Compatibility of Topical Products to Manage Skin Irritation Associated with TTFields

PURPOSE/OBJECTIVE(S)

Tumor Treating Fields (TTFields) are electric fields that disrupt cellular processes critical for cancer cell viability and tumor progression. TTFields therapy is approved for the treatment of recurrent glioblastoma (GBM), newly diagnosed GBM, and pleural mesothelioma, and is currently under clinical investigations for the treatment of other types of cancers. TTFields therapy is delivered continuously and non-invasively, using a portable signal generator connected to 4 arrays attached to the skin. Treatment of at least 18 hours per day is recommended for increasing effectiveness. The main treatment-related adverse effect reported in clinical trials and post-marketing surveillance studies has been low-grade skin irritation under the arrays, which may be treated in most cases with the use of topical steroids or intermittent treatment interruptions. However, for maintaining treatment effectiveness, skin care products suitable for use under the TTFields arrays are those that do not affect field currents. The goal of this study was to investigate strategies to alleviate skin irritation without compromising treatment effectiveness.

MATERIALS/METHODS

TTFields (200 kHz) were applied to rats (Sprague Dawley, 10-20 weeks of age, body weight over 250 gr) using ceramic disks and hydrogels identical to those used with human arrays. The rat torso was depilated, and TTFields were applied to the rat torso before and after applying various skin care products to the surface beneath the arrays. After reaching a steady state, average currents were extracted from the device's log files. Percent change in current was calculated from the measurements with and without the product.

RESULTS

Tested products could be divided into groups according to their medical use: antibiotics, antiseptics, cleansers/adhesive removers, skin barriers, moisturizers, topical corticosteroids, and antiperspirants. The products could also be categorized by their type: creams, gels, soaps, sprays, ointments, wipes/pads, foams, and lotions. Skin care products that significantly reduced currents were mainly ointments. Typical ingredients of ointments are mineral oil and petrolatum, which are expected to create a hydrophobic layer, thereby reducing ionic conduction and hence field currents. These ingredients also hinder adherence of the acrylic-based tape to the skin thus compromising mechanical fixation of the arrays, leading to poor connectivity and hence reduced currents.

CONCLUSION

Identification of products for treating skin irritation that are compatible with TTFields therapy is important for improving patient's quality of life and increasing device usage. Skin care products containing petrolatum should not be applied under the arrays to avoid compromising treatment effectiveness.

P10.10.A Tumor Treating Fields (TTFields), temozolomide and lomustine co-application is efficacious in glioblastoma cancer cell lines

Background

Temozolomide (TMZ) is the standard of care chemotherapy for newly diagnosed glioblastoma (ndGBM), the most common primary malignant brain tumor in adults. However, 50% of patients do not respond to TMZ due to expression of O6-methylguanine-DNA methyltransferase (MGMT), the enzyme involved in repair of TMZ-induced damage. Tumor Treating Fields (TTFields) are alternating electric fields that display anti-mitotic effects on cancerous cells, and have been shown to induce a state of BRCAness in various cancer types. Concurrent treatment with TMZ and TTFields demonstrated a major advance in treatment of patients with ndGBM, and was approved by the FDA in 2014. Recently, the addition of lomustine (CCNU) to TMZ demonstrated clinical benefit in ndGBM patients, with improved overall and progression free survival. The aim of the current study was to examine in GBM cells the effect of TTFields in conjunction with TMZ and CCNU.

Materials and Methods

U-87 MG, LN229, U118 and LN18 human GBM cell lines were tested for their MGMT expression levels, and treated with TTFields (200 kHz, of 0.83 V/cm RMS) for 72 h using the inovitro system. Efficacy of concomitant application of TTFields with TMZ and/or CCNU was tested by measuring cell count, colony formation, and apoptosis levels.

Results

U-87 MG and LN229 displayed no expression of MGMT, while U118 and LN18 expressed low and high levels of MGMT, respectively. Application of TMZ and TTFields resulted in increased cytotoxicity compared with each treatment alone, with an additive interaction seen in all examined cell lines. The cytotoxic effect resulting from co-application of CCNU with TTFields suggested a synergistic interaction between the two modalities for U-87 MG, LN229, and U118, an additivity for LN18. Concurrent TTFields/TMZ/CCNU was more efficacious than TTFields or TMZ/CCNU separately in all cell lines.

Conclusions

Application of TTFields with TMZ was additive, irrespective of MGMT expression levels, while TTFields with CCNU was additive when MGMT was plentiful, but displayed tendency to synergism when MGMT was absent or limited. These outcomes are in line with the BRCAness state induced by TTFields, as in the absence of MGMT, DNA damage induced by CCNU requires the BRCA pathway for repair. Application of TTFields together with TMZ and CCNU demonstrated increased efficacy, suggesting potential benefit of such therapy for ndGBM treatment.

P10.11.B Re-sensitizing cancer cells to Tumor Treating Fields (TTFields) through PI3K/AKT/mTOR pathway inhibition

Background

Tumor Treating Fields (TTFields) are alternating electric fields disrupting cellular processes critical for cancer cell replication and tumor progression. TTFields therapy is approved for treatment of newly diagnosed glioblastoma (GBM), recurrent GBM, and unresectable malignant pleural mesothelioma, and is currently under clinical investigation for treating other solid tumors, such as ovarian cancer, non-small cell lung carcinoma (NSCLC), and hepatocellular carcinoma (HCC). The research herein aimed to identify potential treatment escape mechanisms and explore the possibility of targeted inhibition of these pathways for re-sensitizing the cells to TTFields.

Material and Methods

GBM U-87 MG, ovarian A2780, and NSCLC H1299 cells were treated with TTFields (1.7 V/cm RMS, 200 or 150 kHz) for continuous long-term application (7 or 13 days, specific conditions depending on the cell line). Changes in signaling pathways in these cells relative to cells exposed to short term TTFields application (3 or 7 days, depending on cell line) were examined by Luminex multiplex assay. Specific pathway markers were examined by immunohistochemistry of tumor sections from sham or TTFields-treated rats bearing N1S1 HCC tumors. TTFields were then co-applied with relevant pathway inhibitors, followed by cell count measurements and western blot examinations for specific pathway markers. The concomitant application of TTFields with a selected inhibitor was tested in mice inoculated orthotopically with MOSE-L firefly luciferase (FFL) ovarian cancer cells. Tumor volume was measured at study end by luciferin signal detection using the In Vivo Imaging System (IVIS).

Results

Cancer cells exposed to long-term application of TTFields displayed decreased sensitivity to TTFields. The PI3K/AKT/mTOR pathway was activated in these cells, with significant increases in AKT and RPS6 phosphorylation levels also observed in HCC tumors from rats treated with TTFields. PI3K inhibitors re-sensitized the cells to TTFields cytotoxicity, with associated down regulation of AKT phosphorylation. Application of TTFields concomitant with the PI3K inhibitor alpelisib resulted in enhanced efficacy in the ovarian cancer mouse model.

Conclusions

The current research demonstrated that PI3K/AKT/mTOR signaling pathway activation was involved in the response to long-term application of TTFields, with increased phosphorylation of key proteins observed both in vitro and in vivo. Concomitant treatment with PI3K inhibitors and TTFields re-sensitized the cells to TTFields, as it alleviated TTFields-induced AKT activation.

Childhood adversity, health and quality of life in adults with intellectual and developmental disabilities

BACKGROUND

Associations between childhood adversity and negative health outcomes are well documented within the general population; however, this relationship has yet to be confirmed in adults with intellectual and developmental disabilities (I/DD). Bridging the gap between public health and I/DD research is critical in order to better understand the ways in which the health of people with I/DD are compromised by adversity and social disadvantage and to develop preventative care frameworks and health-promoting practices specifically for adults with I/DD. The aim of this exploratory study was to examine the relationships among adversity, physical health and quality of life in a sample of adults with I/DD.

METHOD

Participants were adults with I/DD currently residing within campus-based residences. Demographic data, psychiatric and medical diagnoses, adverse childhood experiences scores and quality of life scores were aggregated from participants' electronic medical records. A health history form was completed for each participant based on a review of participants' medical records.

RESULTS

Results indicated childhood adversity was significantly associated with number of chronic medical conditions (r = .35, P < .001, 95% BCa CI [.13, .53]). Childhood adversity was not significantly related to quality of life. After controlling for demographic variables, childhood adversity remained a significant predictor of health history (B = .32, P < .005, 95% BCa CI [.10, .52]), with greater adversity predicting greater medical illness.

CONCLUSION

Participants demonstrated higher rates of childhood adversity compared with the general population, suggesting that individuals with I/DD may be particularly vulnerable to experiencing adversity during development. Childhood adversity was a significant predictor of physical illness in adults with I/DD. These findings emphasise the importance of screening for childhood adversity histories in adults with I/DD. Additionally, results demonstrate the importance of offering preventative interventions geared at preventing physical illness and promoting health in adults with I/DD with adversity and trauma backgrounds.

Constraints on geographic variation in fiddler crabs (Ocypodidae: Uca) from the western Atlantic

A key question in evolutionary biology is how intraspecific variation biases the evolution of a population and its divergence from other populations. Such constraints potentially limit the extent to which populations respond to selection, but may endure long enough to have macroevolutionary consequences. Previous studies have focused on the association between covariation patterns and divergence among isolated populations. Few have focused on geographic variation among semi-connected populations, however, even though this may be indicative of early selective pressures that could lead to long-term divergence and speciation. Here, we test whether covariation in the shape of the carapace of fiddler crabs (genus Uca Leach, 1814) is important for structuring geographic variation. We find that morphological divergence among populations is associated with evolvability in the direction of divergence in only a few species. The shape of the ancestral covariation matrix in these species differs from other species in having notably more variation concentrated along fewer directions (i.e. higher eccentricity). For most species, there is some evidence that covariation has constrained the range of directions into which populations have diverged but not the degree of divergence. These results suggest that even though fiddler crab populations have diverged morphologically in directions predicted by covariation, constraints on the extent to which divergence has occurred may only be manifested in species where variation patterns are eccentric enough to limit populations' ability to respond effectively in many directions.

Moisture dynamics in wall paintings monitored by single-sided NMR

The durability of historic wall paintings is highly dependent on environmental influences such as moisture ingress, salt crystallization and temperature changes. A fundamental understanding of dynamic transport processes in wall paintings is necessary to apply suitable conservation and restoration methods to preserve such objects with high cultural value. Non-invasive, mobile-NMR techniques with single-sided sensors, such as the NMR-MOUSE(®), enable to monitor the moisture content, transport and apparent diffusion constants in wall paintings. We investigated this technique by experiment and modeling to correlate salt crystallization, moisture transport and local diffusion in wall-painting samples. Moreover, the influence of different painting techniques (fresco and secco) and conservation/consolidation methods on moisture transport and diffusion is discussed. The results are compared with results from field measurements on real fresco paintings in Casa del Salone Nero and the Villa of the Papyri, Herculaneum, Italy.

Predictive control of thermally induced wavefront aberrations

In this paper we experimentally demonstrate the proof of concept for predictive control of thermally induced wavefront aberrations in optical systems. On the basis of the model of thermally induced wavefront aberrations and using only past wavefront measurements, the proposed adaptive optics controller is able to predict and to compensate the future aberrations. Furthermore, the proposed controller is able to correct wavefront aberrations even when some parameters of the prediction model are unknown. The proposed control strategy can be used in high power optical systems, such as optical lithography machines, where the predictive correction of thermally induced wavefront aberrations is a crucial issue.

An innovative and efficient method to control the shape of push-pull membrane deformable mirror

We carry out performance characterisation of a commercial push and pull deformable mirror with 48 actuators (Adaptica Srl). We present a detailed description of the system as well as a statistical approach on the identification of the mirror influence function. A new efficient control algorithm to induce the desired wavefront shape is also developed and comparison with other control algorithms present in literature has been made to prove the efficiency of the new approach.

Surface UV aging of elastomers investigated with microscopic resolution by single-sided NMR

Depth profiles taken from the surface of UV irradiated natural rubber sheets have been measured with microscopic resolution using a Profile NMR-MOUSE. An NMR observable related to the sum of the spin echoes in the Carr-Purcell-Meiboom-Gill pulse sequence was used to characterize the cross-link density changes produced by the action of UV radiation in each sheet. The aging process was investigated as function of irradiation time and penetration depth. An exponential attenuation law with a space dependent absorption coefficient describes the change in the NMR observable with penetration depth. An Avrami model is used to describe the dependence of the absorption coefficient on the aging time. The method can be applied to investigate the effect of various aging agents on the surfaces of elastomers.

Practical aspects of using the microbatch method in screening conditions for protein crystallization

The microbatch technique is a simple and efficient method for screening for protein crystallization conditions both by hand and using automated systems. Many of the problems associated with more commonly used methods such as vapour diffusion can be overcome using this method. Despite its promise microbatch has not been widely utilized as a viable screening procedure. This review aims to describe the method from a practical point of view with an emphasis on screening crystallization conditions, outlining current progress and discussion of the advantages compared to other methods.

Using natural seeding material to generate nucleation in protein crystallization experiments

The nucleation event in protein crystallization is a part of the process that is poorly controlled. It is generally accepted that the protein should be in the metastable phase for crystal growth, but for nucleation higher levels of saturation are needed. Formation of nuclei in bulk solvent requires interaction of protein molecules until a critical size of aggregate is created. In many crystallization experiments sufficiently high levels of saturation are not reached to allow this critical nucleation event to occur. If an environment can be created that favours a higher local concentration of macromolecules, the energy barrier for nucleation may be lowered. When seeds are introduced at lower levels of saturation in a crystallization experiment, nucleation may be facilitated and crystal growth initiated. In this study, the use of natural materials as stable seeds for nucleation has been investigated. The method makes it possible to introduce seeds into crystallization trials at any stage of the experiment using both microbatch and vapour-diffusion methods.

The advantages of using a modified microbatch method for rapid screening of protein crystallization conditions

In this study, characterization and optimization of a modified microbatch crystallization technique has been attempted in order to provide a rapid screening method. Using this method for screening has certain advantages over standard vapour-diffusion methods: no sealing of drops is required, no reservoir solutions are needed and the experiments can easily be performed over a range of temperatures.

Cytogenetic analysis of fetal chondrocytes: a comparative study

Progress in the prevention and prenatal detection of birth defects has led to a relative increase in the number of interruption of pregnancies associated with chromosomal abnormalities. There is an inverse relationship between the rate of success of fetal cell cultures and the interval between fetal demise and the initiation of culture. This report describes the cytogenetic analyses of cultured fetal chondrocytes compared with tissue cultures of fetal skin, fetal membranes, and placenta. The results show that cells obtained from the fetal chondrocostal junction and/or patella from missed abortions, intrauterine fetal deaths, or stillbirths can be cultured and successfully karyotyped. Since cartilage cells remain viable for some time after fetal demise, the culture of fetal chondrocytes is a complementary method for fetal chromosome analysis, especially in cases of tissue maceration after fetal demise. The success rate of chondrocyte cultures is similar to that of conventional fetal tissue cultures.

Simian virus 40 large T antigen induces or activates a protein kinase which phosphorylates the transformation-associated protein p53

The cellular phosphoprotein p53 is presumably involved in simian virus 40 (SV40)-induced transformation. We have monitored changes in the state of phosphorylation of p53 from normal versus SV40-infected or -transformed cells. In normal cells, p 53 was hardly phosphorylated. Upon infection or transformation, a quantitative and qualitative increase in p53 phosphorylation was observed as revealed by two-dimensional phosphopeptide analysis. This increase was dependent on a functional large T antigen. In rat cells, enhanced phosphorylation of p53 resulted in conversion to a second, electrophoretically distinct form. In cells transformed with transformation-defective mutants, phosphorylation of p53 was reduced and conversion to form 2 was inefficient. These data suggest (i) that SV40 large T antigen induces or activates a protein kinase, one substrate of which is p53, (ii) that transformation-defective mutants are impaired in kinase induction, and (iii) that either a certain phosphorylation state of p53 or the SV40-induced kinase is critical for efficient transformation.

Carbon-13 nuclear magnetic resonance assignments of pactamycin and related compounds

All resonances observed in the 13C NMR spectrum of the antitumor antibiotic pactamycin and its degradation product pactamyçate have been assigned, employing off-resonance and specific proton decoupling as well as comparison with the 13C NMR spectra of the model compounds m-aminoacetophenone and ethyl 6-methylsalicylate.