Donor-Derived Metastatic Melanoma and Checkpoint Inhibition

Donor-derived malignancy, particularly melanoma, is a rare but known complication of organ transplantation. Here we describe a case of metastatic melanoma in a deceased-donor kidney transplant recipient. After diagnosis, the patient was successfully treated with cessation of immunosuppression, explantation of the renal allograft, and novel melanoma therapies, including the mutation-targeted agents dabrafenib and trametinib and the immune checkpoint inhibitor nivolumab. These 2 new classes of melanoma therapy have revolutionized the course of metastatic melanoma, altering it from one of nearly certain mortality to one of potential cure. This case reviews the mechanisms of action of these therapies and reports our experience with them in the rare setting of donor-derived melanoma in a dialysis-dependent patient.

Opinion diversity and community formation in adaptive networks

It is interesting and of significant importance to investigate how network structures co-evolve with opinions. In this article, we show that, a simple model integrating consensus formation, link rewiring, and opinion change allows complex system dynamics to emerge, driving the system into a dynamic equilibrium with the co-existence of diversified opinions. Specifically, similar opinion holders may form into communities yet with no strict community consensus; and rather than being separated into disconnected communities, different communities are connected by a non-trivial proportion of inter-community links. More importantly, we show that the complex dynamics may lead to different numbers of communities at the steady state with a given tolerance between different opinion holders. We construct a framework for theoretically analyzing the co-evolution process. Theoretical analysis and extensive simulation results reveal some useful insights into the complex co-evolution process, including the formation of dynamic equilibrium, the transition between different steady states with different numbers of communities, and the dynamics between opinion distribution and network modularity.

Matrix replenishing by BMSCs is beneficial for osteoarthritic temporomandibular joint cartilage

OBJECTIVES

The present goal was to explore whether matrix replenishment is the primary requirement for osteoarthritic (OA) cartilage.

METHODS

Cells isolated from the superficial and deep zone cartilage of a pig temporomandibular joint (TMJ) were exposed to fluid flow shear stress (FFSS). Differences in matrix production and cellular differentiation were detected. Unilateral anterior crossbite (UAC) was applied to C57BL/6J female mice. Green fluorescent protein-labeled exogenous bone marrow stromal cells (GFP-BMSCs) were injected weekly into TMJs, starting from 3 weeks of UAC stimulation and continuing for 4-, 8- and 12-weeks. Another GFP-BMSCs injection UAC group stopped receiving injections for 4-weeks after 8-weeks of injections. Assessments were focused on morphological alterations in UAC mouse TMJ cartilage, the expression levels of DAP3, an anoikis marker, CD163, a scavenger receptor family member, and ki67, a proliferation indicator.

RESULTS

FFSS down-regulated type-II collagen expression but stimulated terminal differentiation in cells isolated from deep zone cartilage. It down-regulated aggrecan expression but up-regulated type I collagen in cells isolated from both superficial and deep zones. UAC caused matrix loss and anoikis and enhanced scavenging activity in deep zone chondrocytes without affecting cell proliferation. Superficial fibrillation was obvious in the late stage. Weekly injections of BMSCs largely restored these changes. The implanted BMSCs expressed a high level of CD163 protein but did not show remarkable cell proliferation. Terminating the supply of exogenous BMSCs reversed the restorative effects.

CONCLUSIONS

Scavenging the degraded matrix and replenishing the fibrosis-developmental matrix are the primary requirements for the repair of OA cartilage.

Effect of Retrievable Stent Size on Endovascular Treatment of Acute Ischemic Stroke: A Multicenter Study

BACKGROUND AND PURPOSE

In clinical practice, stent diameter is one of the variable properties important for endovascular treatment. A consensus guideline for stent retriever size selection has yet to be established. The aim of this study was to investigate the effects of different diameters of Solitaire retrievers on outcomes.

MATERIALS AND METHODS

Of 628 patients enrolled from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry, 256 were treated with the Solitaire 4-mm device and 372, with the 6-mm device. We matched patients treated with the 2 stent sizes using propensity score analysis. The successful outcome was reperfusion as measured by the modified Thrombolysis in Cerebral Infarction score immediately postprocedure and the dichotomized modified Rankin Scale score at 90 days. Symptomatic intracerebral hemorrhage and in-hospital mortality were also recorded.

RESULTS

After propensity score analysis, group outcomes did not differ. In addition, in patients with atherosclerosis-related occlusion, a higher reperfusion rate (P = .021) was observed in the Solitaire 4 group, as well as a shorter time interval (P = .002) and fewer passes (P = .025). Independent predictors of successful reperfusion in patients with atherosclerotic disease on logistic analysis were the small stent (OR, 3.217; 95% CI, 1.129-9.162; P = .029) and the propensity score acting as a covariate (OR, 52.84; 95% CI, 3.468-805.018; P = .004).

CONCLUSIONS

We found no evidence of a differential effect of intra-arterial therapy based on the size of Solitaire retrievers. In patients with atherosclerotic disease, favorable reperfusion was associated with deployment of a small stent.

Comprehensive evaluation of published gene expression prognostic signatures for biomarker-based lung cancer clinical studies

Background

A more accurate prognosis for non-small-cell lung cancer (NSCLC) patients could aid in the identification of patients at high risk for recurrence. Many NSCLC mRNA expression signatures claiming to be prognostic have been reported in the literature. The goal of this study was to identify the most promising mRNA prognostic signatures in NSCLC for further prospective clinical validation.

Experimental design

We carried out a systematic review and meta-analysis of published mRNA prognostic signatures for resected NSCLC. The prognostic performance of each signature was evaluated via a meta-analysis of 1927 early stage NSCLC patients collected from 15 studies using three evaluation metrics (hazard ratios, concordance scores, and time-dependent receiver-operating characteristic curves). The performance of each signature was then evaluated against 100 random signatures. The prognostic power independent of clinical risk factors was assessed by multivariate Cox models.

Results

Through a literature search, we identified 42 lung cancer prognostic signatures derived from genome-wide expression profiling analysis. Based on meta-analysis, 25 signatures were prognostic for survival after adjusting for clinical risk factors and 18 signatures carried out significantly better than random signatures. When analyzing histology types separately, 17 signatures and 8 signatures are prognostic for adenocarcinoma and squamous cell lung cancer, respectively. Despite little overlap among published gene signatures, the top-performing signatures are highly concordant in predicted patient outcomes.

Conclusions

Based on this large-scale meta-analysis, we identified a set of mRNA expression prognostic signatures appropriate for further validation in prospective clinical studies.

Genetic diversity among mulberry genotypes from seven countries

Mulberry (Morus alba) is an economically and ecologically important, widespread woody plant. It has served human beings for over hundreds of years, and it is still widely used in pharmaceuticals, food industry and farming nowadays. Using modern techniques, deeper understanding in classification and conservation resources of mulberry leads to higher-efficiency hybrids among populations. Genetic polymorphisms among 42 mulberry genotypes from seven countries over Asia and South America were detected using 17 inter simple sequence repeat (ISSR) primers. A dendrogram was constructed using the similarity matrix among genotypes and a principal component analysis (PCA) was carried out to further identify and cluster the mulberry genotypes. In the 42 genotypes, 175 distinct bands were displayed, among which 169 were polymorphic bands (96.57%). The polymorphic information content of 17 ISSR primers ranged from 0.2921 to 0.3746 with the mean of 0.3494. And Nei's index and Shanon's information index averaged 0.116 and 0.174, respectively, indicating low diversity of mulberry. For further study, cluster analysis and PCA were carried out and the results were similar. 42 genotypes were grouped, showing some hybridized combinations. Additionally, a connection between mulberry diseases and their genotypes was noted, which indicates possible application for ISSR in studying disease resistance of mulberry.

Abstract P5-07-10: MiR-146a functions as suppressive non-coding gene via indirect upregulation of Let-7 to promote asymmetric division and inhibit the self-renewal ability of breast cancer stem-like cells

MiR-146a plays as diverse roles in systemic malignancies, stimulating the tumor growth or blocking the tumor proliferation. However, its roles in breast cancer stem-like cells are barely known. We first identified the suppressive role of miR-146a in stem cells' renewal, promoting the asymmetric division of stem-like cells, and the expression of miR-146a was positively related with Let-7b level in vitro and in clinical specimens. Previous studies of Let-7 revealed its suppressive functions in stem-like cells expansion, and miR-146 was predicated to target and bind to the 3'UTR of LIN28, a negative regulator of Let-7 maturation. By using luc-assay and western, results showed that miR-146a increased the Let-7b level through degrading Lin28, and Lin28 is required for miR-146a induction of stem cells arresting and more asymmetric stem cells division. Moreover, Let-7 controlled Wnt signaling pathway activity is governed and strengthened by miR-146a, contributing to decrease the ratio of stem-like cells, forcing stem cells dividing asymmetrically. MiR-146a in turn formed negative feedback loop with Let-7 via the repression of NF-kB and Snai1 caused by Let-7b. Our results suggested the possible miR-146a/LIN28/Let-7/Snai1 signaling pathway in restraining the symmetric cells division, which was referred to the self-renewal capacity of breast cancer-stem like cells, and this axis helps to prohibit long–term tumor resistance and recurrence.MiR-146a plays as diverse roles in systemic malignancies, stimulating the tumor growth or blocking the tumor proliferation. However, its roles in breast cancer stem-like cells are barely known. We first identified the suppressive role of miR-146a in stem cells' renewal, promoting the asymmetric division of stem-like cells, and the expression of miR-146a was positively related with Let-7b level in vitro and in clinical specimens. Previous studies of Let-7 revealed its suppressive functions in stem-like cells expansion, and miR-146 was predicated to target and bind to the 3'UTR of LIN28, a negative regulator of Let-7 maturation. By using luc-assay and western, results showed that miR-146a increased the Let-7b level through degrading Lin28, and Lin28 is required for miR-146a induction of stem cells arresting and more asymmetric stem cells division. Moreover, Let-7 controlled Wnt signaling pathway activity is governed and strengthened by miR-146a, contributing to decrease the ratio of stem-like cells, forcing stem cells dividing asymmetrically. MiR-146a in turn formed negative feedback loop with Let-7 via the repression of NF-kB and Snai1 caused by Let-7b. Our results suggested the possible miR-146a/LIN28/Let-7/Snai1 signaling pathway in restraining the symmetric cells division, which was referred to the self-renewal capacity of breast cancer-stem like cells, and this axis helps to prohibit long–term tumor resistance and recurrence.

Citation Format: Sun X, Du N, Li G, Zhang J, Zhang J, Xiao G, Wang J, Tang S-C, Ren H. MiR-146a functions as suppressive non-coding gene via indirect upregulation of Let-7 to promote asymmetric division and inhibit the self-renewal ability of breast cancer stem-like cells [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-07-10.

Abstract P4-07-11: MicroRNA-367a promotes tumor growth and stemness potential by targeting FBXW7 in breast cancer

Increasing studies showed that MicroRNAs (miRNAs)participate in the carcinogenesis and progression of breast cancer, but the specific mechanism of miRNAs in breast cancer needs to be furtherexplored. in this study, wefound that miR-367a was significantly up-regulated in breast cancer tissue samples and cell lines, compared to paired normal tumor-adjacent samples and MCF-10A. meanwhile, Kaplan–Meier analysis demonstrated high miR-367a expression was evidently correlated with poor prognostic features of breast cancer. overexpression of miR-367a remarkably promoted proliferation, cell cycle,inhibited apoptosis ratios and stem-like capacity of breast cancer cells in vitro, whilesilencing the expression of miR-367a dramaticallyreversed these cellular events .in addition,In vivo studies showed that knockdown of miR-367a inhibited tumor growth of breast cancer ,moreover, F-box and WD repeat domain-containing 7 (FBXW7) was identified as a direct target genes of miR-367a, as miR-367a directly bound to the 3'untranslated region of FBXW7 . Notably, alterations of FBXW7 levels abrogated the effects of miR-367a on breast cancer cell proliferation, cell cycle, apoptosis and stemness potential. In conclusion,evidence from this study demonstrated that miR-367amay serve as a novel prognostic indicator for breast cancer patients andexerts tumor promotion,at least in part, by inhibiting FBXW7.

Key words: miR-367a, FBXW7, breast cancer, tumor growth, stem-like capacity.

Citation Format: Xiao G, Zhang J, Sun X, Qin S, Zhang B, Liu D, Liu J, Ren H. MicroRNA-367a promotes tumor growth and stemness potential by targeting FBXW7 in breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-07-11.

Ontogeny of Hepatic Drug Transporters as Quantified by LC-MS/MS Proteomics

Protein expression of major hepatic uptake and efflux drug transporters in human pediatric (n = 69) and adult (n = 41) livers was quantified by liquid chromatography / tandem mass spectroscopy (LC-MS/MS). Transporter protein expression of OCT1, OATP1B3, P-gp, and MRP3 was age-dependent. Particularly, significant differences were observed in transporter expression (P < 0.05) between the following age groups: neonates vs. adults (OCT1, OATP1B3, P-gp), neonates or infants vs. adolescents and/or adults (OCT1, OATP1B3, and P-gp), infants vs. children (OATP1B3 and P-gp), and adolescents vs. adults (MRP3). OCT1 showed the largest increase, of almost 5-fold, in protein expression with age. Ontogenic expression of OATP1B1 was confounded by genotype and was revealed only in livers harboring SLCO1B1*1A/*1A. In livers >1 year, tissues harboring SLCO1B1*14/*1A showed 2.5-fold higher (P < 0.05) protein expression than SLCO1B1*15/*1A. Integration of these ontogeny data in physiologically based pharmacokinetic (PBPK) models will be a crucial step in predicting hepatic drug disposition in children.

Extraction, molecular weight distribution, and antioxidant activity of oligosaccharides from longan (Dimocarpus Longan Lour.) pulp

Ultrasonic-microwave synergistic extraction (UMSE) was optimized for the extraction of oligosaccharides from longan pulp (OLP). Box-Behnken design was used to evaluate the effects of temperature (35-55°C), ultrasonic time (5-25 min), and water to material ratio (10-30 mL/g) on the extraction efficiency of crude OLP. A regression model was developed and its validity was statistically demonstrated. Significant interaction between temperature and water to material ratio was observed. The following optimal conditions for the extraction yield of crude OLP were determined: extraction temperature 55°C, ultrasonic time 18.52 min, and water to material ratio 10 mL/g. The extracted OLP were purified for the determination of molecular weight distribution and antioxidant activity. Results of matrix-assisted laser desorption ionization time-of-flight mass spectrometry revealed that the molecular weight distribution of the purified OLP ranged from m/z 495.138 to 795.511. The purified OLP exhibited a dose-dependent behavior in 1,1-diphenyl-2-picrylhydrazyl radical scavenging activity.

[Analysis of clinical predictive factors of pathologic complete response after neoadjuvant chemoradiotherapy in rectal cancer]

OBJECTIVE

To evaluate the clinical predictive factors associated with pathologic complete response (pCR) after neoadjuvant chemoradiotherapy in rectal cancer.

METHODS

A retrospective analysis was performed on clinical data of 87 patients with rectal cancer, who underwent neoadjuvant chemoradiotherapy followed by radical surgery from April 2007 to May 2015. All patients received pelvic intensity-modulated radiotherapy (50 Gy/25 fractions) with concurrent fluorouracil- based chemotherapy and then underwent radical surgery 4-8 weeks later. The clinical factors associated with pCR or non-pCR were analyzed by Logistic regression.

RESULTS

Eighty-three patients had completed treatment, of which 15 patients (18.1%) achieved pCR after neoadjuvant chemoradiotherapy. Univariate analysis showed non-diabetes(P=0.033), pre-chemoradiotherapy plasma glucose(≤6.1 mmol/L)(P=0.033), pre-chemoradiotherapy CEA(≤5 μg/L)(P=0.026), pre- chemoradiotherapy plasma lymphocytes count(≤1.5×10(9)/L)(P=0.042), pre- chemoradiotherapy plasma platelet(≤240×10(12))(P=0.043), tumor pathological type(adenocarcinoma)(P=0.036)were significantly correlated with pCR after neoadjuvant chemoradiotherapy in rectal cancer. Logistic regression revealed that non-diabetes, pre-chemoradiotherapy plasma glucose, pre-chemoradiotherapy CEA(≤5 μg/L), pre-chemoradiotherapy plasma lymphocytes count(≤1.5×10(9)/L), tumor pathological type(adenocarcinoma) were independent predictive factors of pCR after neoadjuvant chemoradiotherapy in rectal cancer.

CONCLUSION

Patients with non-diabetes, normal plasma glucose, normal CEA, lower plasma lymphocytes count and adenocarcinoma were associated with pCR after neoadjuvant chemoradiotherapy for rectal cancer.

Comparison of different drying methods on Chinese ginger (Zingiber officinale Roscoe): Changes in volatiles, chemical profile, antioxidant properties, and microstructure

Nowadays, food industry is facing challenges in preserving better quality of fruit and vegetable products after processing. Recently, many attentions have been drawn to ginger rhizome processing due to its numerous health promoting properties. In our study, ginger rhizome slices were subjected to air-drying (AD), freeze drying (FD), infrared drying (IR), microwave drying (MD) and intermittent microwave & convective drying (IM&CD). Quality attributes of the dried samples were compared in terms of volatile compounds, 6, 8, 10-gingerols, 6-shogaol, antioxidant activities and microstructure. Results showed that AD and IR were good drying methods to preserve volatiles. FD, IR and IM&CD led to higher retention of gingerols, TPC, TFC and better antioxidant activities. However, FD and IR had relative high energy consumption and drying time. Therefore, considering about the quality retention and energy consumption, IM&CD would be very promising for thermo sensitive material.

DIGRE: Drug-Induced Genomic Residual Effect Model for Successful Prediction of Multidrug Effects

Multidrug regimens are a promising strategy for improving therapeutic efficacy and reducing side effects, especially for complex disorders such as cancer. However, the use of multidrug therapies is very challenging, due to a lack of understanding of the mechanisms of drug interactions. We herein present a novel computational approach-Drug-Induced Genomic Residual Effect (DIGRE) Computational Model-to predict drug combination effects by explicitly modeling drug response curves and gene expression changes after drug treatments. The prediction performance of DIGRE was evaluated using two datasets: (i) OCI-LY3 B-lymphoma cells treated with 14 different drugs and (ii) MCF breast cancer cells treated with combinations of gefitinib and docetaxel at different doses. In both datasets, the predicted drug combination effects significantly correlated with the experimental results. The results indicated the model was useful in predicting drug combination effects, which may greatly facilitate the discovery of new, effective multidrug therapies.

Successful treatment of acute severe graft-versus-host-disease in a pancreas-after-kidney transplant recipient: case report

The development of acute graft-versus-host-disease (GVHD) in recipients of pancreas transplants is a rare and quite often a fatal post-transplantation complication. We present a 38-year-old male with a longstanding history of type 1 diabetes mellitus and end-stage kidney disease, with a living unrelated kidney transplant from his wife for 3 years, who received an enteric-drained 5-antigen HLA-mismatched deceased-donor pancreas. Five weeks after transplantation, he presented with spiking fevers, severe skin rash, diarrhea, pancytopenia, and increasingly abnormal liver function tests. Skin biopsies were consistent with grade 3 acute GVHD. The patient was treated for GVHD with escalated doses of tacrolimus, pulse doses of steroids, and basiliximab. He was discharged after a 4-week hospital stay with complete resolution of his rash, fever, abnormal liver enzymes, and leukopenia. He remained in good health with excellent kidney and pancreas allograft function 3 years later.