High endoreduplication after drought-related conditions in haploid but not diploid mosses

BACKGROUND AND AIMS

Endoreduplication, the duplication of the nuclear genome without mitosis, is a common process in plants, especially in angiosperms and mosses. Accumulating evidence supports the relationship between endoreduplication and plastic responses to stress factors. Here, we investigated the level of endoreduplication in Ceratodon (Bryophyta), which includes the model organism Ceratodon purpureus.

METHODS

We used flow cytometry to estimate the DNA content of 294 samples from 67 localities and found three well-defined cytotypes, two haploids and one diploid, the haploids corresponding to C. purpureus and Ceratodon amazonum, and the diploid to Ceratodon conicus, recombination occurring between the former two.

KEY RESULTS

The endoreduplication index (EI) was significantly different for each cytotype, being higher in the two haploids. In addition, the EI of the haploids was higher during the hot and dry periods typical of the Mediterranean summer than during spring, whereas the EI of the diploid cytotype did not differ between seasons.

CONCLUSIONS

Endopolyploidy may be essential in haploid mosses to buffer periods of drought and to respond rapidly to desiccation events. Our results also suggest that the EI is closely related to the basic ploidy level, but less so to the nuclear DNA content as previously suggested.

Exploring interactions between socioeconomic context and natural hazards on human population displacement

Climate change is leading to more extreme weather hazards, forcing human populations to be displaced. We employ explainable machine learning techniques to model and understand internal displacement flows and patterns from observational data alone. For this purpose, a large, harmonized, global database of disaster-induced movements in the presence of floods, storms, and landslides during 2016-2021 is presented. We account for environmental, societal, and economic factors to predict the number of displaced persons per event in the affected regions. Here we show that displacements can be primarily attributed to the combination of poor household conditions and intense precipitation, as revealed through the interpretation of the trained models using both Shapley values and causality-based methods. We hence provide empirical evidence that differential or uneven vulnerability exists and provide a means for its quantification, which could help advance evidence-based mitigation and adaptation planning efforts.

Host biomarkers for early identification of severe imported Plasmodium falciparum malaria

BACKGROUND

Severe imported P. falciparum malaria is a source of morbi-mortality in non-endemic regions. WHO criteria don't accurately classify patients at risk of complications. There is a need to evaluate new tools such as biomarkers to better identify patients with severe imported malaria.

METHODS

A case-control study was conducted in Barcelona, from January 2011-January 2021. Adult patients with microbiologically confirmed P. falciparum malaria were classified according to WHO criteria. Patients with imported non-malarial fevers were included as controls. In each group, angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), soluble triggering receptor expressed on myeloid cells (sTREM-1), C-reactive protein (CRP) and platelets were measured and their concentrations were compared between groups. New groups were made with a modified WHO severity classification and biomarkers' performance was evaluated using multiple imputation models.

RESULTS

131 participants were included: 52 severe malaria, 30 uncomplicated malaria and 49 non-malarial fever cases. All biomarkers except sTREM-1 showed significant differences between groups. Using the modified WHO severity classification, Ang-2 and CRP presented the best AUROC; 0.79 (95%CI 0.64-0.94) and 0.80(95%CI 0.67-0.93). A model combining CRP and Ang-2 showed the best AUROC, of 0.84(95%CI 0.68-0.99), with the highest sensitivity and specificity: 84.6%(95%CI 58.9-98.1) and 77.4% (95%CI 65.9-87.7), respectively.

CONCLUSIONS

The combination of Ang-2 and CRP may be a reliable tool for the early identification of severe imported malaria. The use of a rapid prognostic test including the mentioned biomarkers could optimize imported malaria management, with the potential to decrease the rate of complications and hospitalizations in patients with imported malaria.

Phosphoproteomic analysis of neoadjuvant breast cancer suggests that increased sensitivity to paclitaxel is driven by CDK4 and filamin A

Precision oncology research is challenging outside the contexts of oncogenic addiction and/or targeted therapies. We previously showed that phosphoproteomics is a powerful approach to reveal patient subsets of interest characterized by the activity of a few kinases where the underlying genomics is complex. Here, we conduct a phosphoproteomic screening of samples from HER2-negative female breast cancer receiving neoadjuvant paclitaxel (N = 130), aiming to find candidate biomarkers of paclitaxel sensitivity. Filtering 11 candidate biomarkers through 2 independent patient sets (N = 218) allowed the identification of a subgroup of patients characterized by high levels of CDK4 and filamin-A who had a 90% chance of achieving a pCR in response to paclitaxel. Mechanistically, CDK4 regulates filamin-A transcription, which in turn forms a complex with tubulin and CLIP-170, which elicits increased binding of paclitaxel to microtubules, microtubule acetylation and stabilization, and mitotic catastrophe. Thus, phosphoproteomics allows the identification of explainable factors for predicting response to paclitaxel.

Influence of nanoemulsion/gum ratio on droplet size distribution, rheology and physical stability of nanoemulgels containing inulin and omega-3 fatty acids

BACKGROUND

New consumer habits are forcing the food industry to develop new and healthy products. In response to this tendency, in this investigation, we obtained nanoemulgels by microfluidization containing inulin fibre and omega-3 fatty acids. First, the influence of the number of microfluidization cycles on the physical properties of the nanoemulsions was studied. Subsequently, an advanced-performance xanthan gum was added to the nanoemulsion in different nanoemulsion/xanthan ratios (1:1, 2:1, 3:1, 4:1, 1:2, and 1:3).

RESULTS

Laser diffraction, multiple light scattering, and rheology techniques were used to characterize nanoemulsions and the corresponding nanoemulgels. The nanoemulsion with the lowest Sauter mean diameter (138 nm) and the longest physical stability was obtained after three passes through a microfluidization device at a fixed pressure of 103 421 kPa. Thus, these processing conditions were always used to obtain the nanoemulsion; these were subsequently mixed with a xanthan gum solution to produce nanoemulgels that showed weak gel-like viscoelastic and shear-thinning flow behaviours. A decrease in the nanoemulsion/xanthan ratio (i.e. by an increase in the content of xanthan gum in the nanoemulgel) increased the viscoelastic moduli and the zero shear viscosity values. A rise in the droplet size was observed with aging time, probably due to flocculation. The nanoemulsion/xanthan gum mass ratio of 1:3 yielded the most stable nanoemulgel.

CONCLUSIONS

This work is a contribution to the development of functional foods. It has been demonstrated that it is possible to obtain a stable nanoemulgel-based food matrix containing fibre and omega-3 fatty acids. © 2022 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

V-049 E-TEP RIVES-STOPPA AND OPEN REVERSE TRANVERSUS ABDOMINIS RELEASE (TAR): A HYBRID APPROACH FOR LARGE LATERAL-INFERIOR INCISIONAL HERNIAS

Aim

To present hybrid approach with open/endoscopic extraperitoneal dissection for large lateral-inferior incisional hernias

Material and Methods

64 years-old man who underwent left laparoscopic nephrectomy (2019) due to hypernephroma with specimen extraction by a left oblique iliac incision. He presents L3–4 W3 incisional hernia (14×10 cm)

Technique description

Results

After 48 hours ICU admission patient was discharged to hospital ward. Drainages were removed at 2nd-4thpostoperative day and hospital stay was 5 days.

Conclusion

The hybrid approach to large lateral incisional hernias allowed us to use a large sublay mesh with an increased overlap beyond the hernia defect, trying to reduce hernia recurrence rate.

V-007 LESSONS LEARNED DURING THE ABDOMINAL WALL RECONSUTRCTION FOR A MULTIRECURRENT LUMBAR HERNIA AFTER BONE GRAFT HARVESTING

The best approach for lateral incisional hernia is not known. Among these difficult hernias, those arising from iliac crest harvesting can be particularly challenging. The objective of this video is to illustrate the surgical approach of a multirecurrent case with the need of adding a posterior component separation

A 70 years old woman with 2 previous attempts of repair was referred to our center. With the patient in a 45 degrees lateral decubitus, a posterior lumbar approach was initiated through the previous scar. The retromuscular preperitoneal plane was accessed with difficulty due to previous meshes in the subdiaphragmatic, iliac and posterior areas. A big tear on the medial peritoneum changed our plan to add a posterior component separation. As we did not want to enlarge the lumbar incision to denervate more the lateral abdominal wall, we decided to make an accessory midline incision. Probably, an ETEP approach could have been better even before making the posterior incision. Once the retromuscular plane was dissected, the hole in the peritoneum could be closed. The reconstructive phase consisted in making a taco configuration using the combination of a permanent and absorbable mesh.

We have learned from this case, that an eTEP dissection of the retromuscular plane could have helped to avoid the accessory midline incision. It is also important to consider the potential iatrogenic denervation we could add in case of enlargement of the incision.

Telemedicine for international travelers through a Smartphone-based monitoring platform (Trip Doctor®)

BACKGROUND

Overall, more than 50% of international travelers develop symptoms while traveling and 55% of them seek medical assistance during the trip. We conducted a study to evaluate the usefulness of a Smartphone app called TRIP Doctor® to provide telemedicine to international travelers.

METHODS

Participants over 18 years old attending our travel clinic at Hospital Clinic in Barcelona were invited to participate during 2017-2019. After downloading the app, the health status of the traveler was monitored on a daily basis, providing specific medical advice and offering remote contact with specialized physicians through an integrated chat, if needed.

RESULTS

From 449 users, 59 (13%) contacted for medical assistance through the app during the trip. Main reasons for telemedicine were diarrhea (25.7%), skin conditions (19.7%) and fever (12.1%). Among patients who contacted, 90% of the travelers did not require to be referred to a local doctor. Symptomatic treatment was the main treatment prescribed (38%). In a 14.7% of the cases a follow-up was not required, a 63.2% recovered and 22.1% were loss of follow-up. After a multivariate analysis, duration of trip >14 days was found to be the only factor associated with the use of telemedicine (OR 2.2, CI 95% 1.1-4.5, p = 0.03).

CONCLUSION

In conclusion, travelers using telemedicine travelled for longer periods of time and mostly contacted for mild symptoms which could be solved successfully by remote assistance with our specialized doctors.

OS06.7A METPlatform identifies brain metastasis vulnerabilities and predicts patient response to therapy

BACKGROUND

The diagnosis of brain metastasis involves high morbidity and mortality and remains an unmet clinical need in spite of being the most common tumor in the brain. Exclusion of these cancer patients from clinical trials is a major cause of their limited therapeutic options.

MATERIAL AND METHODS

We report a novel drug-screening platform (METPlatform) based on organotypic cultures which allows identifying effective anti-metastasis agents in the presence of the organ microenvironment. We have applied this approach to clinically relevant stages of brain metastasis using both experimental models and human tumor tissue (by performing patient-derived organotypic cultures - PDOCs -). We have also used METPlatform to perform unbiased proteomics of brain metastases in situ to identify potential novel mediators of this disease and explore resistance mechanisms to targeted therapy. Finally, we have exploited METPlatform as “avatars” to predict response to therapy in patients with primary brain tumors.

RESULTS

We identified heat shock protein 90 (HSP90) as a promising therapeutic target for brain metastasis. DEBIO-0932, a blood-brain barrier permeable HSP90 inhibitor, shows high potency against mouse and human brain metastases from different primary origin and oncogenomic profile at clinically relevant stages of the disease, including a novel model of local relapse after neurosurgery. Furthermore, in situ proteomic analysis of brain metastases treated with the chaperone inhibitor revealed non-canonical clients of HSP90 as potential novel mediators of brain metastasis and actionable mechanisms of resistance driven by autophagy. Combined therapy using HSP90 and autophagy inhibitors showed synergistic effects compared to sublethal concentrations of each monotherapy, demonstrating the potential of METPlatform to design and test rationale combination therapies to target metastasis more effectively. Finally, we show that brain tumor PDOCs predict the response of the corresponding patient to standard of care, thus proving the potential of METPlatform for improving personalized care in cancer.

CONCLUSION

Our work validates METPlatform as a potent resource for metastasis research integrating drug-screening and unbiased omic approaches that is fully compatible with human samples and questions the rationale of excluding patients with brain metastasis from clinical trials. We envision that METPlatform will be established as a clinically relevant strategy to personalize the management of metastatic disease in the brain and elsewhere.

Live surgery: Safety study after 17 editions of retroperitoneoscopic surgery

INTRODUCTION

Live surgery has become an excellent tool for medical training. Despite this, there is controversy about the safety of the patients involved.

OBJECTIVE

To analyze the results of live surgeries performed in 17 consecutive retroperitoneoscopy courses organized in our center. Procedures performed were partial nephrectomy (PN), radical nephrectomy (RN) and nephroureterectomy (NU).

MATERIAL AND METHODS

Review from January 2010 to October 2017 of all live surgeries carried out by an expert surgical team in the retroperitoneoscopy courses, compared with a control group of surgeries performed in standard conditions. A matching (1:1 for each RN and 1:2 for each PN and NU) according to age, body mass index and comorbidities was performed.

RESULTS

Twenty-one live surgeries were analyzed (eight PN, seven RN and six NU) with a global median follow-up of 38 months. No significant differences were observed between both groups in terms of perioperative variables (operative time, operative bleeding and intraoperative complications) or of postoperative complications and length of hospital stay. Likewise, there were no differences between recurrence rates (PN: 0% vs. 6.3%, p = 0.47, NU: 33.3% vs. 66.7%, p = 0.180, RN: 0% vs. 28.6%, p = 0,127).

CONCLUSIONS

Live surgery in the hands of expert surgeons in a suitable environment and with well-selected patients does not increase the risk of complications and allows maintaining the same oncological outcomes.

Tocilizumab reduces the risk of ICU admission and mortality in patients with SARS-CoV-2 infection

Objectives

In some patients the immune response triggered by SARS-CoV-2 is unbalanced, presenting an acute respiratory distress syndrome which in many cases requires intensive care unit (ICU) admission. The limitation of ICU beds has been one of the major burdens in the management around the world; therefore, clinical strategies to avoid ICU admission are needed. We aimed to describe the influence of tocilizumab on the need of transfer to ICU or death in non-critically ill patients.

Material and methods

A retrospective study of 171 patients with SARS-CoV-2 infection that did not qualify as requiring transfer to ICU during the first 24h after admission to a conventional ward, were included. The criteria to receive tocilizumab was radiological impairment, oxygen demand or an increasing of inflammatory parameters, however, the ultimate decision was left to the attending physician judgement. The primary outcome was the need of ICU admission or death whichever came first.

Results

A total of 77 patients received tocilizumab and 94 did not. The tocilizumab group had less ICU admissions (10.3% vs. 27.6%, P=0.005) and need of invasive ventilation (0 vs 13.8%, P=0.001). In the multivariable analysis, tocilizumab remained as a protective variable (OR: 0.03, CI 95%: 0.007-0.1, P=0.0001) of ICU admission or death.

Conclusions

Tocilizumab in early stages of the inflammatory flare could reduce an important number of ICU admissions and mechanical ventilation. The mortality rate of 10.3% among patients receiving tocilizumab appears to be lower than other reports. This is a non-randomized study and the results should be interpreted with caution.

DISEÑO Y VALIDACIÓN DE UN INSTRUMENTO OBSERVACIONAL PARA ACCIONES FINALISTAS EN PÁDEL

El pádel es uno de los deportes con mayor crecimiento en España, lo que se ve reflejado en un número cada vez mayor de investigaciones. El objetivo del presente trabajo fue diseñar un instrumento de observación que permita analizar las acciones finalistas en el pádel (IPAAFP) y, además, comprobar su validez y fiabilidad. Un grupo de jueces expertos (n=10), evaluaron en una escala 1-10 la Adecuación y Redacción de 17 items que componen el instrumento. La validez de contenido fue evaluada con la V de Aiken (V=0,83) y la congruencia interna con el ? de Cronbach (0,838). Ningún ítem tuvo que ser eliminado, pero sobre la base de las valoraciones cualitativas de los expertos se realizaron modificaciones en la redacción de los items. Tras el proceso de validación del instrumento, se puede concluir que el IPAAFP es válido y fiable para el análisis de las acciones finalistas en el pádel.

Usefulness of autocidal gravid ovitraps for the surveillance and control of Aedes (Stegomyia) aegypti (Diptera: Culicidae) in eastern Colombia

In the past decade, new strategies have been developed to control the Aedes aegypti (Diptera: Culicidae) mosquito vector, as well as a broad range of arboviral agents. Vector control surveillance programmes in Puerto Rico and Australia have implemented the Centers for Disease Control and Prevention autocidal gravid ovitrap (AGO), which has had an impact on vector density and, consequently, the epidemiology of arboviral infections. Colombia intends to establish the AGO as a new tool for the surveillance and control of the A. aegypti vector. AGOs were evaluated in a hyperendemic area for dengue virus during an 8-week period in Villavicencio city, eastern Colombia. The results indicated that the AGOs detect a high density of A. aegypti, with positive results for these traps of over 80% and an average catch of six individuals per trap per week. Acceptance of AGOs in the community exceeded 95%, and adherence was around 89%. This study's results demonstrate, for the first time in Colombia, that traps are a useful tool for the surveillance of A. aegypti. Future studies must consider the implementation of AGOs in the region.

A temperature-driven model for potato yellow vein virus transmission efficacy by Trialeurodes vaporariorum (Hemiptera: Aleyrodidae)

•

Transmission of potato yellow vein virus by a single whitefly vector was found to be highly temperature dependent.

•

A non-linear mathematical function to describe the relationship between temperature and transmission likelihood was developed.

•

A virus risk index was created by combining the virus transmission function and a whitefly phenology model.

•

Detailed maps were generated indicating the risk of virus transmission using current and predicted future climate scenarios.

•

Maps were used for surveillance of high-risk areas outside the known geographic range of the virus, leading to its discovery in a new region.

Management of viral plant diseases can be improved by using models to predict disease spread. Potato yellow vein virus (PYVV) of the genus Crinivirus (Closteroviridae) is transmitted in a semi-persistent manner by the greenhouse whitefly Trialeurodes vaporariorum (Hemiptera: Aleyrodidae). Although several approaches exist for modeling insect population growth, modeling vector-born virus spread remains difficult because fundamental knowledge on the relationship between virus transmission and temperature is lacking for most vector transmitted viruses. To address this challenge, we initially developed a temperature-dependent phenology model for the whitefly vector using the Insect Life Cycle Modeling (ILCYM) software. In the present study, the effect of temperature on the efficiency of virus transmission by the whitefly was determined through controlled laboratory experiments at 8 constant temperatures in the range from 10 to 25 °C. The vector capacity to transmit the virus was highest at 15 °C (about 70 % probability of infection) but decreased radically as temperature deviated from this optimum temperature to <10 % at temperatures of 10 and 20 °C, respectively. The temperature-dependent probability of virus transmission by a single adult whitefly could be described by a nonlinear function, which was validated by transmission frequencies observed at fluctuating temperatures. This function combined with life table parameters calculated from previously established temperature-dependent phenology model for the vector provided a full temperature-responsive model for predicting PYVV spread potential and transmission probabilities. For spatial risk predictions, we devised two virus transmission risk indexes and tested their performance in correctly predicting virus presence/absence with field survey data. The best performing risk index was used to generate risk maps, which reflected well the current (real) occurrence of the virus but also predicted areas at high risk, where the virus has not previously been reported. One of them in western Panama was targeted for surveillance and resulted in identification of the virus in the country, where it was not previously known to occur. Simulated risk maps for the year 2050 revealed that climate change may significantly affect, the risk of distribution, generally reducing in tropical areas of the world, but increasing in the temperate regions.

SAT0468 EFFECTS OF ANDROGEN DEPRIVATION THERAPY ON BONE QUALITY (TBS) IN PATIENTS WITH PROSTATE CANCER

Background:

Androgen deprivation therapy (ADT), by inducing severe hypogonadism, leads to a loss of bone mineral density (BMD) and an increased risk of fragility fractures after 6 months of treatment in men with prostate cancer1. However, its effect on bone quality has not been described.

Objectives:

To evaluate the changes on bone microarchitecture (bone quality) assessed by TBS (trabecular Bone Score) in male patients with prostate cancer after one year of treatment with ADT.

Methods:

All patients diagnosed with prostate cancer candidates for long-term ADT admitted to Urology department of Hospital Universitari Parc Tauli (reference population of 450,000 inhabitants) between April 2017 and December 2019 were included. Patients who received chemotherapy, previous hormonal therapy or specific treatment for osteoporosis in the last year or those who had a very impaired functional capacity (Barthel index <30) were excluded.

Demographic, clinical and analytical data (testosterone, calcium, phosphorous, alkaline phosphatase, 25-hidroxyvitamin D, PTH) were collected in all patients. A bone densitometry (GE-Lunar Prodigy) including the measurement of lumbar spine TBS (L1-L4) using Medimaps Software was performed at baseline and at 12 months of treatment with ADT.

Results:

78 patients were included. Mean age 77,9±8,3 years. The median Gleason score was 7,88±1,05. 3 patients had previous fragility fracture (one sacral fracture, one fibula and one multiple vertebral fracture). Baseline analytical values in patients were the following: testosterone11,6±74,9 nmol/L.; 25-hidroxyvitamin D 20,8±10,4 ng/ml; PTH 51,8±23,0 pg/ml; CTX 0,58±0,66. The daily calcium intake was 573±207 mg/day.

According to BMD, 17 patients (21,8%) had osteoporosis before starting ADT, with the following average T-score values: lumbar spine +0,15±1,85, femoral neck -1,75±1,00, and total hip -1,19±1,16. Mean baseline TBS value of the entire cohort was 1,279±0,122. 30,5% of the patients showed very degraded microarchitecture (TBS<1,230), 28,8% had partially degraded microarchitecture (TBS 1,230-1,310) and in 40,7% showed normal microarchitecture (TBS >1,310).

After one year of ADT treatment, TBS mildly worsened in this cohort, with a median value of 1,256±0,131 (p = NS). However up to 43% of patients reached highly degraded microarchitecture, 27% partially degraded and only 29,5% had a normal TBS (p = NS).

Conclusion:

Most patients with prostate cancer have an altered bone quality before starting ADT. After 12 months of treatment, the percentage of patients with highly degraded bone microarchitecture increases, although not significantly. More studies are needed to confirm this trend and to evaluate if these patients present more long-term fractures.

References:

[1]Lee R, et al. Bone 2011; 48 (1): 88-95

Disclosure of Interests:

Silvia Garcia-Cirera: None declared, Enrique Casado Speakers bureau: UCB, Lilly, Amgen, Theramex, Gebro, Gedeon-Richter, Stada, Jesús Muñoz: None declared, Luis Del Río: None declared, Marta Arévalo: None declared, Menna Rusiñol: None declared, Noemí Navarro: None declared, Víctor Parejo: None declared, Jordi Gratacos-Masmitja Grant/research support from: a grant from Pfizzer to study implementation of multidisciplinary units to manage PSA in SPAIN, Consultant of: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly

Peritoneal Functional Parameters after Five Years on Continuous Ambulatory Peritoneal Dialysis (CAPD): The Effect of Late Peritonitis

Functional stability of the peritoneum is essential for patients on long-term continuous ambulatory peritoneal dialysis (CAPD) treatment. Sixteen patients on CAPD treatment for at least 4 years were studied. Their mean age was 47 ± 15 years, 5 were males, and none were diabetic. Residual creatinine clearance at the beginning was 2.1 ± 2.6 mL/min.

Once yearly since starting CAPD, we have evaluated their peritoneal ultrafiltration (UF) and diffusion capacities by calculating the peritoneal mass transfer coefficient (MTC, mL/min) for urea and creatinine. Patients were categorized so that we could distinguish the effect of peritonitis, betablockers, and hypertension. For all patients the average initial and final MTCs and UF values were not different.

Early episodes of peritonitis (those occurring <36 months after starting CAPD) did not influence long-term function. However, late peritonitis (occuring >36 months since initiation) induced a decrease in urea-MTC (22.3 ± 6 to 15.8 ± 3.9, p < 0.05), creatinine-MTC (9.4 ± 3.1 to 7.4 ± 2.5, p < 0.05), and a corresponding increase in UF (1.25 ± 0.4 to 1.4 ± 0.3, mL/min, p < 0.05).

Age, sex, betablockers and hypertension did not influence the peritoneal parameters followed.

After 5 years on CAPD, functional stability of the peritoneum is evident, except for patients who suffer late episodes of peritonitis. We speculate that the peritoneum in patients who have been on long-term CAPD are more susceptible to injuries, such as peritonitis, and that this results in functional deterioration.

Age, Gleason Score, and PSA are important prognostic factors for survival in metastatic castration-resistant prostate cancer. Results of The Uroncor Group (Uro-Oncological Tumors) of the Spanish Society of Radiation Oncology (SEOR)

INTRODUCTION

The treatment of metastatic castration-resistant prostate cancer (mCRPC) has changed significantly in recent years. Inhibitors of androgen receptors have shown especially significant benefits in overall (OS) and progression-free survival (PFS), with a good toxicity profile. Treatment selection depends on the patient's individual clinical, radiological, and biological characteristics.

OBJECTIVE

To describe treatment outcomes (efficacy, toxicity) in a cohort of patients with mCRPC in Spain.

MATERIALS AND METHODS

Multicenter, retrospective study of patients with mCRPC included in a database of the Urological Tumour Working Group (URONCOR) of the Spanish Society of Radiation Oncology (SEOR). Metastatic CRPC was defined according to the prostate cancer working group 3 (PCWG3) criteria. The Kaplan-Meier technique was used to evaluate OS and the Common Terminology Criteria for Adverse Events (CTCAE, v.4.0) were used to assess toxicity. Univariate and multivariate Cox regression analyses were performed to identify the factors significantly associated with OS.

RESULTS

A total of 314 patients from 17 hospitals in Spain diagnosed with mCRPC between June 2010 and September 2017 were included in this study. Mean age at diagnosis was 68 years (range 45-89). At a median follow-up of 35 months, OS at 1, 3, and 5 years were 92%, 38%, and 28%, respectively. Grades 1-2 and grade 3 toxicity rates were, respectively, 68% and 19%. No grade 4 toxicities were observed. On the multivariate analysis, the following factors were significantly associated with OS: age (hazard ratio [HR] 0.42, p = 0.010), PSA value at diagnosis of mCRPC (HR 0.55, p = 0.008), and Gleason score (HR 0.61, p = 0.009).

CONCLUSIONS

Age, Gleason score, and PSA at diagnosis of mCRPC are independently associated with overall survival in patients with mCRPC. The efficacy and toxicity outcomes in this patient cohort treated in radiation oncology departments in Spain are consistent with previous reports.

Abstract PD2-09: High-throughput phosphoproteomics (HTPS) in neoadjuvant (NEO) breast cancer (BC) reveals clusters of extreme sensitivity to paclitaxel (T)

Background: NGS has elucidated the mutational landscape in BC. However, the correlation between mutational landscapes and complex phenotypic traits such as drug response is yet unclear. The genomic and transcriptomic aberrations coalesce into a diverse number of phosphorylation-driven patterns of activation of the proteome. These patterns are and associated to clinical outcomes of interest. The specific nature of the phosphopeptides in a profile versus another can be driven by a small number of activated kinases. In the past we relied on mass-spectrometry-based HTPS to build a kinase-based classification of triple-negative breast cancer (TNBC, Nat. Comms, in press), which is more parsimonious than gene-centered classifications and uncovers new actionable targets. We implemented this methodology to find predictors of response to T in early BC.

Methods: Training set: fresh baseline and day+15 tumor biopsies form a trial in NEO HER2-negative BC (N=139) that randomized patients to T (80 mg/m2 weekly x12) plus placebo or nintedanib (150 mg b.i.d) were processed with a hybrid ion trap-orbitrap mass spectrometer after TiO2 phospho-enrichment. Phosphoprofiles were compared pair-wise according to the following factors: day 0 versus day + 15, standard versus experimental arm, pathologic response Symmans/Pusztai (Symmans) 0/1 vs 2/3. Kinases driving each phosphoprofile were solved by an in silico algorithm termed kinase-set enrichment analysis (KSEAS). Validation set: an in-house designed and previously validated mass-spectrometry-to-immunohistochemistry translation algorithm was used to validate the kinases enriched in the profiles from the baseline samples of patients achieving Symmans 0/1 (pCR) or Symmans=3 in the training set. Probes against those kinases were validated in an independent dataset of 160 HER2-negative patients receiving NEO T followed by AC. H-score of each activated kinase was divided in quartiles (Q1 to Q4), and upper-quartiles (Q1) of each kinase were tested in a multivariate logistic regression model to predict pCR adjusted by T, N, age, G, ER/PR and Ki67.

Results: &gt;2.5 millions of spectra were captured, identifying &gt;35000 unique phosphopeptides mapping to &gt;2500 unique proteins per sample. Training set: KSEAS revealed that a high activity of CDK4 and pP70S6K drove the baseline phosphoprofiles of the patients obtaining pCR in the T arm, whereas pSTAT3, pSrc and BARD drove that of the patients achieving Symmans= 3. In the validation set, H-score cut-offs for Q1 were 1.21, 0.69, 0.79, 1.64 and 1.54 for pP70S6K, CDK4, pSTAT3, pSrc and BARD. TNBC patients with Q1 pP70S6K or Q1 CDK4 achieved pCR in 100% of the cases (versus 45% in Q2-4). In the HR+ cases, the pCR rate for Q1 patients was 50% and 61% respectively. In the multivariate model (all patients), having Q1 pP70S6K or CDK4 multiplied by 2.3- and 3.6-fold, respectively, the probability of achieving pCR (P&lt;0.05). Regarding Symmans=3, BARD and pSTAT3 lost significance in the validation but not pSrc (2.5-fold less probability of pCR, P&lt;0.005).

Conclusions: HTPS is a useful tool to find associations with complex traits. TNBC and HR+ patients with high pP70S6K or CDK4 receiving NEO T-based chemotherapy achieve very high rates of pCR.

Citation Format: Quintela-Fandino M, Lluch A, Manso L, Calvo I, Cortes J, Garcia-Saenz JA, Zagorac I, Tapial-Martinez P, Gomez-Lopez G, Fustero C, Muñoz J, Gonzalez-Cortijo L, Mouron S. High-throughput phosphoproteomics (HTPS) in neoadjuvant (NEO) breast cancer (BC) reveals clusters of extreme sensitivity to paclitaxel (T) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD2-09.

Outcomes and prognostic factors in intermediate-risk prostate cancer: multi-institutional analysis of the Spanish RECAP database

PURPOSE

To retrospectively assess outcomes and to identify prognostic factors in patients diagnosed with intermediate-risk (IR) prostate cancer (PCa) treated with primary external beam radiotherapy (EBRT).

MATERIALS AND METHODS

Data were obtained from the multi-institutional Spanish RECAP database, a population-based prostate cancer registry in Spain. All IR patients (NCCN criteria) who underwent primary EBRT were included. The following variables were assessed: age; prostate-specific antigen (PSA); Gleason score; clinical T stage; percentage of positive biopsy cores (PPBC); androgen deprivation therapy (ADT); and radiotherapy dose. The patients were stratified into one of three risk subcategories: (1) favourable IR (FIR; GS 6, ≤ T2b or GS 3 + 4, ≤ T1c), (2) marginal IR (MIR; GS 3 + 4, T2a-b), and (3) unfavourable IR (UIR; GS 4 + 3 or T2c). Biochemical relapse-free survival (BRFS), disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) were assessed.

RESULTS

A total of 1754 patients from the RECAP database were included and stratified by risk group: FIR, n = 781 (44.5%); MIR, n = 252 (14.4%); and UIR, n = 721 (41.1%). Mean age was 71 years (range 47-86). Mean PSA was 10.4 ng/ml (range 6-20). The median radiotherapy dose was 74 Gy, with mean doses of 72.5 Gy (FIR), 73.4 Gy (MIR), and 72.8 Gy (UIR). Most patients (88%) received ADT for a median of 7.1 months. By risk group (FIR, MIR, UIR), ADT rates were, respectively, 88.9, 86.5, and 86.9%. Only patients with ≥ 24 months of follow-up post-EBRT were included in the survival analysis (n = 1294). At a median follow-up of 52 months (range 24-173), respective 5- and 10-year outcomes were: OS 93.6% and 79%; BRFS 88.9% and 71.4%; DFS 96.1% and 89%; CSS 98.9% and 94.6%. Complication rates (≥ grade 3) were: acute genitourinary (GU) 2%; late GU 1%; acute gastrointestinal (GI) 2%; late GI 1%. There was no significant association between risk group and BRFS or OS. However, patients with favourable-risk disease had significantly better 5- and 10-year DFS than patients with UIR: 98.7% vs. 92.4% and 92% vs. 85.8% (p = 0.0005). CSS was significantly higher (p = 0.0057) in the FIR group at 5 (99.7% vs. 97.3%) and 10 years (96.1% vs. 93.4%). On the multivariate analyses, the following were significant predictors of survival: ADT (BRFS and DFS); dose ≥ 74 Gy (BRFS); age (OS).

CONCLUSIONS

This is the first nationwide study in Spain to report long-term outcomes of patients with intermediate-risk PCa treated with EBRT. Survival outcomes were good, with a low incidence of both acute and late toxicity. Patients with unfavourable risk characteristics had significantly lower 5- and 10-year disease-free survival rates. ADT and radiotherapy dose ≥ 74 Gy were both significant predictors of treatment outcomes.

Development of food emulsions containing an advanced performance xanthan gum by microfluidization technique

Gums are often used to increase the viscosity of the continuous phase of oil-in-water emulsions in order to reduce or inhibit some destabilization processes such as creaming. A new type of xanthan gum, advanced performance xanthan gum, which possesses improved rheological properties, has been used as a stabilizer. The addition of advanced performance xanthan gum to egg protein-based emulsions prepared at different homogenization pressures in Microfluidizer was studied. These emulsions showed different droplet size distributions and flocculation degrees. However, all the emulsions studied exhibited the same viscoelastic properties, characterized by a crossover point in the mechanical spectra. This work demonstrates the essential role of this novel gum in the rheology of emulsions. In addition, there is a direct relation between homogenization pressure and flocculation degree. This flocculation led to destabilization by coalescence in these emulsions, being the emulsion processed at the smallest homogenization pressure the most stable.

Chiral magnetic-nanobiofluids for rapid electrochemical screening of enantiomers at a magneto nanocomposite graphene-paste electrode

The development of highly sensitive and selective enantiomeric platforms towards the rapid screening of active pharmaceutical ingredients (APIs) is nowadays a crucial challenge in several fields related to pharmacology, biomedicine, biotechnology and (bio)sensors. Herein, it is presented a novel, facile and generic methodology focused on exploiting the synergistically and electrocatalytic properties of chiral magnetic-nanobiofluids (mNBFs) with electrochemical enantiobiosensing at a magneto nanocomposite graphene paste electrode (mNC-GPE). The feasibility of this approach has been validated by chirally recognizing tryptophan (TRP) enantiomers as a proof-of-concept. For this aim, a specific chiral mNBF based on an aqueous dispersion of cobalt ferrite loaded with gold nanoparticles carrying a thiolated β-cyclodextrin (β-CD-SH/Au/CoFe₂O₄-NPs) has been synthesized and used towards the supramolecular discrimination of TRP enantiomers at an advanced graphene-paste transducer via cyclic voltammetry. This strategy, which is the first demonstration of applicability of chiral mNBFs for electrochemical enantiorecognition, opens up new approaches into enantio(bio)sensing.

Real-time incidence of travel-related symptoms through a smartphone-based app remote monitoring system: a pilot study

Trip Doctor®, a Smartphone-based app monitoring system, was developed to detect infections among travelers in real-time. For testing, 106 participants were recruited (62.2% male, mean age 36 years (SD = 11)). Majority of trips were for tourism and main destinations were in South East Asia. Mean travel duration was 14 days (SD = 10). Diarrhea was the most frequently reported symptom (15.5%). The system demonstrated adequate usability and is ready to be used on a larger scale.

Effects of Oral Prednisone Administration on Serum Cystatin C in Dogs

Background

Oral administration of glucocorticoid alters serum cystatin C (sCysC) concentration in humans.

Objective

To determine if oral administration of prednisone alters sCysC in dogs without pre‐existing renal disease.

Animals

Forty six dogs were included: 10 dogs diagnosed with steroid responsive meningitis arteritis (SRMA; group A), 20 dogs diagnosed of pituitary‐dependent hyperadrenocorticism (PDH; group B), and 16 healthy control dogs (group C).

Methods

Retrospective observational study. SRMA diagnosed dogs were administered prednisone 4 mg/kg/24 h PO 7 days, reducing the dose to 2 mg/kg/24 h 7 days before medication withdrawal. In group A, sampling was performed at days 0, 7, 14 and a final control at day 21. Blood and urine samples were collected in the 3 groups, and in group A, sampling was performed at all time points (days 1, 7, 14, and 21).

Results

In group A, sCysC was significantly higher at day 7 compared to the control group (0.4 ± 0.04 mg/L vs. 0.18 ± 0.03 mg/L mean ± SEM respectively P < 0.01); sCysC values decreased to basal at day 14 when the dose was decreased and after 1 week of withdrawal of prednisone (0.27 ± 0.03 mg/L for group A at day 14 and 0.15 ± 0.02 mg/L at day 21; P > 0.05). Dogs with PDH included in group B did not have significant differences in sCysC (0.22 ± 0.03 mg/L) compared to control (P > 0.05).

Conclusions and Clinical Importance

Oral administration of prednisone unlike altered endogenous glucocorticoid production, increases sCysC in dogs in a dose‐dependent fashion.

Adjuvant versus salvage radiotherapy in prostate cancer: multi-institutional retrospective analysis of the Spanish RECAP database

PURPOSE

To compare adjuvant radiotherapy (ART) to salvage radiotherapy (SRT) after radical prostatectomy (RP) in a cohort of prostate cancer (PCa) patients. The primary aim was to comparatively assess 2- and 5-year biochemical relapse-free survival (BRFS). A secondary aim was to identify predictors of survival.

PATIENTS AND METHODS

Data were acquired from the RECAP database, a population-based prostate cancer registry in Spain. Inclusion criteria included RP (with or without lymphadenectomy) followed by ART or SRT. A total of 702 patients were analyzed. Pre-RT PSA values (>0.5 vs. ≤0.5 ng/ml), pathological stage (T1-2 vs. T3-4), post-surgical Gleason score (≤7 vs. 8-10), margin status (positive vs. negative), hormonal treatment (yes vs. no), and RT dose (≤66 Gy vs. >66 Gy) were evaluated to assess their impact on BRFS.

RESULTS

The mean patient age in the ART and SRT groups, respectively, was 64 years (range 42-82) and 64.8 years (range 42-82). Median follow-up after RT in the whole sample was 34 months (range 3-141). A total of 702 patients were included: 223 (31.8%) received ART and 479 (68.2%) SRT. BRFS rates (95% CI) in the ART and SRT groups at months 24 and 60 were, respectively: 98.1% (95.9-100.0%) vs. 91.2% (88.2-94.2%) and 84.5% (76.4-92.6%) vs. 74.0% (67.4-80.7%) (p = 0.004). No significant differences in OS were observed (p = 0.053). The following variables were significant predictors of biochemical recurrence in the SRT group: (1) positive surgical margin status (p = 0.049); (2) no hormonotherapy (p = 0.03); (3) total prostate dose ≤66 Gy (p = 0.004); and pre-RT PSA ≥0.5 ng/ml (p = 0.013).

CONCLUSIONS

This is the first nationwide study in Spain to evaluate a large cohort of PCa patients treated with RP followed by postoperative RT. ART yielded better 2- and 5-year BRFS rates, although OS was equivalent. These findings are consistent with most other published studies and support ART in patients with adverse prognostic characteristics after radical prostatectomy. Prospective trials are needed to compare immediate ART to early SRT to better determine their relative benefits.

[Diagnosis and treatment of imported eosinophilia in travellers and immigrants: Recommendations of the Spanish Society of Tropical Medicine and International Health (SEMTSI)]

According to published data, prevalence of imported eosinophilia among travellers and immigrants is set between 8% and 28.5%. Etiological diagnosis is often troublesome, and depending on the depth of the study and on the population analyzed, a parasitic cause is identified in 17% to 75.9% of the individuals. Among the difficulties encountered to compare studies are the heterogeneity of the studied populations, the type of data collection (prospective/retrospective) and different diagnostic protocols. In this document the recommendations of the expert group of the Spanish Society of Tropical Medicine and International Health (SEMTSI) for the diagnosis and treatment of imported eosinophilia are detailed.

Physical stability of N,N-dimethyldecanamide/α-pinene-in-water emulsions as influenced by surfactant concentration

In recent years, interest in submicron emulsions has increased due to their high stability and potential applications in the encapsulation and release of active ingredients in many industrial fields, such as the food industry, pharmaceuticals or agrochemicals. Furthermore, the social demand for eco-friendly solutions to replace hazardous solvents in many dispersion formulations has steadily risen. In this study, the influence of surfactant concentration on the formation and physical stability of submicron oil-in-water emulsions using a high-pressure dual-channel homogenizer (microfluidizer) has been investigated. The formulation involved the use of a blend of two green solvents (N,N-dimethyldecanamide and α-pinene) as dispersed phase and a nonionic polyoxyethylene glycerol ester derived from coconut oil as emulsifier (Levenol^® C-201), which enjoys a European eco-label. Therefore, these emulsions may find applications as matrices for agrochemicals. Physical stability and rheological properties of the emulsions studied showed an important dependence on the eco-friendly surfactant concentration. The lowest surfactant concentration (1wt%) yielded the onset of a creaming process after a short aging time and was not enough to avoid recoalescence during emulsification. On the other hand, the higher surfactant concentrations (4-5wt%) resulted in depletion flocculation, which in turn triggered emulsion destabilization by coalescence. The optimum physical stability was exhibited by emulsions containing intermediate surfactant concentrations (2-3wt%) since coalescence was hardly significant and the onset of a weak creaming destabilization process was substantially delayed.