[High dose chemotherapy combined with peripheral blood stem cell transplantation (PBSCT) in the treatment of patients with small cell lung cancer]

BACKGROUND

To investigate the therapeutic effect and safety of PBSCT combined with high dose chemotherapy in the treatment of small cell lung cancer(SCLC).

METHODS

From March, 1994 to June, 1999, high dose chemotherapy combined with PBSCT was carried out in 20 patients with SCLC. Eight patients were in CR status while twelve patients were for salvaging therapy. Allo-PBSCT was performed in 1 patient and Auto-PBSCT in 19 patients. After mobilization of stem cell, mononeuclear cell (MNC) was collected for ≥3.0×10⁸/kg, CD34+ cell≥2.0×10⁶/kg. The high dose chemotherapy included carboplatin 350 mg/m²×3 days, VP-16 120 mg/m²×5 days, and E-ADM 40 mg/m²×2 days.

RESULTS

Encouraging results were achieved in 8 patients who were in CR status. Seven of the eight patients survived after Auto-PBSCT. One patients survived more than 1 year, 4 cases over 2 years, and 3 cases over 3 years. Of the 3 patients, 2 survived more than 4 years. In the group of salvaging therapy, response was good, however there was no long-term survival and median remission time was only 3.5 months.

CONCLUSIONS

High dose chemotherapy combined with PBSCT in the treatment of SCLC with CR status is feasible and safe, although the side effects are severe too. It is worth further studying on clinical practice.

Risk of second primary cancer after treatment for esophageal cancer: a pooled analysis of nine cancer registries

The introduction of new treatments for esophageal cancer including surgery, chemotherapy, radiotherapy, or a combination of these modalities has not only improved patient survival, but may also increase the risk of the second primary cancers. The available evidence is conflicting with most risk estimates based on sparse numbers. Here we estimated standardized incidence ratios (SIRs) of second cancer among 24,557 esophageal cancer survivors (at least 2 months) in the Surveillance, Epidemiology, and End Results (SEER) Program between 1973 and 2007, who had been followed up for median 6.5 years (range 2 months-29.3 years). Second cancer risk was statistically significantly elevated (SIR = 1.34, 95% confidence interval [CI]= 1.25-1.42) among the survivors compared with the general population; the SIRs for cancers of oral and pharynx, stomach, small intestine, larynx, lung and bronchus, thyroid and prostate cancer were 8.64 (95% CI = 7.36-10.07), 2.87 (95% CI = 2.10-3.82), 3.80 (95% CI = 1.82-7.00), 3.19 (95% CI = 2.12-4.61), 1.68 (95% CI = 1.46-1.93), 2.50 (95% CI = 1.25-4.47), and 0.77 (95% CI = 0.65-0.90), respectively. Radiotherapy raised cancer risk of larynx (SIR = 3.98, 95% CI = 2.43-6.14) and thyroid (SIR = 3.57, 95% CI = 1.54-7.03) among all esophageal cancer survivors. For patients who had 5-9 years of follow up after radiotherapy, the SIR for lung cancer was 3.46 (95% CI = 2.41-4.82). Patients with esophageal cancer are at increased risks of second cancers of oral and pharynx, larynx, lung, and thyroid, while at a decreased risk for prostate cancer. These findings indicate that radiotherapy for esophageal cancer patients may increase risk of developing second cancers of larynx, lung, and thyroid. Thus, randomized clinical trials to address the association of radiotherapy and the risk of secondary cancer are warranted.

Effect of greyscale liquid crystal displays of different resolutions on observer performance during detection of small solitary pulmonary nodules

OBJECTIVE

The aim of this study was to evaluate the effect of monochrome liquid crystal displays (LCDs) with different resolutions on observer performance during detection of small solitary pulmonary nodules.

METHODS

Chest images of digital radiography were selected online from the hospital's picture archiving and communication system. Of the 164 images selected, small solitary non-calcified pulmonary nodules were present in 63 images and absent in 101 images. Observer performance was assessed among 3 extremely experienced, 3 very experienced and 3 moderately experienced radiologists, who independently interpreted these images on 2, 3 and 5 megapixel greyscale LCDs. A five-point confidence level rating scale was used to represent the presence of nodules: definite absence, probable absence, indetermination, probable presence and definite presence. The observers were requested to rank each image on the given display according to the presence of the pulmonary nodule. Observer performance was analysed in terms of receiver operating characteristics (ROCs).

RESULTS

The areas under the ROC curves which represented the observer performance for the 2, 3 and 5 megapixel LCDs were found to be 0.705, 0.722 and 0.764, respectively, for the extremely experienced radiologists; 0.687, 0.712 and 0.721, respectively, for the very experienced radiologists; and 0.689, 0.696 and 0.711, respectively, for the moderately experienced radiologists. These differences were not statistically significant.

CONCLUSION

The observer performances for detection of small solitary non-calcified pulmonary nodules by radiologists with varying degrees of experience were comparable between the 2, 3 and 5 megapixel monochrome LCDs.

Effects of duration of treatment and dosage of eicosapentaenoic acid and stearidonic acid on red blood cell eicosapentaenoic acid content

OBJECTIVE

The purpose of this randomized, controlled, parallel group study was to characterize the relationships between dosages of stearidonic acid (SDA) and eicosapentaenoic acid (EPA), and incorporation of EPA into red blood cell (RBC) membranes over time.

METHODS

Healthy subjects (n=131) received capsules with placebo (safflower oil), SDA (0.43, 1.3, 2.6, or 5.2 g/d) or EPA (0.44, 1.3, or 2.7 g/d) for 12 weeks. RBC fatty acids were analyzed biweekly.

RESULTS

RBC %EPA increased in all EPA and SDA groups (p<0.02 vs. control) except the 0.43 g/d SDA group (p=0.187). For theoretical intakes of EPA of 0.25, 0.5, and 0.89 g/d, the amounts of SDA needed to achieve equivalent RBC EPA enrichment were 0.61, 1.89, and 5.32 g/d (conversion efficiencies of 41%, 26%, and 17%), respectively.

CONCLUSIONS

SDA increased RBC %EPA in a dosage and time-dependent manner at intakes as low as 1.3 g/d.

P2-02-04: Novel Functions of vps34 in Non-Transformed Epithelial Cells: Regulation of Cell Proliferation and Tumorigenesis

Autophagic and endocytic pathways are tightly regulated membrane rearrangement processes that are crucial for homeostasis, development and disease. A list of proteins regulating these cellular processes show altered expression in cancers, suggesting derailed autophagy or endocytosis as an emerging feature of cancer. Class III phosphatidylinositol 3-kinase (PI3kinase) Vps34 regulates both autophagic and endocytic systems by recruiting proteins containing PtdIns3P binding domains. Recently, many new insights into the biology of class III PI3Kinase have been reported. Most of these studies, however, used mainly transformed cells. It is unclear whether class III PI3Kinase works similarly in non-transformed cells. In the recent study, we explored this by depleting both transformed and non-transformed mammary epithelial cell lines of Vps34 using shRNA. In consistent with previous finding, vps34-depleted cells are defect in formation of FYVE-GFP puncta, and showed altered early and recycling endosome dynamics. In a shark contrast to transformed cells where knockdown of Vps34 was associated with decreased growth, Vps34 deficiency in non-transformed cells resulted in a marked increase in cell proliferation. The deregulated autophagy function found in Vps34-depleted cells appeared to be not involved in cell growth regulation as silence of either Atg7 or Beclin1 expression did not affect the growth rate. On the other hand, reporter luciferase-based ten-pathway screens suggested an altered activity of the MAPK pathway. Indeed, biochemical analysis indicated a sustained ERK activation resulting from the impediment of endosome-mediated EGFR turnover in Vps34 deficient cells. A contribution of the endosomal pathway to Vps34-mediated regulation of cell proliferation was further confirmed by using Rab5 and Rab11 mutants that deregulated early and recycling endosome, respectively. Importantly, inactivation of Vps34 compromised the cellular barrier against oncogene-mediated transformation, as demonstrated by the increased susceptibility of Vps34 depleted cells to Ras-induced colony formation in vitro and tumor development in mice. All together, our data uncover a novel role for the class III PI3Kinase-endosomal pathway in regulation of cell proliferation.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-02-04.

Molecular cloning, expression, and imprinting status of maternally expressed gene 8 (Meg8) in dairy cattle

At present, small number imprinted genes have been reported in cattle compare to human and mouse. Maternally expressed gene 8 (Meg8), a non-coding gene, have been identified maternally expressed in mouse and sheep, but its sequences and imprinting status have not been established in cattle. In this study, the full-length of cattle Meg8cDNA sequence was obtained by reverse transcript polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE) method, which has a high homology in exons sequences with the corresponding region of sheep Meg8. The isolation of cDNA sequence showed the presence of multiple splice variants in cattle Meg8 gene. The Meg8 was found to be expressed in all adult examined tissues, including heart, liver, spleen, lung, kidney, brain, subcutaneous fat and skeletal muscle. A single nucleotide polymorphism (SNP) was identified in exon 6 by Single-Strand Conformation Polymorphism (SSCP), and used to distinguish between monoallelic and biallelic expression in cattle tissues. The expression analysis of Meg8 in a heterozygous cattle showed that only one parental allele was expressed in all examined tissues, suggesting that Meg8 is imprinted in cattle.

Transforming growth factor-β1 polymorphisms and chronic obstructive pulmonary disease: a meta-analysis

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a complex polygenic disease in which gene- environment interactions play a critical role in disease onset and progression. Transforming growth factor-β 1 (TGF-β 1) is one of several candidate loci for the pathogenesis of COPD, and is highly polymorphic.

OBJECTIVE

To derive a more precise estimation of the relationship between the T869C and C-509T polymorphisms of the TGF-β 1 gene and COPD, a meta-analysis of 11 published case-control studies was performed.

METHODS

Ten studies with 1507 cases and 2542 controls for T869C polymorphism and six studies with 955 cases and 2136 controls for C-509T polymorphism were included. The pooled odds ratios were performed respectively for allele contrasts, additive genetic model, dominant genetic model and recessive genetic model. A subgroup analysis was also performed by ethnicity for T869C polymorphism.

RESULTS

With respect to T869C polymorphism, a significant association of TGF-β 1 gene polymorphism at 869T/C with COPD was observed in the overall analysis (C vs. T: OR 0.82, 95%CI 0.70-0.96, P = 0.01). In the subgroup analysis by ethnicity, significant risks were also found in the Caucasian population for C vs. T (OR 0.77, 95%CI 0.60-0.98, P = 0.03), but not in the Asian population (C vs. T: OR 0.88, 95%CI 0.76-1.03, P = 0.10). With respect to C-509T polymorphism, no significant association with COPD was demonstrated in the overall analysis (T vs. C: OR 0.84, 95%CI 0.68- 1.04, P = 0.11).

CONCLUSION

Potentially functional TGF-β 1 T869C polymorphism may play a low penetrance role in COPD susceptibility in an ethnicity-specific manner.

COP9 signalosome subunit 8 is required for postnatal hepatocyte survival and effective proliferation

Studies using lower organisms and cultured mammalian cells have revealed that the COP9 signalosome (CSN) has important roles in multiple cellular processes. Conditional gene targeting was recently used to study CSN function in murine T-cell development and activation. Using the Cre-loxP system, here we have achieved postnatal hepatocyte-restricted knockout of the csn8 gene (HR-Csn8KO) in mice. The protein abundance of other seven CSN subunits was differentially downregulated by HR-Csn8KO and the deneddylation of all cullins examined was significantly impaired. Moreover, HR-Csn8KO-induced massive hepatocyte apoptosis and evoked extensive reparative responses in the liver, including marked intralobular proliferation of biliary lineage cells and trans-differentiation and proliferation of the oval cells. However, division of pre-existing hepatocytes was significantly diminished in HR-Csn8KO livers. These findings indicate that Csn8 is essential to the ability of mature hepatocytes to proliferate effectively in response to hepatic injury. The histopathological examinations revealed striking hepatocytomegaly in Csn8-deficient livers. The hepatocyte nuclei were dramatically enlarged and pleomorphic with hyperchromasia and prominent nucleoli, consistent with dysplasia or preneoplastic cellular alteration in HR-Csn8KO mice at 6 weeks. Pericellular and perisinusoid fibrosis with distorted architecture was also evident at 6 weeks. It is concluded that CSN8/CSN is essential to postnatal hepatocyte survival and effective proliferation.

A role for trichosanthin in the expansion of CD4CD25 regulatory T cells

CD4(+)CD25(+) regulatory T cells (Tregs) are critical for the peripheral immune tolerance. Understanding the signals for the generation of Tregs is important for the clinical immunotherapy, but only limited progress has been made on obtaining enough peripheral Tregs. The aim of this study was to evaluate the role of trichosanthin (Tk) extracted from Chinese medicinal herb Trichosanthes kirilowi on the function of Tregs in vitro and in vivo. We reported here that Tk is needed for the expansion of freshly isolated CD4(+)CD25(+)Tregs (nTregs) into Tk-expanded CD4(+)CD25(+)Tregs (Tk-Tregs) through up-regulating CD25 and Foxp3 expression. The dose-response analyses indicated that 100 ng/ml Tk was the most appropriate dose. The result of real-time PCR showed that Tk-Tregs expressed 1.5-fold higher levels of Foxp3 than those observed in nTregs. Tk-Tregs markedly suppressed activation of effector T cells at a suppressor/responder ratio of 1:1, 1:2, 1:4, 1:8 or 1:16, and their effect was dose dependent. Moreover, Tk-Tregs secreted more immunosuppressive cytokines interleukin (IL)-10 and transforming growth factor (TGF)-beta1 after stimulating with antigen and antigen-presenting cells (APC). Transwell experiments showed that not only cell-to-cell contact but also soluble cytokines were involved in suppressive mechanism of Tk-Tregs. And Tk-Tregs were more efficient in suppressing CD25(-)T cell response to specific antigen than to irrelative antigen. Most importantly, it was revealed for the first time that Tk-Tregs could prolong the survival duration of mice with acute graft-versus-host disease (aGVHD). In conclusion, the study suggests a possible therapeutic potential of Tk-Tregs for clinical treatment on aGVHD.

Weight Gain Is Associated with Increased Risk of Hot Flashes in Breast Cancer Survivors on Aromatase Inhibitors

Objective: Hot flashes in breast cancer survivors (BCS) receiving adjuvant aromatase inhibitor (AI) therapy are common, but risk factors for these symptoms are not well-defined. This study tested if body size is associated with hot flashes in BCS on AI therapy.Materials and methods: We performed a cross-sectional analysis of a cohort of postmenopausal women with Stages 0-III breast cancer receiving adjuvant AI therapy at a university hospital-based outpatient breast oncology clinic. Subjects provided patient-reported outcomes on hot flashes, current and pre-breast cancer weight and height, and additional demographic and treatment data.The primary outcome was occurrence of hot flashes. Secondary outcomes included hot flash severity and frequency. The exposures of interest were 1) current weight and 2) weight change since breast cancer diagnosis, categorized as weight loss (lost 10 pounds or more), maintenance (+/- 10 pounds), or gain (gained 10 pounds or more). Multivariable logistic regression models examined the independent association between hot flash outcomes and current weight or weight change while controlling for confounders.Results: 300 participants were enrolled at a mean age of 61 years (range 33-86) after mean duration of AI exposure of 23 months (range 1 month-9 years). 177 (59%) reported hot flashes overall, 96 (32%) reported moderate to very severe hot flashes, and 60 (20%) had at least 4 hot flashes daily. 182 (61%) experienced weight maintenance, while 81 (27%) had weight gain and 34 (11%) had weight loss. In a multivariable model, weight gain was independently associated with hot flash occurrence (OR 2.1, 95% CI 1.1-4.4) and hot flash severity (OR 2.4, 95% CI 1.4-4.9), but not hot flash frequency, after adjusting for current weight and height, age, smoking, race, prior chemotherapy and prior tamoxifen therapy. Hot flash occurrence was also significantly associated with current smoking (OR 5.1, 95% CI 1.1-24.0) and age (OR for each additional year of age 0.93, 95% CI 0.90-0.97). Current weight, alcohol use, AI type, and AI duration were not associated with any of the three outcomes.Conclusions: In an outpatient BCS population on AI therapy, weight gain is a risk factor for both hot flash occurrence and severity. Women who gained at least ten pounds since breast cancer diagnosis were two times more likely to have hot flashes than women who maintained or lost weight. These results support the thermoregulatory model of hot flashes and argue against a protective effect of body fat in this population.Support: ACS MRSG-08-110-01-CCE, ACS CCDA#-08-107-01, Pennsylvania Department of Aging

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1059.