Enhanced morphological transformation of human lung epithelial cells by continuous exposure to cellulose nanocrystals

Cellulose nanocrystals (CNC), also known as nanowhiskers, have recently gained much attention due to their biodegradable nature, advantageous chemical and mechanical properties, economic value and renewability thus making them attractive for a wide range of applications. However, before these materials can be considered for potential uses, investigation of their toxicity is prudent. Although CNC exposures are associated with pulmonary inflammation and damage as well as oxidative stress responses and genotoxicity in vivo, studies evaluating cell transformation or tumorigenic potential of CNC's were not previously conducted. In this study, we aimed to assess the neoplastic-like transformation potential of two forms of CNC derived from wood (powder and gel) in human pulmonary epithelial cells (BEAS-2B) in comparison to fibrous tremolite (TF), known to induce lung cancer. Short-term exposure to CNC or TF induced intracellular ROS increase and DNA damage while long-term exposure resulted in neoplastic-like transformation demonstrated by increased cell proliferation, anchorage-independent growth, migration and invasion. The increased proliferative responses were also in-agreement with observed levels of pro-inflammatory cytokines. Based on the hierarchical clustering analysis (HCA) of the inflammatory cytokine responses, CNC powder was segregated from the control and CNC-gel samples. This suggests that CNC may have the ability to influence neoplastic-like transformation events in pulmonary epithelial cells and that such effects are dependent on the type/form of CNC. Further studies focusing on determining and understanding molecular mechanisms underlying potential CNC cell transformation events and their likelihood to induce tumorigenic effects in vivo are highly warranted.

Global Collaborations for Cervical Cancer: Can the East-West Alliance Facilitate Treatment for all?

Despite the advances in the primary prevention of cervical cancer, there is an absolute increase in the incidence of cervical cancer as a result of an increase in world population. A vast majority of patients in low and low-middle income countries continue to present at a locally advanced stage, necessitating treatment with chemoradiation and brachytherapy. There is a dearth of equipment and trained professionals for the treatment of cervical cancer, especially in low and low-middle income countries. There is an urgent need to improve treatment availability and develop better treatments. Worldwide trends, however, reveal a low number of therapeutic and innovative research trials in cervical cancer. The present article elucidates the existing challenges and provides solutions to improve outcomes. The proposed strategies hinge on strengthening collaborations for global advocacy.

Future of Global Cancer From the Perspective of Young Oncology Leaders

Background: Oncology organizations and professional associations (OA) across the cancer control continuum have developed Young Leader (YL) programs to engage promising members of their organizations and to facilitate opportunities for their advancement. Although these groups share common aims, there has been little synergy across YL programs and limited understanding of the shared perspectives, experiences, and challenges of YLs. Aim: To understand the profile, activities and challenges facing YLs worldwide from the perspective of global cancer control. Methods: The survey was generated by a task force of YLs and was pilot-tested among 10 international physicians. The final survey was composed of four sections: baseline characteristics, challenges in cancer control, building a career in cancer control and networking in cancer control. The survey was sent out in 2018 to 867 people, who were identified as potential YLs by 7 OA, with 2 reminder e-mails within 2-4 weeks interval. The final responses were summarized using descriptive analysis method. Results: A total of 139 survey responses were received from 61 countries (per region - 38.4% Europe, 29.6% America, 22% Asia-Pacific, and 10% Africa). Median response rate was 62.2% (range 5%-100% per organizational group, overall 16%). The majority of respondents were < 39 years old (64%), female (53.6%), with a higher degree (Ph.D. 43.1%), and in academic positions (68.1%). Clinicians made up 65.2% of the sample, followed by researchers (20.2%), and advocacy leaders (5.1%). YLs believed that the most important priorities to the future of cancer control were 1) to make cancer care available globally (47.5%), 2) to provide value based cancer care (27.5%) and 3) to transform cancer care through technology (10.5%). To address these aims, 70% of YLs believed that the most important next step was to improve screening and early diagnosis. YLs identified the lack of financial resources (65.2%), increasing treatment costs (64.5%) and late diagnosis (61.6%) as important barriers to achieving these aims. YLs reported that their greatest obstacles to engaging in global cancer control were lack of funding (46%), lack of opportunities (42%) and toxic political/academic environments (46%). 70% reported that mentorship and network development followed by academic success (51.4%) and leadership training (42%) were the most important factors in support of their future goals. Conclusion: YL experience similar challenges and aspiration concerning global cancer control. The need to make cancer care available globally, and to receive mentorship and training were highlighted. Our findings also suggest that oncology groups should aim to ensure a global agenda, promote collaboration and mentorship and rediscuss program objectives to guarantee sustainability of current organizational plans and to better support the YLs’ future goals.

Mobilising Expertise and Resources to Close the Radiotherapy Gap in Cancer Care

Closing the gap in cancer care within low- and middle-income countries and in indigenous and geographically isolated populations in high-income countries requires investment and innovation. This is particularly true for radiotherapy, for which the global disparity is one of the largest in healthcare today. New models and paradigms and non-traditional collaborations have been proposed to improve global equity in cancer control. We describe recent initiatives from within the radiation oncology community to increase access to treatment, build the low- and middle-income countries' radiation oncology workforce, mobilise more professionals from within high-income countries and raise awareness of the global need for equitable cancer care.

The Brain Metastases Symptom Checklist as a novel tool for symptom measurement in patients with brain metastases undergoing whole-brain radiotherapy

PURPOSE

We evaluated the feasibility, reliability, and validity of the Brain Metastases Symptom Checklist (bmsc), a novel self-report measure of common symptoms experienced by patients with brain metastases.

METHODS

Patients with first-presentation symptomatic brain metastases (n = 137) referred for whole-brain radiotherapy (wbrt) completed the bmsc at time points before and after treatment. Their caregivers (n = 48) provided proxy ratings twice on the day of consultation to assess reliability, and at week 4 after wbrt to assess responsiveness to change. Correlations with 4 other validated assessment tools were evaluated.

RESULTS

The symptoms reported on the bmsc were largely mild to moderate, with tiredness (71%) and difficulties with balance (61%) reported most commonly at baseline. Test-retest reliability for individual symptoms had a median intraclass correlation of 0.59 (range: 0.23-0.85). Caregiver proxy and patient responses had a median intraclass correlation of 0.52. Correlation of absolute scores on the bmsc and other symptom assessment tools was low, but consistency in the direction of symptom change was observed. At week 4, change in symptoms was variable, with improvements in weight gain and sleep of 42% and 41% respectively, and worsening of tiredness and drowsiness of 62% and 59% respectively.

CONCLUSIONS

The bmsc captures a wide range of symptoms experienced by patients with brain metastases, and it is sensitive to change. It demonstrated adequate test-retest reliability and face validity in terms of its responsiveness to change. Future research is needed to determine whether modifications to the bmsc itself or correlation with more symptom-specific measures will enhance validity.

Identification, localization, and expression of two novel human genes similar to deoxyribonuclease I

Two novel cDNAs, DNAS1L2 and DNAS1L3, are predicted to encode proteins of 299 and 305 amino acids with 56 and 46% residue identity (71 and 63% similarity), respectively, to deoxyribonuclease I (DNase I). DNAS1L2 is located on a 16p13.3 cosmid, while DNAS1L3 maps to 3p14.3-p21.1 by fluorescence in situ hybridization and by PCR analysis of a radiation hybrid panel. Northern analysis revealed DNAS1L3 expression nearly exclusively in liver, while DNAS1L2 expression was detected in brain by RT-PCR. The previously defined DNL1L or DNAS1L1 is expressed highest in heart and skeletal muscle, while DNase I is expressed in the pancreas, parotid gland, and kidney. Thus, to date, four DNase I-like genes that show different tissue expression patterns are known. A comparison of DNAS1L1, DNAS1L2, and DNAS1L3 with the well-characterized DNase I suggests that the DNAS1L proteins are unlikely to be glycosylated or bind actin; however, catalytic and calcium- and DNA-binding residues are conserved, and potentially cleavable signal peptides are present among all these proteins. This analysis also identifies regions of high conservation among these proteins with no currently assigned function.