Abstract P1-11-12: Re-evaluating outcomes of partial-breast irradiation using multicatheter brachytherapy for Japanese patients with breast cancer by European brachytherapy phase 3 trial

[Purpose] The Groupe European de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) has reported the equivalent outcomes of partial-breast irradiation (PBI) using multicatheter interstitial brachytherapy (MCB) to whole-breast irradiation (WBI) in breast-conserving therapy, showing that the incidence of local recurrence was 1.44% with MCB-PBI and 0.92% with WBI. Based on the trial, MCB-PBI could be considered as an alternative method to WBI for low-risk breast cancer patients. However, it would be difficult to translate it directly into Japanese community practice. After categorization of Japanese patients using the inclusion and exclusion criteria of this trial, our databases were re-evaluated to validate the data for Japanese patients, and the possibility to extend the candidate for MCB-PBI was also investigated.

[Methods] Patients undergoing BCT were retrospectively examined between November 2007 and December 2015. The technique involved an open-cavity implant with a dose of 32 Gy in eight fractions. WBI was performed with a total dose of 50 Gy in fractions of 2 Gy. The 4-year clinical outcomes of MCB-PBI were evaluated in the two distinct categories, and comparisons of outcomes between MCB-PBI and WBI were performed in patients with unfavorable features.

[Results] Of a total of 501 lesions undergoing BCT, 301 lesions were treated with MCB-PBI and 200 lesions with WBI. At a median follow-up time of 52 months, the 4-year rate of ipsilateral breast tumor recurrence (IBTR)-free, disease-free, and overall survival in patients with MCB-PBI and WBI were 98.9% vs. 98.0% (p = 0.56), 97.0% vs. 95.3% (p = 0.78), and 99.6% vs. 98.2% (p = 0.38), respectively. In the exclusion cohort treated with MCB-PBI, IBTR-free and disease-free survival were significantly poorer than in the inclusion cohort.However, no significant differences in the outcomes between the two radiotherapy techniques were demonstrated with respect to either IBTR-FS (95.0% vs. 97.2%, p = 0.24), DFS (95.0% vs. 95.8%, p = 0.31), or OS (100% vs. 99.0%, p = 0.80) in patients with exclusion criteria

Univariate and multivariate analysis of prognostic factors for IBTR and breast cancer eventVariablesIBTR  Locoregional and distant recurrences   P-value  P-value   UnivariateMultivariateHR (95% CI)UnivariateMultivariateHR (95% CI)Age ≥ 40 vs < 40years.25—2.49 (0.53–11.72) —0.90 (0.21–3.85)Axillary node negative vs. positive<.05<.054.09 (1.18–14.12)<.05<.052.75 (1.19–6.36)Margin negative vs. positive<.01<.015.58 (1.54–20.29).075.0682.55 (0.93–6.97)WBI vs. MCB-PBI.56—0.69 (0.20–2.39).78—0.89 (0.39–2.03).

ConclusionsTo our knowledge, this study includes the largest cohort of Asian patients undergoing MCB-PBI. Although the retrospective chart review with relatively short follow-up time and small number of patients does not allow reaching any definite conclusion, we could expect the same outcomes by MCB-PBI as those in the GEC-ESTRO trial with respect to the tumor control only for Japanese but for Asian patients with breast cancer. Moreover, no negative impact on the outcomes of MCB-PBI as compared to WBI was not found in patients with exclusion criteria.

Citation Format: Sato K, Mizuno Y, Fuchikami H, Takeda N, Kato M. Re-evaluating outcomes of partial-breast irradiation using multicatheter brachytherapy for Japanese patients with breast cancer by European brachytherapy phase 3 trial [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 P1-11-12.

Doppler sonography of the deep lingual artery

Purpose: To clarify the Doppler sonographic features of the lingual artery in normal subjects and to evaluate those of patients with cancer of the tongue.

Material and Methods: Sixty-seven volunteers and 12 patients with cancer and/or leukoplakia of the tongue were examined with an intraoral sonographic probe. The visibility of the deep lingual artery was determined on transverse and anteroposterior images. On the transverse images, the vascular index, which was defined as the number of colored pixels, was measured on bilateral lingual arteries. Thereafter, the degree of symmetry was evaluated for normal subjects and patients.

Results: In normal subjects, between younger and older volunteers, there were no significant differences in visibility of the trunk but differences were found between the two groups for the dorsal branches. The vascular indices of the right and left sides were not different. The characteristic Doppler sonographic feature was vasculature in and around the tumors in the patients with cancer of the tongue. The symmetry indices of the cancer patients were significantly different from those of normal subjects.

Conclusion: Doppler sonography should be an important procedure for evaluation of tongue neoplasms.

Characterization of SPATA5-related encephalopathy in early childhood

Mutations in SPATA5 have recently been shown to result in a phenotype of microcephaly, intellectual disability, seizures, and hearing loss in childhood. Our aim in this report is to delineate the SPATA5 syndrome as a clinical entity, including the facial appearance, neurophysiological, and neuroimaging findings. Using whole-exome sequencing and Sanger sequencing, we identified three children with SPATA5 mutations from two families. Two siblings carried compound heterozygous mutations, c.989_991del (p.Thr330del) and c.2130_2133del (p.Glu711Profs*21), and the third child had c.967T>A (p.Phe323Ile) and c.2146G>C (p.Ala716Pro) mutations. The three patients manifested microcephaly, psychomotor retardation, hypotonus or hypertonus, and bilateral hearing loss from early infancy. Common facies were a depressed nasal bridge/ridge, broad eyebrows, and retrognathia. Epileptic spasms or tonic seizures emerged at 6-12 months of age. Interictal electroencephalography showed multifocal spikes and bursts of asynchronous diffuse spike-wave complexes. Augmented amplitudes of visually evoked potentials were detected in two patients. Magnetic resonance imaging revealed hypomyelination, thin corpus callosum, and progressive cerebral atrophy. Blood copper levels were also elevated or close to the upper normal levels in these children. Clinical delineation of the SPATA5-related encephalopathy should improve diagnosis, facilitating further clinical and molecular investigation.

Characterization of pediatric Philadelphia-negative B-cell precursor acute lymphoblastic leukemia with kinase fusions in Japan

Recent studies revealed that a substantial proportion of patients with high-risk B-cell precursor acute lymphoblastic leukemia (BCP-ALL) harbor fusions involving tyrosine kinase and cytokine receptors, such as ABL1, PDGFRB, JAK2 and CRLF2, which are targeted by tyrosine kinase inhibitors (TKIs). In the present study, transcriptome analysis or multiplex reverse transcriptase–PCR analysis of 373 BCP-ALL patients without recurrent genetic abnormalities identified 29 patients with kinase fusions. Clinically, male predominance (male/female: 22/7), older age at onset (mean age at onset: 8.8 years) and a high white blood cell count at diagnosis (mean: 94 200/μl) reflected the predominance of National Cancer Institute high-risk (NCI-HR) patients (NCI-standard risk/HR: 8/21). Genetic analysis identified three patients with ABL1 rearrangements, eight with PDGFRB rearrangements, two with JAK2 rearrangements, three with IgH-EPOR and one with NCOR1-LYN. Of the 14 patients with CRLF2 rearrangements, two harbored IgH-EPOR and PDGFRB rearrangements. IKZF1 deletion was present in 16 of the 22 patients. The 5-year event-free and overall survival rates were 48.6±9.7% and 73.5±8.6%, respectively. The outcome was not satisfactory without sophisticated minimal residual disease-based stratification. Furthermore, the efficacy of TKIs combined with conventional chemotherapy without allogeneic hematopoietic stem cell transplantation in this cohort should be determined.

Protective effects of heat-killed Lactococcus lactis subsp. lactis BF3, isolated from the intestine of chum salmon, in a murine model of DSS-induced inflammatory bowel disease

Oxidative stress is considered an etiological factor responsible for several symptoms of inflammatory bowel disease (IBD). In vitro anti-inflammatory activities of heat-killed Lactococcus lactis subsp. lactis BF3 have been reported. In this study, the anti-inflammatory effect of these cells was examined using a dextran sodium sulphate (DSS)-induced murine IBD model. Administration of heat-killed L. lactis BF3 via drinking water suppressed the IBD symptoms, such as shortening of colon length, damage to the colon mucosa as observed under the microscope, and spleen enlargement. This result suggests that heat-killed L. lactis BF3 has the potential to treat IBD.

Role of apolipoprotein B100 and oxidized low-density lipoprotein in the monocyte tissue factor induction mediated by anti-β2 glycoprotein I antibodies

OBJECTIVE

The objective of this paper is to elucidate the not yet known plasma molecule candidates involved in the induction of tissue factor (TF) expression mediated by β2GPI-dependent anticardiolipin antibody (aCL/β2GPI) on monocytes.

METHODS

Human serum incubated with FLAG-β2GPI was applied for affinity chromatography with anti- FLAG antibody. Immunopurified proteins were analyzed by a liquid chromatography coupled with mass spectrometry (LC-MS). TF mRNA induced by the identified molecules on monocytes was also analyzed.

RESULTS

Apolipoprotein B100 (APOB) was the only identified serum molecule in the MS search. Oxidized LDL, containing APOB as well as ox-Lig1 (a known ligand of β2GPI), was revealed as a β2GPI-binding molecule in the immunoprecipitation assay. TF mRNA was markedly induced by oxidized LDL/β2GPI complexes with either WBCAL-1 (monoclonal aCL/β2GPI) or purified IgG from APS patients. The activities of lipoprotein-associated phospholipase A2, one of the component molecules of oxidized LDL, were significantly higher in serum from APS patients than in those from controls.

CONCLUSION

APOB (or oxidized LDL) was detected as a major β2GPI binding serum molecule by LC-MS search. Oxidized LDL/aCL/β2GPI complexes significantly induced TF expressions on monocytes. These data suggest that complexes of oxidized LDL and aCL/β2GPI may have a crucial role in the pathophysiology of APS.