caucasian cohorts. BRCA mutations were associated with pathologically, poor prognostic features (TN and high grade) especially in younger women.

No significant financial relationships to disclose.

Phase I study of bavituximab, a novel anti-phosphatidylserine monoclonal antibody in patients with advanced refractory cancer: Preliminary results

1080

Background: Aminophospholipid are normally expressed on damaged or apoptotic cells, as well as on the intravascular surface of EC of vessels feeding the tumor as a result of the tumor microenvironment (e.g., hypoxia, reactive oxygen species). Bavituximab (B), a novel monoclonal antibody against PS, has demonstrated preclinical anti-tumor activity by eliciting both innate and adaptive immune responses specific to tumor vasculature. Here we report preliminary results of the phase I study in patients (pts) with advanced solid tumors. Methods: This is a phase I, dose escalation, safety, tolerability and pharmacokinetic (PK) study, as well as to define DLT, MTD and/or maximum effective dose (MED) in pts with advanced refractory cancers. Planned cohorts of 6 pts, each were to receive 0.1, 0.3, 1 or 3 mg/kg. Escalation was permitted if mean cohort Cmax ≤ 65 mcg/mL and dose limiting toxicities (DLT) was observed in ≤ 1 of 6 pts. No premedication was planned or needed. DLT was defined as ≥ grade 3 drug-related adverse events (AE), ≥ grade 2 PT, or ≥ grade 3 aPTT. B was given as a 90 minute IV infusion (on days 0, 28, 35, 42 for the first two dose cohorts and 0, 7, 14, 21 for the third- and fourth-dose cohorts. Although not a study endpoint, tumor response was collected at day 56. Results: Data are available for the first 20 pts enrolled (10 breast, 3 colorectal, 2 pancreatic, 1 each of hepatocellular carcinoma, head and neck, melanoma, mesothelioma, and prostate cancer). Cohorts by dose: 0.1 mg/kg (8 pts), 0.3 mg/kg (6pts), and 1 mg/kg (6pts). Median age was 59 years and 70% of pts were females. (Q: see attached Excel file). No DLTs or drug-related severe AEs were reported. Common drug-related AEs were fatigue (7pts), nausea (6 pts), dry skin (3 pts), constipation (2 pts) and dyspnea (2 pts). All AEs were grade 1 or 2 and no dose relationship was observed. PK was dose proportional with mean serum Cmax of 2.3, 5.2 and 16.6 mcg/mL for the 0.1, 0.3 and 1 mg/kg groups, respectively. No accumulation of B was seen after multiple weekly dosing. Conclusions: Single agent bavituximab is well tolerated to date, with a predictable PK profile. Accrual of the last planned cohort is underway. MTD has not been reached. Final results will be available for presentation at the time of the Meeting.

[Table: see text]