POS1255 REACTOGENICITY OF SARS-COV-2 VACCINES IN PATIENTS WITH AUTOIMMUNE AND INFLAMMATORY DISEASE

Background:

Patients with autoimmune disease often require immunosuppressive medications that may increase their risk of developing severe illness from COVID-19. The importance of immunization in this population is particularly high. While the studied vaccines show efficacy in the general population, nothing is known regarding the immune response or safety profile in patients with autoimmune disease and those taking immunomodulatory medications.

Objectives:

To assess the safety profile and degree of adverse events from SARS-CoV-2 vaccines in patients with autoimmune and inflammatory disease.

Methods:

This study is part of a larger prospective observational study examining the immunogenicity and safety profile of the SARS-CoV-2 vaccine in patients with immune-mediated diseases taking immunomodulatory medications. Adults with an immune-mediated disease scheduled to receive either a Pfizer or Moderna SARS-COV-2 vaccine were enrolled in this study. Subjects participated in 3 study visits (pre-vaccine, dose 1 (D1) and dose 2 (D2)) where blood, for immunologic assays, and clinical data were collected. Assessments of adverse events (AE), including local and systemic symptoms and validated degree of AE severity were solicited within 7 days of receiving each vaccine dose.

Results:

To date, 70 patients with autoimmune and inflammatory disease have been enrolled. Demographic and clinical characteristics are shown in Table 1. Distribution of current immunomodulatory medications included prednisone 18.6%, conventional synthetic DMARD 55.7%, targeted synthetic DMARD 4.3%, and biologic DMARD 68.5%. Almost all participants experienced an adverse event following vaccination (D1 96%, D2 100%). Following D1 AEs were generally mild (76.5%) whereas following D2 a large portion of patients experienced AEs that were moderate (47.8%) and severe (30.5%). Injection site pain was the most common AE following both doses followed by arthralgias (D1 21.6%, D2 78.2%), fever (D1 21.6%, D2 70%) and fatigue (D1 21.6%, D2 65.2%) (Figure 1).

Figure 1.

Solicited Local and Systemic Adverse Events. Percentage of participants who had endorsed an adverse event within 7 days of first or second dose of SARS-CoV-2 Vaccine. ‘Other’ symptoms included chills, blurry vision, brain fog and dizziness.

Conclusion:

Patients with autoimmune and inflammatory disease experience a significant burden of adverse events following SARS-CoV-2 vaccination with both frequency and severity appearing greater than that of the reported results from the vaccine clinical trials. Several of the endorsed AEs such as fever, fatigue and arthralgias can also be commonly seen in rheumatologic diseases, mimicking flares. While SARS-CoV-2 immunization is crucial in patients with autoimmune diseases, this study demonstrates the importance of understanding the AEs experienced by this patient population to better inform patients of possible expected side effects of SARS-CoV-2 vaccination and further management in the future.

Table 1.

Demographic and Clinical Characteristics of Participants

Parameter N (%)N=70Age [years], mean (SD)Age group48.3 ± 16.4 < 6553 (75.7) 65+17 (24.3)Gender Female48 (68.6) Male20 (38.5) Other2 (2.9)Race White47 (67.1) Asian14 (20.0) Hispanic8 (11.4) Black1 (1.4) BMI [kg/m2], mean (SD)25.0 ± 5.4Immunologic Diagnosis Rheumatoid Arthritis21 (30.0) Spondyloarthritis*21 (30.0) Systemic Lupus Erythematous8 (11.4) Connective Tissue Disease, Other‡12 (17.1) Vasculitis3 (4.2) Inflammatory Bowel Disease7 (10.0) Autoinflammatory Syndrome5 (7.1) Multiple Sclerosis2 (2.9) IgG4 Related Disease2 (2.9)Disease Duration [years], mean (SD)9.0 ± 5Medications Prednisone13 (18.6)DMARDs Hydroxychloroquine16 (22.9) Methotrexate15 (21.4) Sulfasalazine6 (8.6) Tofacitinib3 (4.3) Azathioprine2 (2.9)Biologics TNF inhibitor33 (47.1) Rituximab7 (10) Abatacept6 (8.6) IL-23 inhibitor2 (2.9)

* Spondyloarthritis includes Axial Spondyloarthritis and Psoriatic Arthritis. ‡ Other Connective Tissue Disease includes scleroderma, Sjogren’s syndrome, polymyositis, and UCTD.

Disclosure of Interests:

Monica Yang: None declared, Patti Katz: None declared, Diana Paez: None declared, Alexander Carvidi: None declared, Mehrdad Matloubian: None declared, Mary Nakamura: None declared, Lianne S. Gensler Consultant of: AbbVie, Eli Lilly, Gilead, GSK, and Novartis, Grant/research support from: Pfizer and UCB

Effect of cardiac resynchronization therapy on septal perfusion and septal thickening: Association with left ventricular function, reverse remodelling and dyssynchrony

BACKGROUND

We evaluated the effect of cardiac resynchronization therapy (CRT) on septal perfusion and thickening at 6 months post implantation assessed on Tc99m-MIBI Gated myocardial perfusion SPECT (GMPS).We also studied the association of change in septal perfusion and thickening with primary outcome defined as at least one [improvement in ≥1NYHA class, left ventricular ejection fraction (LVEF) by ≥ 5%, reduction of end-systolic volume (ESV) by ≥ 15%, and improvement ≥ 5 points in Minnesota living with heart failure questionnaire (MLHFQ)].

METHOD

One hundred and five patients underwent clinical and GMPS evaluation before and at 6 months post CRT.

RESULT

Post CRT there was significant improvement in mean normalized septal perfusion uptake and in septal thickening (P value = 0.001, both). There was no significant relation between improvement in septal perfusion and primary outcome. However, improvement in septal thickening was statistically significant with favorable primary outcome (P = 0.001).There was no significant correlation between improvement of septal perfusion and improvement in LVEF, reduction in End diastolic volume (EDV), ESV, and Left ventricular Dyssynchrony (LVD). But, there was significant correlation between improvement of septal thickening and these parameters.

CONCLUSION

Improvement in septal thickening was associated with reverse remodeling, improvement in LVEF, and reduction of LVD.

Correction to: Nuclear medicine services after COVID-19: gearing up back to normality

The authors P. Orellana and N. El-Haj were inadvertently deleted in the original paper.

Impact of International Atomic Energy Agency support to the development of nuclear cardiology in low-and-middle-income countries: Case of Latin America and the Caribbean

Cardiovascular diseases (CVDs) are the leading cause of death in Latin America and the Caribbean (LAC) region as well as worldwide. Lifestyle, nutritional habits and the upsurge of obesity have contributed to the increase in the prevalence of CVDs in the region. The role of nuclear cardiology in the management of patients with CVDs is well established. Particularly, myocardial perfusion imaging is widely used in LAC countries and has been increasingly integrated into the healthcare systems in the region for the diagnosis of coronary artery disease, risk stratification and to guide patient management. In its role to support countries around the world to address their health needs through the peaceful applications of nuclear techniques, the International Atomic Energy Agency (IAEA) has provided assistance to the LAC region for the establishment and strengthening of the nuclear cardiology practice. To that extent, the IAEA provides support in building capacities of multidisciplinary teams of professionals, the provision of medical equipment and the promotion of communication and exchange of knowledge among the different stakeholders. In addition, the IAEA encourages the participation of nuclear medicine centers in international multi-center research studies. In this paper, we present some of the projects through which the IAEA has supported the LAC region, including regional technical cooperation projects and coordinated research projects related to cardiology within the current multimodality approach to cardiac imaging.

Introducing FDG PET/CT-guided chemoradiotherapy for stage III NSCLC in low- and middle-income countries: preliminary results from the IAEA PERTAIN trial

Purpose

Patients with stage III non-small-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT) in low- and middle-income countries (LMIC) continue to have a poor prognosis. It is known that FDG PET/CT improves staging, treatment selection and target volume delineation (TVD), and although its use has grown rapidly, it is still not widely available in LMIC. CRT is often used as sequential treatment, but is known to be more effective when given concurrently. The aim of the PERTAIN study was to assess the impact of introducing FDG PET/CT-guided concurrent CRT, supported by training and quality control (QC), on the overall survival (OS) and progression-free survival (PFS) of patients with stage III NSCLC.

Methods

The study included patients with stage III NSCLC from nine medical centres in seven countries. A retrospective cohort was managed according to local practices between January 2010 and July 2014, which involved only optional diagnostic FDG PET/CT for staging (not for TVD), followed by sequential or concurrent CRT. A prospective cohort between August 2015 and October 2018 was treated according to the study protocol including FDG PET/CT in treatment position for staging and multimodal TVD followed by concurrent CRT by specialists trained in protocol-specific TVD and with TVD QC. Kaplan–Meier analysis was used to assess OS and PFS in the retrospective and prospective cohorts.

Results

Guidelines for FDG PET/CT image acquisition and TVD were developed and published. All specialists involved in the PERTAIN study received training between June 2014 and May 2016. The PET/CT scanners used received EARL accreditation. In November 2018 a planned interim analysis was performed including 230 patients in the retrospective cohort with a median follow-up of 14 months and 128 patients in the prospective cohort, of whom 69 had a follow-up of at least 1 year. Using the Kaplan–Meier method, OS was significantly longer in the prospective cohort than in the retrospective cohort (23 vs. 14 months, p = 0.012). In addition, median PFS was significantly longer in the prospective cohort than in the retrospective cohort (17 vs. 11 months, p = 0.012).

Conclusion

In the PERTAIN study, the preliminary results indicate that introducing FDG PET/CT-guided concurrent CRT for patients with stage III NSCLC in LMIC resulted in a significant improvement in OS and PFS. The final study results based on complete data are expected in 2020.

Electronic supplementary material

The online version of this article (10.1007/s00259-019-04421-5) contains supplementary material, which is available to authorized users.

Improving Access to Treatment of Gynecologic Cancers/Cervix Cancers

Aim and purpose: The session aims at outlining actions that the healthcare community can take to improve the current situation and inform cervix cancer control plans. Highlighting the need to address opportunities in the prevention and management of cervix cancer, the session will provide guidance on primary, secondary and tertiary prevention and management of cervix cancer and will discuss the role of radiotherapy, while showcasing examples of collaboration. Audiences: Healthcare professionals with a special interest in women's cancers/cervix cancer and healthcare services planning. Cancer care advocates and patients advocates Decision makers involved in the planning of health care services Stakeholders in LMICs Suggested panel participants: Cherian Varghese, WHO Topic “The UN Joint Global Programme on Cervical Cancer Prevention and Control” The speaker will present this important initiative that builds on the world's collective endeavors so that in a generation, death from cervical cancer ceases to be a public health issue. Kennedy Lishimpi Topic, “Case study: Zambia” Illustrate how Zambia went from having no radiotherapy facilities to being able to offer up-to-date treatment to cancer patients Lusaka, Zambia Ted Trimble, NCI Topic, “NCI Activities in Support of Cervical Cancer” To present the important initiatives of the NCI/NHI to tackle the burden of gynecologic cancers Bethesda, Maryland May Abdel-Wahab, IAEA Topic, “International Program Results on the Ground in Support of Cervical Cancer” The speaker will present available support cooperation, education and training, and the need for enhanced safety and quality and use an example of interventions in Africa.

The IAEA Human Health Campus: Online Educational Resource for Health Care Professionals in Radiation Medicine

Background: Cognizant of the educational needs of the member states, and taking advantage of the current technological advances in this digital age, the International Atomic Energy Agency (IAEA) officially launched in 2010 the Human Health Campus (HHC; http://humanhealth.iaea.org ), which is an online educational resource initiative geared toward enhancing professional knowledge of health professionals in radiation medicine. Aim: Determine how and by whom the IAEA HHC is being visited and used since its inception in October 2010. Methods: Using the information provided by Google Analytics, determine the overall key performance indicators (KPIs) such as total sessions, total users, total page views, session duration, including daily number of visits to the HHC, county of origin, evaluation of the most popular sections and source of the traffic. Results: Since its launch on October 6th, 2010, KPIs are as follows: total sessions 374,279, total users 243,195, total page views 1,393,310, pages/session 3.72, average session duration 00:03:08. % of new sessions 64.92%. The HHC has witnessed continual growth year on year (YoY) in total sessions (visits) since its inception in October 2010, and total users. For 2016 (the highest performing year so far) there were 201 visits/day, 40% increase in traffic YoY and 20% user growth. Traffic to the Webinar content has seen sustained growth in the number of YoY since being introduced to the HHC in 2013. 2016 saw the largest increase of over +600%. E-Learning modules have also seen growth in the traffic YoY since being introduced to the HHC in 2011. The year 2015 saw a large increase in total traffic with over +95%. E-Learning traffic accounts for almost 25% of all traffic to the Nuclear Medicine section. Visits by mobile devices have increased YoY exponentially since the launch of the HHC, with the mobile traffic growing strong through 2015-2016 with an increase of 5482 sessions, or an 81% uplift YoY. For 2017, it represented 18% of the total traffic (from 3% in 2012). There is a clear prevalence of desktop users (85.5%), as the preferred method of browsing the HHC. A total of 210 countries and overseas territories have visited the HHC. The United States is the largest contributor of traffic from a global perspective with 16.31% of total traffic, almost double the next largest which is the UK with 9.10%. India with 5.45% and Australia with 3.27% of total traffic, respectively, round out the top 4. Not surprisingly, more than 60% of users are from English-speaking countries. Spanish is the second most popular language of users with just over 6% of total traffic. Conclusion: The HHC is an IAEA open access Web based educational resource for professionals in the field of radiation medicine being visited by as many as 210 countries. The upward trend in its use suggests that the IAEA HHC will continue to be an important player in providing educational resources for professionals worldwide.

An Incipient Lancet Oncology Commission, Toward Bridging the Global Shortfall in Medical Imaging Critical to Cancer Management

Background and context: Medical imaging is an evidence-based, vital puzzle piece in cancer management, without which public health targets for NCDs and more specifically for cancer cannot be achieved. Yet global access to radiology and nuclear medicine remains untenably low, and absent from major metrics for progress monitoring. Aim: This commission is forming to define a few most impactful, achievable priorities toward global provision of essential imaging services for the continuum of cancer management for every patient in need. The highest attainable standard of health is indeed a human right, and essential cancer management services include medical imaging, for example, for follow-up to assess response to therapy; image-guided interventions, such as biopsies, placement of catheters for chemotherapy, and more; screening in certain contexts; imaging for planning of treatment, such as before surgery or radiotherapy; and image-guided treatment, both curative and palliative, such as for radiofrequency ablation of tumors. Strategy/Tactics: Preliminarily brainstormed, possible commission topics to address in a task force divided per section include: 1) how to incorporate medical imaging and nuclear medicine as a priority in universal healthcare ´essential´ packages; 2) the role for innovation, artificial intelligence, use of big data, links to the cloud, electronic medical records, machine learning, teleradiology, and better interpretation of complex images (e.g., computer-assisted detection for pulmonary nodules, mammography); 3) easier systems for interpretation and reporting/dictation templates; 4) technologies to decrease radiation exposure; 5) imaging for therapy planning and patient follow-up; 6) precision medicine - targeted, personalized, and patient-centered; 7) nuclear medicine theragnostic potential; 8) implementation of quality management systems; clinical imaging referral guidelines; strengthening country disease registries most relevant to tailoring cancer imaging needs; 9) structured needs assessments and readiness evaluation for stepwise improvement of radiology. Program/Policy process: This commission is convening relevant international stakeholders to foster collaboration and select a few high-impact global cancer imaging targets to address over the coming several years, with long-term sustainable spinoff initiatives anticipated. Outcomes: Ongoing. A commission roadmap of next steps is being generated, to coincide and synergize with NCDs targets. What was learned: The evidence base for incorporating medical imaging in addressing NCDs in the post-2015 development agenda is strong, but a roadmap has yet to be defined. Medical imaging for all remains elusive and relevant technologies are evolving rapidly, including artificial intelligence, which stand to greatly serve population-based global cancer management needs.

Activities of the International Atomic Energy Agency in the Field of Cervical Cancer

Background and context: In 2012, 560,000 women were diagnosed with cervical cancer (CXCA) worldwide and 266,000 women died of the disease: 86% of cases and 88% of deaths occurred in low- and middle-income countries (LMICs), and two thirds of the cases are locally advanced. For locally advanced CXCA the evidence-based treatment is a combination of external beam radiotherapy with chemotherapy and brachytherapy. Five-year overall survival for all stages combined ranges between 60%-69%, depending on the case-mix and the treatment modalities used. Countries with no access to radiotherapy may only offer palliative treatment to women diagnosed with locally advanced cervical cancer. Any curative attempt for these patients should include the two components of radiotherapy: concomitant radio-chemotherapy and brachytherapy. Radiotherapy is also a cost-effective treatment modality. Aim: To show the contribution and impact of the International Atomic Energy Agency (IAEA) to the improvement of results of CXCA in LMICs. Strategy/Tactics: Through its various programs, such as the Technical Cooperation programs, the Human Health program and the Program of Action for Cancer Therapy, the IAEA is committed to address these disproportionate geographic incidence and mortality rates introducing, expanding and improving radiotherapy services, working with partners such as WHO to improve cancer diagnosis, treatment, care, and control through collective action in these countries. Program/Policy process: During the last six decades, the IAEA has helped in addressing the growing cancer burden, delivering cancer-related assistance to LMICs, with financial and in-kind support from member states, donors and partners. The IAEA assistance has been primarily facilitated through the deployment of robust radiotherapy and nuclear medicine programs, coordinated research activities, documentation system and quality assurance program. This has enabled many member states to establish safe and effective diagnostic imaging and radiation therapy capacity to provide treatment and higher quality care to many of their cancer patients. The Program of Action for Cancer Therapy (PACT) is the IAEA's umbrella program for combating cancer and builds upon the above experience in radiation medicine expertise and technology. The WHO-IAEA Joint Program enable LMI member states to introduce, expand and improve their cancer treatment capacities and therapeutic effectiveness by integrating radiotherapy into a comprehensive national cancer control program. Outcomes: The IAEA provides tools for improving the practice of radiation medicine around the world. A fully implemented department (megavoltage and afterloading units, trained staff and quality assurance procedures in place) can treat up to 666 new CXCA cases per year, of which around 70% (466) can be cured. What was learned: Investing in radiotherapy can save lives!

Appropriate use of noninvasive ischemia testing to guide revascularization decision making following acute ST elevation myocardial infarction in Latin American countries: Results from an expert panel meeting of the International Atomic Energy Agency

Across Latin American and Caribbean countries, cardiovascular disease and especially ischemic heart disease is currently the main cause of death both in men and in women. For most Latin American and Caribbean countries, public and community health efforts aim to define care strategies which are both clinically and cost effective and promote primary and secondary prevention, resulting in improved patient outcomes. The optimal approach to deal with acute events such as ST-elevation myocardial infarction (STEMI) is a matter of controversy; however, there is an expanding role for assessing residual ischemic burden in STEMI patients following primary percutaneous coronary intervention. Although randomized clinical trials have established the value of staged fractional flow reserve-guided revascularization, the use of noninvasive functional imaging modalities may play a similar role at a much lower cost. For LAC, available stress imaging techniques could be applied to define residual ischemia in the non-infarct related artery and to target revascularization in a staged procedure after primary percutaneous coronary intervention The use of nuclear cardiac imaging, supported by its relatively wide availability, moderate cost, and robust quantitative capabilities, may serve to guide effective care and to reduce subsequent cardiac events in patients with coronary artery disease. This noninvasive approach may avert potential safety issues with repeat and lengthy invasive procedures, and serve as a baseline for subsequent follow-up stress testing following the index STEMI event. This consensus document was devised from an expert panel meeting of the International Atomic Energy Agency, highlighting available evidence with a focus on the utility of stress myocardial perfusion imaging in post-STEMI patients. The document could serve as guidance to the prudent and appropriate use of nuclear imaging for targeting therapeutic management and avoiding unnecessary invasive procedures within Latin American and Caribbean countries, where resources could be scarce.

Abstract OT1-01-06: PIQHASSO: Open label, non-randomized, multicenter phase 1/2b study investigating safety and efficacy of PQR309 and eribulin combination in patients (pts) with locally advanced (LA) or metastatic HER2 (-) and triple-negative breast cancer (TNBC) (study PQR309-007)

BACKGROUND:

The PI3K/AKT/mTOR (PAT) pathway alteration has been strongly implicated in breast cancer and may contribute to resistance to available therapy. PQR309 is an oral pan-PI3K and mTOR inhibitor that penetrates the blood-brain barrier. Experiments of eribulin in combination with PI3K inhibitors in luminal and TNBC pre-clinical models enhanced antitumor activity.

TRIAL OBJECTIVES:

The primary objectives of the study are: to identify the maximum tolerated dose (MTD), evaluate the efficacy, safety and tolerability as well as the pharmacokinetics (PK) of PQR309 in combination with eribulin. In addition, exploratory objectives include assessments of: PAT pathway alterations prior to treatment, pharmacodynamics (PD) activity of PQR309 in combination with eribulin and correlation of PAT pathway alterations and PD activity with PQR309 and eribulin PK.

TRIAL DESIGN:

This is an open label, non-randomized, multicenter phase 1/2b clinical trial (dose escalation followed by expansion part) of PQR309 p.o. in combination with the standard dose of eribulin mesylate (1.4 mg/m2) in patients with LAMBC until progression or unacceptable adverse events (AE).

The dose escalation part of the study will first investigate PQR309 administered in a continuous daily (q.d.) and two intermittent treatment schedules in combination with standard administration of eribulin mesylate in patients with HER2 negative LAMBC following the “modified” 3 by 3 design. MTD is defined as the highest dose level at which ≤1 of 6 pts experiences dose-limiting toxicity (DLT) during the 1st cycle. After the MTD of PQR309 in combination with eribulin has been defined in all the three treatment schedules, one schedule will be selected, based on the overall evaluation of clinical data from the dose escalation part of the study, for further evaluation of efficacy in the expansion part of the study.

The expansion part of the trial applies Simon's MiniMax two-stage design. At the first stage, &gt; 3 pts with TNBC with clinical benefit (CB) among 14 pts will be necessary to continue to the second stage. At the study end, &gt; 9 pts with CB out of 28 pts are required to reject the null hypothesis. With this design, there is an 80% probability of a positive finding if the true clinical benefit rate (CBR) is ≥ 43% and a 5% probability of a positive finding if the true CBR is ≤ 21%.

ELIGIBILITY:

Women with HER2- LAMBC with two to 5 prior chemotherapy regimens in advanced disease. Adequate organ function and performance status. Phase II specific selection criteria are: triple negative LAMBC and RECIST v1.1 evaluable disease.

ACCRUAL:

Approximately 60 patients will be enrolled in approximately 10 sites

Recruitment opened in March 2016.

TRIAL REGISTRATION: NCT02723877. Date of registration: 21/12/2015. First patient included: 04/04/2016.

Citation Format: López-Miranda E, Gávila J, Pernas S, Saura C, Oliveira M, Serra V, Schmid P, Lord S, Paez D, Perez J, Llombart A, Petrovic K, Dimitrijevic S, Cortes J. PIQHASSO: Open label, non-randomized, multicenter phase 1/2b study investigating safety and efficacy of PQR309 and eribulin combination in patients (pts) with locally advanced (LA) or metastatic HER2 (-) and triple-negative breast cancer (TNBC) (study PQR309-007) [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 OT1-01-06.

Genetic variants of kinase suppressors of Ras (KSR1) to predict survival in patients with ERα-positive advanced breast cancer

In patients with breast cancer (BC), deregulation of estrogen receptor (ERα) activity may account for most resistance to endocrine therapies. Our previous study used a whole-human kinome siRNA screen to identify functional actors in ERα modulation and showed the implication of proteins kinase suppressors of ras (KSR1). From those findings we evaluated the clinical impact of KSR1 variants in patients with ERα+ BC treated with TAM. DNA was obtained from 222 patients with advanced ERα+ BC treated with TAM who had undergone surgery from 1981 to 2003. We selected three potentially functional relevant KSR1 polymorphisms; two within the 3'UTR (rs224190, rs1075952) and one in the coding exon 7 (rs2293180). The primary end points were overall survival (OS) and disease-free survival (DFS). After a 6.4-year median follow-up, patients carrying the rs2241906 TT genotype showed shorter DFS (2.1 vs 7.1 years, P=0.005) and OS (2.6 vs 8.4 years P=0.002) than those with the TC or TT genotypes. Those associations remained significant in the multivariable analysis adjusting age, lymph node status, LMTK3 and IGFR variants and HER2 status. The polymorphisms rs2241906 and rs1075952 were in linkage disequilibrium. No association was shown between rs2293180 and survival. Among the actors of ERα signaling, KSR1 rs2241906 variants may predict survival in patients with advanced ERα+ BC treated with adjuvant TAM.

Investigating the relationship between the Millon Adolescent Personality Inventory and the Personality Inventory for Children with a sample of learning disabled adolescents

The present study involved a preliminary evaluation of the correlations between subscales on the Personality Inventory for Children and the Millon Adolescent Personality Inventory with 25 learning disabled adolescents. Analysis yielded a number of significant correlations between these two scales, using the Personality Inventory for Children as the anchor scale, and showed that these adolescents as a group scored within clinically acceptable ranges on both diagnostic scales. Both scales need further psychometric and clinical investigation, and as such, the limitations of the study and the research needed are addressed, including the need for more multitrait, multimethod studies.