SEOM guideline in ovarian cancer 2014

Ovarian cancer is the leading cause of death due to gynecological cancer and the 5th cause of death for cancer in women in Europe. Optimal management of patients with ovarian cancer needs the participation of a well-trained multidisciplinary team. In the last few years, we have observed a significant improvement in the knowledge of the molecular biology of the different histotypes of ovarian cancer that will probably change our standard of care in the forthcoming years. In this Guideline, we summarize the most current evidence for the medical management of ovarian cancer.

Do Students Eventually Get to Publish their Research Findings? The Case of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Research in Cameroon

Background:

Scientific publication is commonly used to communicate research findings and in most academic/research settings, to evaluate the potential of a researcher and for recruitment and promotion. It has also been said that researchers have the duty to make public, the findings of their research. As a result, researchers are encouraged to share their research findings with the scientific world through peer review publications. In this study, we looked at the characteristics and publication rate of theses that documented studies on human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome in Cameroon.

Materials and Methods:

To check if a thesis resulted in a publication, we searched: A database of publications on HIV in Cameroon, African Journals Online, PubMed and Google scholar. For each publication we recorded if the student was an author, the position of the student in the author listing, the journal and where the journal was indexed. We also looked at the impact factor of the journals.

Results:

One hundred and thirty theses/dissertations were included in the study, 74.6% (97/130) were written as part of a medical degree (MD), 23.8% (31/130) a postgraduate (PG) degree and 1.5% (2/130) for a Doctorate/PhD. On a whole, 13.9% (18/130) of the theses resulted in at least one publication in a scientific journal with a total of 22 journal articles, giving a mean publication rate of 0.17 article/thesis, 86.4% (11/22) were indexed on PubMed, 9.1% (2/22) on African Journals Online and 4.6% (1/22) on Google scholar. One PG thesis led to two book chapters. The student was the first author in 22.7% (5/22) of the articles and not an author in 9.1% (2/22) of the articles. Student supervisor was an author in all the articles.

Conclusion:

This study reveals that most students in Cameroon failed to transform their theses/dissertations to scientific publications. This indicates an urgent need to sensitize students on the importance of presenting their research findings in scientific meetings and peer reviewed journals. There is also a great necessity to build capacity in scientific writing among university students in Cameroon.

Abstract P4-19-04: Biobank management and tracking web-based system for a breast cancer oriented biobank v2.0: Preliminary analysis

The quality of biospecimens and associated data accuracy in a Biobank must be collected and consistent according to standardized methods in order to achieve international harmonization and coordination among biobanking networks.

Sharing successful strategies between the Baylor College of Medicine (BCM) Breast and Cancer Centers and Breast Center Buenos Aires (BCBA) was the fundamental stone for the creation of an Argentinean Breast Cancer oriented Biobank with a shared data management system. We have designed, developed and implemented a computer system to easily manage sensible associated data. This innovative system, allows the data entry in a visual, intuitive, friendly and orderly way, integrating all the information for further analysis and easy use of samples for translational research.

Objective: Develop and improve (v2.0) a bilingual web-based tool for biospecimen management, inventory, clinical and breast cancer data registration according with international standards of data security quality assurance and ISBER Best Practices for Biorepositories.

Methods: System Characteristics:

Multi-tier architecture, relying on a SQL server 2008 R2 data base. Operating System: Windows Server Series. Programmer Language .net 4.0 C#.. The system operates with Internet Explorer as flat client or similar.

Bilingual English/Spanish system, fully configurable by modules, HIPPA compliant sensible data confidentiality, with de-identification of samples through 2D bar codes.

Results : System Capabilities and Improvements v2.0:

• Security Module: Allows to manage predetermined profiles (Clinical Research Coordinator Clinical staff as Phlebotomist, Pathologist, PA, MDs, PhDs, Researchers), audit controls implemented through permits according to the profile.

• Master Tables: allows to insert/add/change data associated into master tables, providing system user independence.

• General Registration Module: Online statistics allows to see immediately the number of consented individuals, types of samples and their classification.

• Sample Management: Assigns unequivocally identification of each sample in a 2D bar code for freezer lab labels(LabExpert®). Has online statistical information on the number of samples and tubes used, for an easy supply management. Automatically assigns the location of samples per product type in the freezer. Allows to know the occupancy rate online.

• Breast Cancer Module: A comprehensive data base in an attractive visual environment of eight screens: Clinical data, Biopsy, Definitive Surgery, Systemic Treatment, Radiation Treatment, Cancer Events, follow up and Summary screen. Includes path reports and sample collection forms attached in each corresponding biopsy or surgery screen for easy view and data entry quality assurance.

Conclusion: This Biobank Management System was designed in a friendly and intuitive data entry environment by a multidisciplinary team including breast surgeons, pathologists, oncologists, statisticians, system engineers and programmers from BCM and BCBA. It could be adapted to be used in full or in separate modules by Breast Centers and Breast Cancer Oriented Biobanks.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-19-04.

Abstract P4-19-03: Breast cancer oriented biobank and associated biobank management system: Preliminary analysis on 9043 samples from 274 individuals

Four years ago, after our Baylor College of Medicine (BCM) Breast and Cancer Centers experience, we decided to initiate a related translational research Project at the Breast Center Buenos Aires (BCBA) in Argentina. This included the development of a breast cancer-oriented Management System for clinical and lab data attached to a biorepository of tumor and normal breast tissue with matched blood specimens. We strictly followed ISBER Best Practices for Biorepositories, and shared the same protocols and strategies with BCM to facilitate international collaborative breast cancer research, being extremely aware of international standards.

Objectives: Creation of a breast cancer-oriented blood, breast tissue and tumor biobank for translational research purposes. Creation of a Biobank Management and Tracking System, with a breast cancer database for associated epidemiological, pathological, clinical, and follow-up data of each patient.

Methods: From April 2011 to June 2013 we processed blood and tissue samples from BCBA. Blood is collected at several time points during the breast cancer disease process: pre-surgical, pre-systemic treatment, and, if applicable, in the metastatic setting. Blood products are stored as whole blood, plasma, buffy coat, red blood cell pellet, serum and clot at -80°C or in GenPlates®. Fresh tissue and tumor samples were collected during surgical or core biopsy proceedings and stored fresh at -80°C in 1 ml cryovials and as FFPE (formalin-fixed paraffin embedded) tissue. Upon enrollment, participants completed an extensive epidemiological and risk factor questionnaire, which is supplemented by medical record abstraction for relevant pathological and clinical data, and re-contacted once a year for follow-up.

Preparation and adaptation processes were compliant with the Population Sciences Biorepository and Smith Breast Center Tumor Bank at BCM: 1) IRB-approved informed consent documents 2) Epidemiological and risk factor questionnaires (Core/Breast module); 3) Blood and tissue collection and processing protocols.

A web-based data management and tracking system was specifically designed for the BCBA biobank.

Results:

To date, we have collected 9043 samples, from 274 individuals, in 293 sample collections. Of 5449 frozen samples, 5054 (92.7%) are blood and 395 (7.3%) are tissue. We also collected 3264 blood samples in GenPlate® wells from 68 patients on 17 plates, and extracted DNA from them into Gentegra® tubes, all stored at room temperature.

230 FFPE breast cancer tissue biopsies from 20 surgical specimens, given by the pathologist after diagnosis, stored in cassettes at room temperature in our lab, were also included in the system starting from January 2013.

All of them have been classified by the physician into three categories: Healthy Control 15.3% (n = 42), Benign 55.1% (n = 151) and Cancer 29.6% (n = 81). We collected epidemiological, and cancer data from all of them in our system.

Conclusion: It took nearly 4 years from inception to realization for this biobank; however, the potential benefit to translation breast cancer research is large. The overall value of this biobank will depend on the number of individuals/samples accrued, the follow-up attained and data accuracy.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-19-03.

Apoptotic effects of tamoxifen on leukocytes from horse peripheral blood and bronchoalveolar lavage fluid

A reduction in inflammatory cell apoptosis is an important concept in the maintenance of inflammation and a potential target for the resolution of inflammation in many inflammatory diseases. Dysregulation of apoptosis has been implicated in a range of diseases, including tumors, neurodegenerative disorders and autoimmunity, and may also be implicated in allergic asthma. In horses, recurrent airway obstruction (RAO) is an asthma-like condition that is characterized increased survival neutrophil bronchial. Tamoxifen is a synthetic, non-steroidal, anti-estrogen agent that is widely used for treating all stages of breast cancer and has been approved for the prevention of breast cancer in high-risk women. The observed efficacy of tamoxifen has been attributed to both growth arrest and the induction of apoptosis. Therefore, the aim of our study was to evaluate the ability of tamoxifen to induce apoptosis in vitro in granulocytic cells from peripheral blood and in mononuclear cells from bronchoalveolar lavage fluid (BALF) in horses. Flow cytometry using commercial AnnexinV-FITC and propidium iodide was used to quantify early and late apoptotic leukocytes, respectively. The results showed a significant increase in early apoptosis in peripheral blood and bronchial granulocytic cells treated with tamoxifen. The rate of early apoptosis of mononuclear cells from blood and BALF when incubated with tamoxifen was significantly lower compared with granulocytic cells. We did not observe a direct effect of tamoxifen on late apoptosis in any of the in vitro assays in the cell types used here. These results indicate that the apoptotic mechanisms under these experimental conditions would affect only blood and BALF granulocytic cells, particularly in early apoptosis. Finally, further in vitro and in vivo studies are needed to better understand apoptotic mechanisms because tamoxifen could be used to treat chronic, inflammatory pathologies associated with granulocytes and allergic diseases, such as asthma or equine RAO.

Homozygous and compound heterozygous MMP20 mutations in amelogenesis imperfecta

In this article, we focus on hypomaturation autosomal-recessive-type amelogenesis imperfecta (type IIA2) and describe 2 new causal Matrix metalloproteinase 20 (MMP20) mutations validated in two unrelated families: a missense mutation p.T130I at the expected homozygous state, and a compound heterozygous mutation having the same mutation combined with a nucleotide deletion, leading to a premature stop codon (p.N120fz*2). We characterized the enamel structure of the latter case using scanning electron microscopy analysis and microanalysis (Energy-dispersive X-ray Spectroscopy, EDX) and confirmed the hypomaturation-type amelogenesis imperfecta as identified in the clinical diagnosis. The mineralized content was slightly decreased, with magnesium substituting for calcium in the crystal structure. The anomalies affected enamel with minimal inter-rod enamel present and apatite crystals perpendicular to the enamel prisms, suggesting a possible new role for MMP20 in enamel formation.

Abstract P6-11-06: A phase Ib study of LCL161, an oral inhibitor of apoptosis (IAP) antagonist, in combination with weekly paclitaxel in patients with advanced solid tumors

Background: Impaired apoptosis is a common feature of cancer cells and may contribute to chemoresistance. LCL161 is an oral small molecule antagonist of Inhibitor of Apoptosis Proteins (IAPs) that sensitizes a subset of tumors from diverse lineages to treatment with cytotoxic therapies, including paclitaxel. Multiple breast cancer models are sensitive to LCL161 as a single agent and LCL161 acts synergistically with paclitaxel in these models. A phase I study established an LCL161 dose of 1800 mg once weekly as well tolerated, with strong evidence of pharmacodynamic activity at doses ≥320 mg. This ongoing phase Ib study defines the dose limiting toxicities (DLTs), maximum tolerated dose (MTD), safety, and pharmacokinetics (PK) of LCL161 in combination with weekly paclitaxel.

Methods: Patients with advanced/metastatic solid tumors were treated with paclitaxel 80 mg/m2 each week followed by escalating doses of LCL161 administered once weekly immediately following paclitaxel. PK and biomarker sampling was performed.

Results: Thirty-two patients have received LCL161 doses of 600 mg (n = 3), 1200 mg (n = 5), 1500 mg (n = 4), and 1800 mg (n = 20). The most frequent adverse events considered LCL161-related included diarrhea (n = 11; 1 Grade 3), nausea (n = 8), fatigue (n = 7; 2 Grade 3), peripheral neuropathy (n = 6; 1 Grade 3), vomiting (n = 6), decreased appetite (n = 5), alopecia (n = 4), and anemia (n = 4). The principal DLTs were neutropenia, fatigue, and neuropathy. Significant cytokine release syndrome, the DLT of single-agent LCL161, has not been observed likely due to the use of dexamethasone as a premedication. No PK interaction between LCL161 and paclitaxel was observed. RECIST partial responses have been observed in 4 patients with diverse tumor types, including breast cancer. Preliminary antitumor activity in the expansion cohort with breast cancer patients will be presented.

Discussion: LCL161 and paclitaxel combination therapy is well tolerated, with manageable toxicities and no evidence of a PK interaction that might interfere with the activity of either agent. Enrollment of additional patients with breast and ovarian cancer into an expansion cohort is ongoing, utilizing an approach to identify those more likely to respond to treatment with IAP antagonists.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-11-06.

Controlling the morphology of gold nanoparticles synthesized photochemically in a polymer matrix through photonic parameters

A facile method for the preparation of gold nanoparticles (AuNPs) with various morphologies, including triangles, cubes and nanospheres into a urethane methacrylate polymer matrix, has been developed. The hybrid nanocomposites have been obtained by photoreduction of a gold precursor in the presence of a 30 wt% urethane methacrylate containing quaternary ammonium structure and 70 wt% functional monomer, carboxyl oligo-urethane dimethacrylate. The final materials contain gold nanoparticles with a morphology dependant on the reaction conditions. The influence of photonic and chemical parameters on the shape of the nanoparticles has been examined. Specific interactions between the macromolecular network and the nascent particles play an important role insofar as they control the access of metal atoms to the different crystalline planes of the growing nanoparticles, which is necessary to obtain anisotropic objects. A common mechanism for the formation of the various types of AuNPs is proposed. Coupling the intrinsic characteristics of metal nanoparticles with those of the copolymer substrate could result in materials with innovative properties.

Nanobubble and nanodroplet template growth of particle nanorings versus nanoholes in drying nanofluids and polymer films

Here we demonstrate how confined nanobubbles and nanodroplets, which can either form spontaneously at the suspension/substrate interface, or can more interestingly be purposely introduced in the system, allow assembly of nanoparticles (NPs) into nanoring-like structures with a flexible control of both the size and distribution. As with most wetting-mediated nanopatterning methods, this approach provides an alternative to direct replication from templates. The formation of two-dimensional ring-shaped nanostructures was obtained by drying a nanocolloidal gold (Au) suspension drop confining nanobubbles (or nanodroplets) that are settled at a solid substrate. AFM investigation of the dry nanostructures showed the formation of isolated Au NPs rings having diameters ranging from 200 nm to 500 nm along the dewetting-drying path of the suspension drop. The flexibility of these wetting processes for the variation of the spatial features of the nanoring (size and shape resolution) essentially depends on physical parameters such as the nanobubble/nanodroplet size and concentration, the wettability, and the evaporation rate of the nanofluid drop on the substrate. Furthermore, we show that the underpinning mechanism of this evaporation-assisted assembly of Au NPs into supported functional nanoring patterns is fairly similar to that at work in the spontaneous formation of nanoholes in drying polymer thin films. Finally, the method proves to be a simple and flexible nanofabrication tool to be extended to various nanosize objects, towards specific optical and sensing applications.

A phase I study of the safety and pharmacokinetics of the histone deacetylase inhibitor belinostat administered in combination with carboplatin and/or paclitaxel in patients with solid tumours

Background:

This phase I study assessed the maximum tolerated dose, dose-limiting toxicity (DLT) and pharmacokinetics of belinostat with carboplatin and paclitaxel and the anti-tumour activity of the combination in solid tumours.

Methods:

Cohorts of three to six patients were treated with escalating doses of belinostat administered intravenously once daily, days 1–5 q21 days; on day 3, carboplatin (area under the curve (AUC) 5) and/or paclitaxel (175 mg m⁻²) were administered 2–3 h after the end of the belinostat infusion.

Results:

In all 23 patients received 600–1000 mg m⁻² per day of belinostat with carboplatin and/or paclitaxel. No DLT was observed. The maximal administered dose of belinostat was 1000 mg m⁻² per day for days 1–5, with paclitaxel (175 mg m⁻²) and carboplatin AUC 5 administered on day 3. Grade III/IV adverse events were (n; %): leucopenia (5; 22%), neutropenia (7; 30%), thrombocytopenia (3; 13%) anaemia (1; 4%), peripheral sensory neuropathy (2; 9%), fatigue (1; 4%), vomiting (1; 4%) and myalgia (1; 4%). The pharmacokinetics of belinostat, paclitaxel and carboplatin were unaltered by the concurrent administration. There were two partial responses (one rectal cancer and one pancreatic cancer). A third patient (mixed mullerian tumour of ovarian origin) showed a complete CA-125 response. In addition, six patients showed a stable disease lasting ⩾6 months.

Conclusion:

The combination was well tolerated, with no evidence of pharmacokinetic interaction. Further evaluation of anti-tumour activity is warranted.