Reproducible preclinical models of androgen receptor driven human prostate cancer bone metastasis

BACKGROUND

Preclinical models recapitulating the metastatic phenotypes are essential for developing the next-generation therapies for metastatic prostate cancer (mPC). We aimed to establish a cohort of clinically relevant mPC models, particularly androgen receptor positive (AR+) bone metastasis models, from LuCaP patient-derived xenografts (PDX) that reflect the heterogeneity and complexity of mPC.

METHODS

PDX tumors were dissociated into single cells, modified to express luciferase, and were inoculated into NSG mice via intracardiac injection. The progression of metastases was monitored by bioluminescent imaging. Histological phenotypes of metastases were characterized by immunohistochemistry and immunofluorescence staining. Castration responses were further investigated in two AR-positive models.

RESULTS

Our PDX-derived metastasis (PDM) model collection comprises three AR+ adenocarcinomas (ARPC) and one AR- neuroendocrine carcinoma (NEPC). All ARPC models developed bone metastases with either an osteoblastic, osteolytic, or mixed phenotype, while the NEPC model mainly developed brain metastasis. Different mechanisms of castration resistance were observed in two AR+ PDM models with distinct genotypes, such as combined loss of TP53 and RB1 in one model and expression of AR splice variant 7 (AR-V7) expression in another model. Intriguingly, the castration-resistant tumors displayed inter- and intra-tumor as well as organ-specific heterogeneity in lineage specification.

CONCLUSION

Genetically diverse PDM models provide a clinically relevant system for biomarker identification and personalized medicine in metastatic castration-resistant prostate cancer.

Tumor-derived biomarkers predict efficacy of B7H3 antibody-drug conjugate treatment in metastatic prostate cancer models

Antibody-drug conjugates (ADCs) are a promising targeted cancer therapy; however, patient selection based solely on target antigen expression without consideration for cytotoxic payload vulnerabilities has plateaued clinical benefits. Biomarkers to capture patients who might benefit from specific ADCs have not been systematically determined for any cancer. We present a comprehensive therapeutic and biomarker analysis of a B7H3-ADC with pyrrolobenzodiazepine(PBD) payload in 26 treatment-resistant, metastatic prostate cancer (mPC) models. B7H3 is a tumor-specific surface protein widely expressed in mPC, and PBD is a DNA cross-linking agent. B7H3 expression was necessary but not sufficient for B7H3-PBD-ADC responsiveness. RB1 deficiency and/or replication stress, characteristics of poor prognosis, and conferred sensitivity were associated with complete tumor regression in both neuroendocrine (NEPC) and androgen receptor positive (ARPC) prostate cancer models, even with low B7H3 levels. Non-ARPC models, which are currently lacking efficacious treatment, demonstrated the highest replication stress and were most sensitive to treatment. In RB1 WT ARPC tumors, SLFN11 expression or select DNA repair mutations in SLFN11 nonexpressors governed response. Importantly, WT TP53 predicted nonresponsiveness (7 of 8 models). Overall, biomarker-focused selection of models led to high efficacy of in vivo treatment. These data enable a paradigm shift to biomarker-driven trial designs for maximizing clinical benefit of ADC therapies.

Abstract 976: The regulation of FOLH1/PSMA in prostate cancer

Prostate Specific Membrane Antigen (PSMA) is a prominent biomarker in Prostate Cancer (PC) and has evolved into a useful target for both imaging and therapy. But how PSMA becomes overexpressed upon PC development, its modulation by androgen deprivation therapy (ADT), and its absence in neuroendocrine-differentiated PC is not well understood. The exact mechanism by which PSMA is regulated has not been defined. Understanding PSMA regulation in PC patients for diagnostic, prognostic, and treatment purposes would be extremely valuable and could be exploited for PSMA-targeted therapies. To address this, we sought to characterize the epigenetic landscape of FOLH1 (the gene for PSMA) and determine the regulatory factors involved in FOLH1 transcription. Based on histone marker and protein ChIP-Seq data sets alongside ATAC-seq, we found that FOLH1 is a Super Enhancer (SE) and is collectively bound by an array of transcription factors (TFs), including AR, FOXA1, and HOXB13. We developed a hidden Markov model (HMM) with seven chromatin states built on average TF binding in the FOLH1 landscape and trained on the FOLH1 gene and known enhancer regions. Chromatin states were annotated based on features in the FOLH1 gene. With a simple regression model and k-fold cross-validation, mean occupancy of the three TFs and H3K27Ac in each state accurately predicts FOLH1 expression (ρ > 0.9) across PC samples. To assess the functionality of the enhancer regions predicted by our computational HMM, we performed a CRISPR interference (CRISPRi) screen with a nuclease dead-Cas9 protein conjugated to the KRAB transcriptional repressor and directed by a pool of gRNAs that tile across the AR protein-bound regions within the FOLH1 landscape. A sliding window analysis of our CRISPRi screen revealed that the top scoring gRNAs delineate 5 Regulatory Regions (RRs) found within the SE region of FOLH1 that control FOLH1/PSMA expression. Motif identification in these RRs have provided a list of potential TF candidates involved in regulating FOLH1, and knockdown experiments are currently being conducted to evaluate individual and combinations of TF contribution to FOLH1 expression. There is evidence for a constellation of TFs responsible for regulating FOLH1, and context-specific modifications in FOLH1 regulation will need to be evaluated in various models and conditions. These results suggest FOLH1 is regulated by epigenetic control in the SE region and may be altered in progression or with ADT. Characterizing the regulation of FOLH1/PSMA will result in a deeper understanding of the meaning of alterations in uptake on PSMA imaging and may enable some degree of control over expression, thus aiding in PSMA-directed treatments.

Citation Format: Margaret E. White, Thomas Pranzatelli, Xavier Moore, Joel Bowman, Jay Chiorini, Peter Choyke, Kathy Kelly. The regulation of FOLH1/PSMA in prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 976.

TMPRSS2-ERG promotes the initiation of prostate cancer by suppressing oncogene-induced senescence

ERG translocations are commonly involved in the initiation of prostate neoplasia, yet previous experimental approaches have not addressed mechanisms of oncogenic inception. Here, in a genetically engineered mouse model, combining TMPRSS2-driven ERG with KrasG12D led to invasive prostate adenocarcinomas, while ERG or KrasG12D alone were non-oncogenic. In primary prostate luminal epithelial cells, following inducible oncogenic Kras expression or Pten depletion, TMPRSS2-ERG suppressed oncogene-induced senescence, independent of TP53 induction and RB1 inhibition. Oncogenic KRAS and TMPRSS2-ERG synergized to promote tumorigenesis and metastasis of primary luminal cells. The presence of TMPRSS2-ERG compared to a wild-type background was associated with a stemness phenotype and with relatively increased RAS-induced differential gene expression for MYC and mTOR-regulated pathways, including protein translation and lipogenesis. In addition, mTOR inhibitors abrogated ERG-dependent senescence resistance. These studies reveal a previously unappreciated function whereby ERG expression primes preneoplastic cells for the accumulation of additional gene mutations by suppression of oncogene-induced senescence.

Canada lynx (Lynx canadensis) gene flow across a mountain transition zone in western North America

Mountain ecotones have the potential to cause multiple patterns in divergence, from simple barrier effects to more fundamental ecological divergence. Most work in mountain ecotones in North America has focused on reinforcement between refugial populations, making prediction of how mountains impact species that are not restricted to separate glacial refugia remains difficult. This study focused on the Canada lynx (Lynx canadensis Kerr, 1792), a highly mobile felid considered to be a habitat and dietary specialist. Specifically, we used 14 microsatellite loci and landscape genetic tools to investigate if the Rocky Mountains and associated climatic transitions influence lynx genetic differentiation in western North America. Although lynx exhibited high gene flow across the region, analyses detected structuring of neutral genetic variation across our study area. Gene flow for lynx most strongly related to temperature and elevation compared with other landscape variables (terrain roughness, percent forest cover, and habitat suitability index) and geographic distance alone. Overall, genetic structure in lynx is most consistent with barrier effects created by the Rocky Mountains rather than ecological divergence. Furthermore, warmer temperatures had a measurable impact on gene flow, which suggests connectivity may further decrease in peripheral or fragmented populations as climate warms.

Continent-wide effects of urbanization on bird and mammal genetic diversity

Urbanization and associated environmental changes are causing global declines in vertebrate populations. In general, population declines of the magnitudes now detected should lead to reduced effective population sizes for animals living in proximity to humans and disturbed lands. This is a cause for concern because effective population sizes set the rate of genetic diversity loss due to genetic drift, the rate of increase in inbreeding and the efficiency with which selection can act on beneficial alleles. We predicted that the effects of urbanization should decrease effective population size and genetic diversity, and increase population-level genetic differentiation. To test for such patterns, we repurposed and reanalysed publicly archived genetic datasets for North American birds and mammals. After filtering, we had usable raw genotype data from 85 studies and 41 023 individuals, sampled from 1008 locations spanning 41 mammal and 25 bird species. We used census-based urban-rural designations, human population density and the Human Footprint Index as measures of urbanization and habitat disturbance. As predicted, mammals sampled in more disturbed environments had lower effective population sizes and genetic diversity, and were more genetically differentiated from those in more natural environments. There were no consistent relationships detectable for birds. This suggests that, in general, mammal populations living near humans may have less capacity to respond adaptively to further environmental changes, and be more likely to suffer from effects of inbreeding.

Isolation of peripheral populations of Canada lynx (Lynx canadensis)

Landscape barriers to gene flow, such as rivers, can affect animal populations by limiting the potential for rescue of these isolated populations. We tested the riverine barrier hypothesis, predicting that the St. Lawrence River in eastern Canada would cause genetic divergence of Canada lynx (Lynx canadensis Kerr, 1792) populations by restricting dispersal and gene flow. We sampled 558 lynx from eastern Canada and genotyped these at 14 microsatellite loci. We found three genetic clusters, defined by the St. Lawrence River and the Strait of Belle Isle, a waterway separating Newfoundland from mainland Canada. However, these waterways were not absolute barriers, as we found 24 individuals that appeared to have crossed them. Peripheral populations of lynx are threatened in parts of Canada and the USA, and it is thought that these populations are maintained by immigration from the core. Our findings suggest that in eastern North America, rescue might be less likely because the St. Lawrence River restricts dispersal. We found that ice cover was often sufficient to allow lynx to walk across the ice in winter. If lynx used ice bridges in winter, then climate warming could cause a reduction in the extent and longevity of river and sea ice, further isolating these peripheral lynx populations.

The Processing and Properties of γ-irradiated HDPE Granules

Granular high density polyethylene has been irradiated to relatively low doses prior to processing. The molecular weight was, at the lower doses, increased and the molecular weight distribution broadened with increasing dose. At the two highest doses an insoluble gel was introduced. These variously irradiated granules were processed by two routes, compression and injection molding, and selected structural features and mechanical properties ascertained. For all granule doses compression molded samples could be produced, with the plaque density decreasing with increasing granule dose. While the ductility of the moldings improved with increasing granule dose, the modulus and yield stress both declined as the density of the moldings decreased. Injection molded samples could only be prepared from granules free of gel. The density of the moldings depended on both granule dose and barrel temperature: in general, the density first increased then declined with increasing granule dose, an effect associated with preferred molecular orientation. The yield stress and modulus both appeared to correlate better with melt flow index rather than density, to infer that preferred molecular orientation is significant in injection moldings and can override the influence of density.

Textile Based Antennas

The increasing desire to internet the soldier on the battlefield requires a new approach to outfit the soldier with communications systems capable of operating in multiple frequency domains as shown in Table 1. Outfitting the soldier with multiple unwieldy antennas often results in the equipment being left behind, used improperly or broken. The ultimate in unobtrusive antennas is one that conforms to the body and does not interfere with the normal degrees of freedom of the soldier's uniform. Conformal antennas mounted on the body must take into account the electrical properties of the body, particularly at frequencies above 30 MHz. In addition, integration into the textile structure requires that the antenna be isolated from effects of clothing usage including clothing movement, wet operation, washing, and mechanical abrasion.

Rtp801, a suppressor of mTOR signaling, is an essential mediator of cigarette smoke-induced pulmonary injury and emphysema

Rtp801, a stress – related protein triggered by adverse environmental conditions, inhibits mTOR and enhances oxidative stress – dependent cell death. We postulated that Rtp801 acts as potential amplifying switch in the development of cigarette smoke – induced lung injury, leading to emphysema. Rtp801 was overexpressed in human emphysematous lungs and in lungs of mice exposed to cigarette smoke. The upregulation of Rtp801 expression by cigarette smoke in the lung relied on oxidative stress – dependent activation of the CCAAT response element. Rtp801 was necessary and sufficient for NF – κ B activation in cultured cells and, when forcefully expressed in mouse lungs, it promoted NF – kB activation, alveolar inflammation, oxidative stress, and apoptosis of alveolar septal cells. On the other hand, Rtp801 ^{− / −} mice were markedly protected against acute cigarette smoke – induced lung injury, partly via increased mTOR signaling, and, when exposed chronically, against emphysema. Our data support the notion that Rtp801 may represent an important molecular sensor and mediator of lung injury to cigarette smoke.

Providing nicotine dependence treatment to psychiatric inpatients: the views of Australian nurse managers

The prevalence of smoking in psychiatric settings remains high. This study aims to describe the views of nurse managers in psychiatric inpatient settings regarding the provision of nicotine dependence treatment, and whether there were associations between such views and the provision of nicotine dependence treatment. A cross-sectional survey was mailed to all public psychiatric inpatient units in New South Wales, Australia, for completion by nurse managers. Of the identified 131 service units, 123 completed questionnaires were returned (94%). Patient-related factors were considered to have a high level of influence on the provision of nicotine dependence treatment: patients requesting assistance to quit (58%), patients being receptive to interventions (52%), and patient health improving with quitting (45%). Units where the respondent reported that nicotine dependence treatment was as important as other roles were more likely to provide nicotine dependence treatment compared to units whose respondents did not hold this view (OR = 0.257, d.f. = 1, P < 0.01). While the results indicate strong support for the provision of nicotine dependence treatment, this support appears qualified by perceived patient readiness to quit, suggesting care is provided selectively rather than systematically. Positioning smoking as an addiction requiring treatment within a traditional curative approach may lead to a health service more conducive to the routine provision of nicotine dependence treatment.

Hybridization between escaped domestic and wild American mink (Neovison vison)

The release of domesticated organisms into natural populations may adversely affect these populations through predation, resource competition, and the introduction of disease. Additionally, the potential for hybridization between wild and domestic conspecifics is of great concern because it can alter the evolutionary integrity of the affected populations. Wild American mink (Neovison vison) populations may be threatened not only by competition for resources with domestic mink originating from farms, but by breeding with such escapees. Using 10 microsatellite loci, we genotyped mink from Ontario, Canada, sampled from two farms, two putatively mixed populations in regions surrounding the mink farms, and two wild populations with no recent history of mink farming. Using individual-based Bayesian population assignment, we identified four population clusters, including one wild, and three domestic populations. The latter were not clustered by farm but rather by distinct line-bred colour phases. Population clustering also identified domestic and hybrid mink in the free-ranging populations. Nearly two-thirds of the mink sampled in the two putatively mixed populations (78% and 43%) were either farm escapees or descendants of escapees. Principal components analysis of allele frequencies supported our Bayesian assignment results. The power of our assignment test was assessed using simulated hybrid genotypes which suggested that our overall correct classification rate was 96.2%. The overwhelming presence of domestic animals and their hybridization with mink in natural populations is of great concern for the future sustainability of wild mink populations.

Effectiveness of a baking soda toothpaste delivering calcium and phosphate in reducing dentinal hypersensitivity

OBJECTIVE

The purpose of this controlled clinical trial was to determine the effectiveness and safety of a single-phase dentifrice that delivers calcium, phosphate, and fluoride to the tooth surface (Arm & Hammer Enamel Care for Sensitive Teeth toothpaste, United Kingdom) in reducing dentinal hypersensitivity.

METHODS

Two-hundred and eight qualifying subjects were randomly assigned to either the Enamel Care dentifrice group or a control dentifrice group, and brushed twice daily with their assigned dentifrice for eight weeks. Pain/discomfort in response to a thermal stimulus was assessed at baseline, week 4, and week 8 using a Visual Analogue Scale (VAS; primary outcome variable) and the Schiff Thermal Sensitivity Scale (STSS; secondary outcome variable). After eight weeks, volunteers from the Enamel Care group were switched to the control dentifrice and participated in a second eight-week study to determine the degree of persistence of pain reduction.

RESULTS

Both groups had statistically significant VAS score reductions from baseline at weeks 4 and 8, with mean VAS scores in the Enamel Care group decreasing by 45.6% at week 4 and 61.1% at week 8 (p < 0.0001). Enamel Care was statistically significantly more effective than the control at weeks 4 and 8, with respective mean VAS reductions of 63% (p < 0.0001) and 33% (p = 0.0004) greater than the control. Consistent with the VAS score results, the Enamel Care group had respective statistically significant STSS score reductions of 77% and 58% greater than the control group (p < 0.0001). The reductions in dentinal hypersensitivity seen in the Enamel Care group at week 8 persisted for an additional eight weeks, during which the subjects discontinued use of Enamel Care and brushed with the control dentifrice.

CONCLUSION

Enamel Care for Sensitive Teeth toothpaste (United Kingdom) is an effective dentifrice for the management of dentinal hypersensitivity, and its efficacy persists for a least eight weeks following discontinued product use.

A multi-sample design for assessing the comedolytic activity of topical products

BACKGROUND

Facial comedolytic studies allow testing of a maximum of two products. The upper back provides a larger area with a more uniform distribution of microcomedones for comedolytic studies.

OBJECTIVE

To design a multi-sample method for assessing comedolytic activity of topical products on the back. The effect of season on product discrimination was also explored.

METHODS

Three cleansing formulations (products B, C and D), a negative water control and 0.025% Retin-A cream (positive control) were tested. Seven subjects were recruited in summer and nine in fall. Products were applied for 8 weeks, comedolysis was assessed by visually evaluating cyanoacrylate follicular biopsies taken at baseline and post-treatment.

RESULTS

In all data sets (summer, fall and combined), sites treated with Retin-A had a significantly lower number of microcomedones as compared to the negative water control. In addition, cleansers B and D showed a significant reduction from baseline in the fall and combined (summer and fall) data, but not in summer data alone indicating different responses to treatment during the year.

CONCLUSIONS

The design was sensitive enough to detect differences between cleansing formulations under normal washing conditions. Reduced sensitivity observed during summer suggests hot humid conditions may decrease the comedolytic performance of topical products.

A comparison of molecular typing methods for Moraxella catarrhalis

AIMS

Three molecular typing techniques were examined to determine which method was the most discriminatory in order to perform epidemiological typing of Moraxella catarrhalis.

METHODS AND RESULTS

Twenty-five Mor. catarrhalis isolates obtained from nasopharyngeal aspirates collected from Aboriginal and non-Aboriginal children were subjected to random amplified polymorphic DNA (RAPD) analysis, automated ribotyping and pulsed field gel electrophoresis (PFGE). RAPD analysis determined two Mor. catarrhalis types, automated ribotyping with PstI determined four Mor. catarrhalis ribogroups and PFGE analysis with NotI determined 21 pulse field groups within the 25 isolates examined.

CONCLUSIONS

Analysis of discrimination index and typeability demonstrated that PFGE is the most discriminatory method for typing Mor. catarrhalis.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study confirms that PFGE is the most appropriate molecular tool for the epidemiological study of Mor. catarrhalis.

Essential gene identification and drug target prioritization in Aspergillus fumigatus

Aspergillus fumigatus is the most prevalent airborne filamentous fungal pathogen in humans, causing severe and often fatal invasive infections in immunocompromised patients. Currently available antifungal drugs to treat invasive aspergillosis have limited modes of action, and few are safe and effective. To identify and prioritize antifungal drug targets, we have developed a conditional promoter replacement (CPR) strategy using the nitrogen-regulated A. fumigatus NiiA promoter (pNiiA). The gene essentiality for 35 A. fumigatus genes was directly demonstrated by this pNiiA-CPR strategy from a set of 54 genes representing broad biological functions whose orthologs are confirmed to be essential for growth in Candida albicans and Saccharomyces cerevisiae. Extending this approach, we show that the ERG11 gene family (ERG11A and ERG11B) is essential in A. fumigatus despite neither member being essential individually. In addition, we demonstrate the pNiiA-CPR strategy is suitable for in vivo phenotypic analyses, as a number of conditional mutants, including an ERG11 double mutant (erg11BΔ, pNiiA-ERG11A), failed to establish a terminal infection in an immunocompromised mouse model of systemic aspergillosis. Collectively, the pNiiA-CPR strategy enables a rapid and reliable means to directly identify, phenotypically characterize, and facilitate target-based whole cell assays to screen A. fumigatus essential genes for cognate antifungal inhibitors.

Aspergillus fumigatus is an opportunistic filamentous fungal pathogen of emerging clinical significance. Although virulence factors are seen as potential drug targets, neither genetic analyses nor genomic comparisons have identified genuine virulence factors in A. fumigatus. Essential genes required for fungal growth and viability also serve as potential drug targets, yet few have been described in this pathogen. To begin to catalog essential genes in A. fumigatus, we devised a genetic strategy for creating conditional mutants by promoter replacement of target genes using a nitrogen-regulated promoter. Applying this genetic approach to A. fumigatus genes orthologous to known essential genes of the nonpathogenic yeast, Saccharomyces cerevisiae and Candida albicans, we demonstrate a robust enrichment for identifying essential genes conserved within this pathogen. We show that A. fumigatus conditional mutants can be evaluated according to their terminal phenotypes (e.g., conidial germination, growth, morphology, and cidal versus static consequences) and pathogenesis in a murine model of systemic aspergillosis to prioritize essential genes as novel drug targets suitable for developing broad-spectrum antifungal agents.

Gas chromatography-mass spectrometry/mass spectrometry analysis to determine natural and post-administration levels of oestrogens in bovine serum and urine

A novel analytical approach has been developed and shown to be capable of detecting the isomers of oestradiol in the low ppt (pg mL(-1)) range in bovine serum and urine. Following extractive derivatisation the analytes were detected as their 3-pentafluorobenzoyl 17-trimethylsilyl ether derivatives by gas chromatography-mass spectrometry/mass spectrometry (GC-MS/MS), using electron capture negative ion chemical ionisation. The isomers of oestradiol were quantified in both blank and post-administration urine and serum samples, with a view to setting action/threshold levels for these compounds, to allow discrimination between normal samples and samples from animals treated with growth promoting ear implants. A non-parametric statistical assessment of the data resulted in proposed action levels (with a false positive probability of 1 in 1000) of 1.6 and 2.7 ng mL(-1) for 17alpha-oestradiol, in male and female urine, respectively, and 40 and 44 pg mL(-1) for 17beta-oestradiol, in male and female urine, respectively. An action level of 20 pg mL(-1) was proposed for 17alpha- and 17beta-oestradiol in male serum. In female serum the proposed action levels were 40 and 20 pg mL(-1) for 17alpha- and 17beta-oestradiol, respectively.

Information systems in food safety management

Information systems are concerned with data capture, storage, analysis and retrieval. In the context of food safety management they are vital to assist decision making in a short time frame, potentially allowing decisions to be made and practices to be actioned in real time. Databases with information on microorganisms pertinent to the identification of foodborne pathogens, response of microbial populations to the environment and characteristics of foods and processing conditions are the cornerstone of food safety management systems. Such databases find application in: Identifying pathogens in food at the genus or species level using applied systematics in automated ways. Identifying pathogens below the species level by molecular subtyping, an approach successfully applied in epidemiological investigations of foodborne disease and the basis for national surveillance programs. Predictive modelling software, such as the Pathogen Modeling Program and Growth Predictor (that took over the main functions of Food Micromodel) the raw data of which were combined as the genesis of an international web based searchable database (ComBase). Expert systems combining databases on microbial characteristics, food composition and processing information with the resulting "pattern match" indicating problems that may arise from changes in product formulation or processing conditions. Computer software packages to aid the practical application of HACCP and risk assessment and decision trees to bring logical sequences to establishing and modifying food safety management practices. In addition there are many other uses of information systems that benefit food safety more globally, including: Rapid dissemination of information on foodborne disease outbreaks via websites or list servers carrying commentary from many sources, including the press and interest groups, on the reasons for and consequences of foodborne disease incidents. Active surveillance networks allowing rapid dissemination of molecular subtyping information between public health agencies to detect foodborne outbreaks and limit the spread of human disease. Traceability of individual animals or crops from (or before) conception or germination to the consumer as an integral part of food supply chain management. Provision of high quality, online educational packages to food industry personnel otherwise precluded from access to such courses.

Cancer clinical trials available in the community setting: A 5-year analysis from 1999–2004

6056

Background: Less than 5% of newly diagnosed cancer patients are accrued into clinical trials. In the community setting, the lack of appropriate clinical trials is a major barrier. Our prospective study in 2004 determined that 58% of newly diagnosed adult cancer patients at our community-based cancer center didn’t have a clinical trial available appropriate for their disease stage. Among those with clinical trials, 23% were subsequently found to be ineligible (Go RS, et al. Cancer 2006, in press). However, the availability of clinical trials may vary from year to year. Methods: A retrospective study was conducted to determine what clinical trials were available for newly diagnosed adult cancer patients at our institution from June 1999-July 2004. The study also investigated the proportions of newly diagnosed patients who had a clinical trial available appropriate for type and stage of disease and patients accrued. Results: Over the 5-year period, 207 (82, 87, 99, 102, 117, years 1–5, respectively) trials were available. Most (50.7%) trials were for the following cancers: breast (15.5%), lung (13.5%), head and neck (7.7%), colorectal (7.2%) and lymphoma (6.8%). ECOG (53%), RTOG (26%), and CTSU (9%) provided the majority of the trials. A total of 5,776 new adult cancer patients were seen during this period. Overall, 60% of the patients had a trial available appropriate for type and stage of their cancer, but only 103 (3%) were enrolled. There was a significant upward trend in the proportions of patients with available trials over the years (60.2%, 55.9%, 59.2%, 60.7%, 63.9%, years 1–5, respectively; Mantel-Haenszel P=.008). The proportion of patients with a trial available was highest for prostate (97.3%), lung (90.9%), and breast (73.9%), and lowest for melanoma (17.1%), renal (11.6%), and bladder (7.2%). The majority of patients accrued to trials had the following cancers: breast (32%), lung (17%), lymphoma (9%), colon (7%), and prostate (5%). Conclusions: Nearly half of the newly diagnosed adult patients at our center had no trials available appropriate for type and stage of their cancers. It is likely that if strict clinical trial eligibility criteria were applied, approximately 2/3 of our patients would not be eligible for a clinical trial.

No significant financial relationships to disclose.

Regional scale evidence for improvements in surface water chemistry 1990-2001

The main aim of the international UNECE monitoring program ICP Waters under the Convention of Long-range Transboundary Air Pollution (CLRTAP) is to assess, on a regional basis, the degree and geographical extent of the impact of atmospheric pollution, in particular acidification, on surface waters. Regional trends are calculated for 12 geographical regions in Europe and North America, comprising 189 surface waters sites. From 1990-2001 sulphate concentrations decreased in all but one of the investigated regions. Nitrate increased in only one region, and decreased in three North American regions. Improvements in alkalinity and pH are widely observed. Results from the ICP Waters programme clearly show widespread improvement in surface water acid-base chemistry, in response to emissions controls programs and decreasing acidic deposition. Limited site-specific biological data suggest that continued improvement in the chemical status of acid-sensitive lakes and streams will lead to biological recovery in the future.