Abstract 747: Racial differences in clinical outcome in patients treated for clinically localized prostate cancer by radical prostatectomy

Introduction: African Americans (AA) had a higher mortality from prostate cancer than Caucasian Americans (CA). The racial disparity in the outcome of prostate cancer is explained by socioeconomic factors. However, if equally accessible to standard care, whether AA with prostate cancer have an inferior outcome than CAs remains unknown. To understand the biochemical recurrence free survival (RFS) after radical prostatectomy in a racial disparity perspective, we analyzed a large cohort of patients and made important observations.

Method: AA (n=1020) and CA (n=1263) who received prostatectomy for prostate cancer were included. Their demographic and clinicopathologic characteristics were compared using the Chi-squared test and the Wilcox-rank test. RFS between AA and CA was compared using Kaplan-Meier curves with stratified log-rank test and cox-ph models. The Gleason grade across multiple biopsies was summarized by spaghetti plot and compared by linear mixed models.

Results: Compared with CA, AA were younger at the time of prostatectomy (60.5 vs 62 years), had higher pre-operative PSA levels (5.7 vs 5.3 ng/mL), were fewer with Gleason grade of 5 (7.9% vs 13.3%) and lymph node metastasis (6.1% vs 9.5%), and waited longer from biopsy to prostatectomy (3 vs 2.3 months)(all p <.05). Of note, longer RFS (16 vs 15.6 years, p=0.005) and higher 5-year RFS rate (0.82 vs 0.71) were observed in AA than CA. AA had a better RFS than CA (Hazard Ratio=1.25, p=0.05) after adjusting known prognostic factors (Table 1). For those who had multiple biopsies before prostatectomy, Gleason grade increased with time for AA (0.15 per year, p=0.005), but not for CA (-0.11 per year, p=0.06).

Conclusion: Our data showed that contrary to common belief, AA had a better RFS than CA after receiving prostatectomy. This study further supported the underlying biological difference of prostate cancer between AA and CA that requires future studies to elucidate.

RFS Summary HR Race African American 1020 (44.7) - Caucasian 1263 (55.3) 1.25 (1.00-1.58, p=0.05) Pre-operative PSA (ng/mL) Mean (SD) 7.5 (9.0) 1.01 (1.01-1.02, p<0.001) Tumor volume (%) Mean (SD) 14.9 (14.5) 1.01 (1.00-1.02, p=0.02) Gleason Grade Group 1 375 (16.7) - 2 1060 (47.2) 1.84 (1.05-3.22, p=0.03) 3 435 (19.4) 3.91 (2.20-6.94, p<0.001) 4 129 (5.7) 4.10 (2.25-7.47, p<0.001) 5 249 (11.1) 3.82 (2.10-6.96, p<0.001) Tumor margins Positive 730 (32.0) 1.78 (1.43-2.13, p<0.001) Lymph vascular invasion Present 274 (12.0) 1.50 (1.10-2.05, p=0.01)

Citation Format: Pin Li, Wei Zhao, Shannon Carskadon, Craig Rogers, James Peabody, Mani Menon, Dhananjay Chitale, Sean Williamson, Nilesh Gupta, Nallasivam Palanisamy. Racial differences in clinical outcome in patients treated for clinically localized prostate cancer by radical prostatectomy [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 747.

Abstract 5762: New perspective on racial disparities in prostate cancer: identification of new molecular subsets using whole-mount radical prostatectomy

Introduction: Prostate cancer is a heterogenous multifocal disease. We hypothesize that different tumor foci may harbor distinct driver molecular aberrations, making it a more complex disease and difficult to manage. To avoid overlooking smaller tumor foci with clinical and biological significance, we used an innovative approach to understand the genetic underpinnings of each tumor foci based on the molecular analysis of whole-mount radical prostatectomy specimens rather than a systematic sampling of dominant nodules alone. Our study aimed to identify distinct molecular subsets of prostate cancer, if any, and correlate them with clinical outcomes in Caucasians (CA) and African Americans (AA).

Method: We randomly selected 834 whole-mount radical prostatectomy tissues including 463 (56%) CA and 371 (44%) AA. We used combined dual immunohistochemistry (IHC) for ERG and SPINK1 and dual RNA in-situ hybridization (ISH) for ETV1 and ETV4. The racial disparity in aberrant oncogene expression was analyzed by the Chi-squared test. The recurrence-free survival (RFS) of patients with distinct molecular subsets of prostate cancer was examined by the Kaplan-Meier method and cox-ph models. The Gleason’s grades of prostate biopsies were summarized by spaghetti plot and compared by linear mixed models.

Results: Patients with localized prostate cancer expressing none, one, two, and three of four oncogenes were 16.4%, 58.4%, 21.7%, and 3.5%, respectively. The expression of ERG and SPINK1 was negatively correlated (odds ratio (OR)=0.38, 95% CI 0.29-0.51, p<.001). Compared with CA, AA had a lower incidence of ERG (38.8% vs 60.3%), a higher incidence of SPINK1 (63.3% vs 35.6%), and similar incidences of ETV1 (9.4% vs 9.3%) and ETV4 (4.6% vs 3.9%). Importantly, ETV1 expression was associated with a worse RFS in CAs (hazard ratio (HR)=2.49, 95% CI 1.15-5.38, p=.02). ETV4 expression was associated with a worse RFS in AA (HR=3.11, 95% CI 1.32-8.04, p=.01). In addition, ETV4 expression was associated with lymph node metastasis in AA (OR=4.0, 95% CI 1.06-12.44, p=.02) but not in CA (OR=0.56, 95% CI 0.03-2.85, p=.57). For those who had multiple biopsies before radical prostatectomy, Gleason’s grade increased with time in AA (0.23 per year, p<.001) but was unchanged in CA. ERG expression was associated with a lower Gleason grade (-0.20, p=.03). ETV4 was associated with a higher Gleason grade (0.50, p=.02).

Conclusion: Our findings showed the molecular heterogeneity between CA and AA who had localized prostate cancer, and supported ETV1 and ETV4 as prognostic markers that can be incorporated into clinical practice to better predict prostate cancer recurrence after radical prostatectomy in CA and AA, respectively.

Citation Format: Wei Zhao, Pin Li, Shannon Carskadon, Craig Rogers, James Peabody, Mani Menon, Dhananjay Chitale, Sean Williamson, Nilesh Gupta, Nallasivam Palanisamy. New perspective on racial disparities in prostate cancer: identification of new molecular subsets using whole-mount radical prostatectomy. [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 5762.

Satellite Tracking of Head-Started Juvenile Green Turtles (Chelonia mydas) Reveals Release Effects and an Ontogenetic Shift

Juveniles of marine species, such as sea turtles, are often understudied in movement ecology. To determine dispersal patterns and release effects, we released 40 satellite-tagged juvenile head-started green turtles (Chelonia mydas, 1–4 years) from two separate locations (January and July 2023) off the coast of the Cayman Islands. A statistical model and vector plots were used to determine drivers of turtle directional swimming persistence and the role of ocean current direction. More than half (N = 22) effectively dispersed in 6–22 days from the islands to surrounding areas. The January turtles radiated out (185–1138 km) in distinct directions in contrast to the northward dispersal of the July turtles (27–396 km). Statistical results and vector plots supported that daily swimming persistence increased towards the end of tracks and near coastal regions, with turtles largely swimming in opposition to ocean currents. These results demonstrate that captive-reared juvenile greens have the ability to successfully navigate towards key coastal developmental habitats. Differences in dispersal (January vs. July) further support the importance of release timing and location. Our results inform conservation of the recovering Caymanian green turtles and we advise on how our methods can be improved and modified for future sea turtle and juvenile movement ecology studies.

Transcriptomic Features of Cribriform and Intraductal Carcinoma of the Prostate

BACKGROUND

Cribriform (CF) and/or intraductal carcinoma (IDC) are associated with more aggressive prostate cancer (CaP) and worse outcomes.

OBJECTIVE

The transcriptomic features that typify CF/IDC are not well described and the capacity for clinically utilized genomic classifiers to improve risk modeling for CF/IDC remains undefined.

DESIGN, SETTING, AND PARTICIPANTS

We performed a retrospective review of CaP patients who had Decipher testing at a single high-volume institution. Index lesions from radical prostatectomy specimens were identified by genitourinary pathologists who simultaneously reviewed prostatectomy specimens for the presence of CF and IDC features. Patients were grouped based on pathologic features, specifically the absence of CF/IDC (CF-/IDC-), CF positive only (CF+/IDC-), and CF/IDC positive (CF+/IDC+).

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Clinical, pathologic, and genomic categorical variables were assessed using the Pearson chi-square test, while quantitative variables were assessed with the Kruskal-Wallis test. Multivariable logistic regression was used to identify the predictors of high-risk Decipher scores (>0.60). A gene set enrichment analysis was performed to identify genes and gene networks associated with CF/IDC status.

RESULTS AND LIMITATIONS

A total of 463 patients were included. Patients who were CF+/IDC+ had the highest Decipher risk scores (CF+/IDC+: 0.79 vs CF+/IDC-: 0.71 vs CF-/IDC-: 0.56, p < 0.001). On multivariate logistic regression, predictors of high-risk Decipher scores included the presence of CF, both alone (CF+/IDC-; odds ratio [OR]: 5.45, p < 0.001) or in combination with positive IDC status (CF+/IDC+; OR: 6.87, p < 0.001). On the gene set enrichment analysis, MYC pathway upregulation was significantly enriched in tumor samples from CF/IDC-positive patients (normalized enrichment score [NES]: 1.65, p = 0.046). Other enriched pathways included E2F targets (NES: 1.69, p = 0.031) and oxidative phosphorylation (NES: 1.68, =0 .033).

CONCLUSIONS

This is the largest series identifying an association between a clinically validated genomic classifier and the presence of CF and IDC at radical prostatectomy. Tumors with CF and intraductal features were associated with aggressive transcriptomic signatures.

PATIENT SUMMARY

Genomic-based tests are becoming readily available for the management of prostate cancer. We observed that Decipher, a commonly used genomic test in prostate cancer, correlates with unfavorable features in tissue specimens.

Bendamustine is safe and effective for lymphodepletion before tisagenlecleucel in patients with refractory or relapsed large B-cell lymphomas

BACKGROUND

Anti-CD19 chimeric antigen receptor T-cell immunotherapy (CAR-T) is now a standard treatment of relapsed or refractory B-cell non-Hodgkin lymphomas; however, a significant portion of patients do not respond to CAR-T and/or experience toxicities. Lymphodepleting chemotherapy is a critical component of CAR-T that enhances CAR-T-cell engraftment, expansion, cytotoxicity, and persistence. We hypothesized that the lymphodepletion regimen might affect the safety and efficacy of CAR-T.

PATIENTS AND METHODS

We compared the safety and efficacy of lymphodepletion using either fludarabine/cyclophosphamide (n = 42) or bendamustine (n = 90) before tisagenlecleucel in two cohorts of patients with relapsed or refractory large B-cell lymphomas treated consecutively at three academic institutions in the United States (University of Pennsylvania, n = 90; Oregon Health & Science University, n = 35) and Europe (University of Vienna, n = 7). Response was assessed using the Lugano 2014 criteria and toxicities were assessed by the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 and, when possible, the American Society for Transplantation and Cellular Therapy (ASTCT) consensus grading.

RESULTS

Fludarabine/cyclophosphamide led to more profound lymphocytopenia after tisagenlecleucel infusion compared with bendamustine, although the efficacy of tisagenlecleucel was similar between the two groups. We observed significant differences, however, in the frequency and severity of adverse events. In particular, patients treated with bendamustine had lower rates of cytokine release syndrome and neurotoxicity. In addition, higher rates of hematological toxicities were observed in patients receiving fludarabine/cyclophosphamide. Bendamustine-treated patients had higher nadir neutrophil counts, hemoglobin levels, and platelet counts, as well as a shorter time to blood count recovery, and received fewer platelet and red cell transfusions. Fewer episodes of infection, neutropenic fever, and post-infusion hospitalization were observed in the bendamustine cohort compared with patients receiving fludarabine/cyclophosphamide.

CONCLUSIONS

Bendamustine for lymphodepletion before tisagenlecleucel has efficacy similar to fludarabine/cyclophosphamide with reduced toxicities, including cytokine release syndrome, neurotoxicity, infectious and hematological toxicities, as well as reduced hospital utilization.

Clinical utility of histopathology data: urological cancers

Cancer datasets recommend standardised reporting of histopathological data items with elements categorised as either core (required) or non-core (recommended), irrespective of the clinical scenario. However, the clinical significance of a data item in an individual case would depend on the clinicopathological setting as well as local management guidelines. A data item that is critical for patient management in one clinical scenario may be largely irrelevant in another patient. Pathologists must understand how their data are used in clinical practice so that they can focus their limited resources appropriately. We briefly review the use of histopathological data in the management of urological cancers, highlighting scenarios where a data item may be of limited clinical utility.

A genomic classifier for prostate cancer correlates with adverse pathologic features: Transcriptomic features of cribriform and intraductal carcinoma of the prostate

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Background: Invasive cribriform and intraductal carcinoma (CF/IDC) portends an unfavorable prognosis for patients diagnosed with prostate cancer (CaP). Limited studies with small sample sizes have explored whether genomic classifiers are associated with IDC and/or CF status. We investigated the correlation between Decipher genomic risk score and IDC/CF status and assessed PCa transcriptomic features. Methods: We performed a retrospective review of CaP patients who had Decipher testing at a single high volume center between 2009-2020. The highest grade index lesion from radical prostatectomy specimens was identified by GU pathologists and used for Decipher testing. Genitourinary pathologists reviewed prostatectomy specimens for the presence of CF and IDC features. Patients were divided into three groups based on pathologic features, absent CF/IDC (CF-/IDC-), CF positive only (CF+/IDC-), and CF/IDC positive (CF+/IDC+). Categorical clinical, genomic, and pathologic variables were assessed using the Pearson Chi-Square test, quantitative with the Kruskal-Wallis test. Multivariable logistic regression was used to identify predictors of high-risk Decipher GC scores. The Kaplan-Meier method with log-rank was used to compare biochemical recurrence free survival. Differential gene expression and gene network analysis was used to identify genes and pathways associated with IDC/CF features. Results: 463 patients were included with a median follow-up of 25 months. Patients who were CF+/IDC+ had higher GC scores (CF+/IDC+: 0.77 vs. CF+/IDC-: 0.71 vs. CF-/IDC-: 0.61, p<0.001). Patients who were CF+/IDC+ had a higher percentage of Gleason grade group >3 (CF+/IDC+: 79% vs. CF+/IDC-: 52% vs. CF-/IDC-: 52%, p<0.001). On multivariate logistic regression, predictors of high-risk GC score were presence of CF+/IDC+ features on final pathology (OR: 3.94, p<0.001) and pathologic Gleason grade group >3 (OR: 1.58, p=0.04). Transcriptomic analysis revealed that the hallmark androgen response pathway was significantly upregulated in CF+/IDC+ patients (Log fold change: 15.7, p<0001). Conclusions: This is the largest series investigating the association of a clinically validated genomic classifier and pathologic features such as cribriform and intraductal carcinoma. These findings have implications for the use of genomic classifiers in settings where expert GU pathology is not readily available and in potentially unmasking adverse histology at the time of biopsy.[Table: see text]

Case of renal cell carcinoma with immunotherapy effect mimicking xanthogranulomatous pyelonephritis

Introduction/Objective

The histologic features of renal cell carcinoma (RCC) after immunotherapy are not fully established. We report the pathologic findings of one case of clear cell RCC after treatment with pembrolizumab which is a humanized monoclonal anti-PD1 antibody.

Methods/Case Report

46-year-old man completed three cycles of pembrolizumab for recurrent basal cell carcinoma. A 5.0 cm mass was incidentally found within left kidney during staging CT scan. He subsequently had left radical nephrectomy. Pathologic examination of nephrectomy specimen identified one 5.0 cm, well-circumscribed, solid mass in the upper pole, confined to the kidney with predominantly hemorrhagic, focally golden-yellow soft cut surface. The remaining parenchyma appears unremarkable. The pelvicalyceal system is not dilated. Sections of tumor show predominance of foamy histiocytes, lymphoplasmacytic infiltrate, and scattered cells having pale or eosinophilic cytoplasm, conspicuous nucleoli and low nuclear: cytoplasm ratio. Cholesterol clefts and hemosiderin deposits are noted. The immunostaining profile highlights areas suspicious for viable tumor cells by using pan-keratin, CK8/18, EMA, CA9 and CD10. Focal positivity in the same area is noted by the stains of PAX 8 and AMACR. However, with numerous histiocytes, it is difficult to determine if the tumor cells are positive for Vimentin. Moreover CD 117 is negative in the tumor cells.

Results (if a Case Study enter NA)

NA

Conclusion

Differential diagnosis includes renal cell carcinoma and xanthogranulomatous pyelonephritis. The overall findings support a clear cell RCC affected by the immunotherapy. With immunotherapy-based combinations becoming standard of care in advanced malignancies, it makes the pathological diagnosis more challenging and difficult, especially for incidental tumors.

Growth and differentiation factor 15 and NF-κB expression in benign prostatic biopsies and risk of subsequent prostate cancer detection

Growth and differentiation factor 15 (GDF‐15), also known as macrophage inhibitory cytokine 1 (MIC‐1), may act as both a tumor suppressor and promotor and, by regulating NF‐κB and macrophage signaling, promote early prostate carcinogenesis. To determine whether expression of these two inflammation‐related proteins affect prostate cancer susceptibility, dual immunostaining of benign prostate biopsies for GDF‐15 and NF‐κB was done in a study of 503 case‐control pairs matched on date, age, and race, nested within a historical cohort of 10,478 men. GDF‐15 and NF‐κB expression levels were positively correlated (r = 0.39; p < 0.0001), and both were significantly lower in African American (AA) compared with White men. In adjusted models that included both markers, the odds ratio (OR) for NF‐κB expression was statistically significant, OR =0.87; p = 0.03; 95% confidence interval (CI) =0.77–0.99, while GDF‐15 expression was associated with a nominally increased risk, OR =1.06; p = 0.27; 95% CI =0.96–1.17. When modeling expression levels by quartiles, the highest quartile of NF‐κB expression was associated with almost a fifty percent reduction in prostate cancer risk (OR =0.51; p = 0.03; 95% CI =0.29–0.92). In stratified models, NF‐κB had the strongest negative association with prostate cancer in non‐aggressive cases (p = 0.03), older men (p = 0.03), and in case‐control pairs with longer follow‐up (p = 0.02). Risk associated with GDF‐15 expression was best fit using nonlinear regression modeling where both first (p = 0.02) and second (p = 0.03) order GDF‐15 risk terms were associated with significantly increased risk. This modeling approach also revealed significantly increased risk associated with GDF‐15 expression for subsamples defined by AA race, aggressive disease, younger age, and in case‐control pairs with longer follow‐up. Therefore, although positively correlated in benign prostatic biopsies, NF‐κB and GDF‐15 expression appear to exert opposite effects on risk of prostate tumor development.

Studies of Charm Quark Diffusion inside Jets Using Pb-Pb and pp Collisions at sqrt[s_{NN}]=5.02 TeV

The first study of charm quark diffusion with respect to the jet axis in heavy ion collisions is presented. The measurement is performed using jets with p_{T}^{jet}>60  GeV/c and D^{0} mesons with p_{T}^{D}>4  GeV/c in lead-lead (Pb-Pb) and proton-proton (pp) collisions at a nucleon-nucleon center-of-mass energy of sqrt[s_{NN}]=5.02  TeV, recorded by the CMS detector at the LHC. The radial distribution of D^{0} mesons with respect to the jet axis is sensitive to the production mechanisms of the meson, as well as to the energy loss and diffusion processes undergone by its parent parton inside the strongly interacting medium produced in Pb-Pb collisions. When compared to Monte Carlo event generators, the radial distribution in pp collisions is found to be well described by pythia, while the slope of the distribution predicted by sherpa is steeper than that of the data. In Pb-Pb collisions, compared to the pp results, the D^{0} meson distribution for 4<p_{T}^{D}<20  GeV/c hints at a larger distance on average with respect to the jet axis, reflecting a diffusion of charm quarks in the medium created in heavy ion collisions. At higher p_{T}^{D}, the Pb-Pb and pp radial distributions are found to be similar.

Abstract A113: Comprehensive molecular mapping of prostate cancer- Approaching health disparities in molecular tumor heterogeneity perspective

Prostate cancer (PCa) is a heterogeneous disease and the diverse clinical outcomes may be associated with hitherto unidentified tumor molecular heterogeneity. In the era of precision medicine, new approaches to identify distinct molecular subsets of tumors may lead to the development of targeted treatment options. Given the disparity in the disease progression between African American (AA) and Caucasian American (CA) patients, understanding the existence of distinct molecular subtypes between the two racial groups may facilitate effective cancer management. Therefore, we carried out a comprehensive molecular analysis using prostate cancer-specific molecular markers, including ERG, ETV1, ETV4, ETV4, ETV5 and SPINK1, to study tumor molecular heterogeneity in a large cohort of AA and CA PCa patients. A total of 1,117 PCa cases comprising 575 (52%) CA and 453 (41%) AA patients were included in this study. Dual IHC for ERG/SPINK1 and RNA ISH for ETV1, ETV4 and ETV5 were carried out on whole mount prostatectomy specimens. Incidence of markers in each tumor foci, difference between the two racial groups, and the association of the markers with the clinical and pathologic findings in each racial group were analyzed. Independent clonal origin of tumor foci in patients with multifocal disease were observed with the presence of dual and triple marker positivity in dominant and/or secondary tumor foci. ERG was more frequently overexpressed among CA patients (P=0.0000) while SPINK1 was more prevalent among AA patients (P=0.0000). The incidence of dual marker positive cases for ERG+/SPINK1+ and SPINK1+/ETV1+ were more prevalent among AA patients than CA patients (P=0.0124 and P=0.0417, respectively). In both CA and AA patients, ERG overexpression is associated with young men age lower than 50 and a positive perineural invasion,(CA; P=0.0037 and P=0.0199, respectively; AA; P= 0.0338 and P=0.0309, respectively). Among CA patients, ERG overexpression also associated with a lower Gleason grade group (group 1 and 2, P=0.0483). SPINK1 overexpression associated with grade group lower than 5 and a negative family history among AA patients (P=0.0003 and P=0.0063). In CA patients, SPINK1 overexpression associated with grade group higher than 1, pT3 stage and tumor volume larger than 10% (P= 0.0036, P=0.0426 and P=0.0377, respectively). ETV1 overexpression is associated with positive family history (P=0.0043) and ETV4 overexpression associated with a tumor volume of 1-10% (P=0.0385) in CA patients. In AA patients, ETV4 expression associated with an age higher than 70 (P=0.0212). ERG/SPINK1 overexpression associated with grade group 2, tumor volume of 10-20%, and an age lower than 70 among CA patients (P=0.0013, P=0.0316, and P=0.0191, respectively). AA patients, on the other hand, showed an association between ERG/SPINK1 and age group lower than 40 (P=0.0092). We will discuss the details on the identification of new molecular subsets of PCa with clonal molecular heterogeneity in racial disparity perspective.

Citation Format: Shannon Carskadon, Mireya Diaz-Insua, Nilesh Gupta, Sean Williamson, Craig Rogers, James Peabody, Mani Menon, Nallasivam Palanisamy. Comprehensive molecular mapping of prostate cancer- Approaching health disparities in molecular tumor heterogeneity perspective [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A113.

The effect of multiplicity of PI-RADS 3 lesions on cancer detection rate of confirmatory targeted biopsy in patients diagnosed with prostate cancer and managed with active surveillance

BACKGROUND AND OBJECTIVE

To determine the effect of multiplicity of prostate imaging reporting and data system assessment category 3 (PI-RADS 3) lesions on cancer detection rate (CDR) of confirmatory targeted biopsy of such lesion in patients diagnosed with prostate cancer and managed with active surveillance.

METHODS

This study was conducted at a single academic institution. There were 91 men with ≥ 1 PI-RADS 3 lesion detected through magnetic resonance imaging (MRI) after systematic prostate biopsy in the course of management of patients diagnosed with prostate cancer with active surveillance. We compared the CDRs based on targeted biopsy of PI-RADS 3 lesions that occurred (1) as solitary lesions, (2) as 1 of multiple PI-RADS 3 only lesions, or (3) with ≥ 1 higher grade lesion.

RESULTS

Median age was 65.0 years (interquartile range 59.5-70.0), median prostate specific antigen was 5.95 ng/ml (interquartile range 4.30-8.83), and median prostate specific antigen density was 0.161 ng/ml² (0.071-0.194). Forty-three men had solitary PI-RADS 3 lesions, 22 had multiple PI-RADS 3 only lesions, and 26 had multiple lesions with ≥ 1 higher grade lesion. The overall CDR (Gleason score ≥ 3 + 3) based on confirmatory MRI targeted biopsy in a given PI-RADS 3 lesion in each group was 23%, 45%, and 54%, respectively (P = 0.0274). The CDRs for clinically significant disease (Gleason score ≥ 3 + 4) were 16%, 32%, and 35%, respectively (P = 0.1701).

CONCLUSIONS

Coexisting lesions increase the CDR of confirmatory MRI targeted biopsy of PI-RADS 3 lesions in patients managed with active surveillance. Risk stratification algorithms for PI-RADS 3 lesion to guide biopsy and management decisions may consider including multiplicity of lesions.

Azimuthal separation in nearly back-to-back jet topologies in inclusive 2- and 3-jet events in pp collisions at s = 13 Te

A measurement for inclusive 2- and 3-jet events of the azimuthal correlation between the two jets with the largest transverse momenta, Δ ϕ 12 , is presented. The measurement considers events where the two leading jets are nearly collinear ("back-to-back") in the transverse plane and is performed for several ranges of the leading jet transverse momentum. Proton-proton collision data collected with the CMS experiment at a center-of-mass energy of 13 Te and corresponding to an integrated luminosity of 35.9 fb - 1 are used. Predictions based on calculations using matrix elements at leading-order and next-to-leading-order accuracy in perturbative quantum chromodynamics supplemented with leading-log parton showers and hadronization are generally in agreement with the measurements. Discrepancies between the measurement and theoretical predictions are as large as 15%, mainly in the region177 ∘ < Δ ϕ 12 < 180 ∘ . The 2- and 3-jet measurements are not simultaneously described by any of models.

Innovative playgrounds: use, physical activity, and implications for health

OBJECTIVES

The aim of the study is to assess the use and levels of moderate-to-vigorous physical activity (MVPA) occurring in innovative playgrounds in London vs. traditional playgrounds in the US in neighborhoods with a similar population density.

STUDY DESIGN

This is a cross-sectional observational study.

METHODS

We selected a sample of London playgrounds based on their innovative design. One group of eight playgrounds was matched to the US playgrounds by size and population density; a second group of very large London playgrounds was matched only by population density. Playground use and person-hours of MVPA were measured using direct observation at similar times of the day and days of the week in all locations.

RESULTS

The number of playground visit hours was 58% higher in London than in the US (394 vs 249). The matched London playgrounds had 37.8% more children and 129% more adults who were, respectively, engaging in 90% and 116% more MVPA. While the London playgrounds were nearly 8.5 times larger than the US ones, they attracted a total of 5.8 times more visitors (1399 vs 243, P < .0001), and this included 10 times as many adults (679 vs. 66, P < .0001) and 7.5 times more seniors (23 vs. 3). The London playgrounds included more amenities targeting adults.

CONCLUSIONS

The design of an innovative playground was associated with the amount of MVPA in similar-sized playgrounds, but the size of the playground was more strongly associated with the number of visitors. It is as important to design playgrounds for adults as it is for children to increase visit hours.

Measurement of exclusive ρ 770 0 photoproduction in ultraperipheral pPb collisions at s NN = 5.02 Te

Exclusiveρ 770 0 photoproduction is measured for the first time in ultraperipheral pPb collisions ats NN = 5.02 Te with the CMS detector. The cross section σ ( γ p → ρ 770 0 p ) is 11.0 ± 1.4 (stat) ± 1.0 (syst) μ b at ⟨ W γ p ⟩ = 92.6 Ge for photon-proton centre-of-mass energies W γ p between 29 and 213 Ge . The differential cross section d σ / d | t | is measured in the interval0.025 < | t | < 1 Ge 2 as a function of W γ p , where t is the squared four-momentum transfer at the proton vertex. The results are compared with previous measurements and theoretical predictions. The measured cross section σ ( γ p → ρ 770 0 p ) has a power-law dependence on the photon-proton centre-of-mass, consistent with electron-proton collision measurements performed at HERA. The W γ p dependence of the exponential slope of the differential cross section d σ / d | t | is also measured.

Atopic dermatitis in the elderly: a review of clinical and pathophysiological hallmarks

BACKGROUND

Atopic dermatitis (AD) is a multifactorial and complex disease, characterized by an impaired skin barrier function and abnormal immune response. Many elderly patients present with pruritus and xerosis to dermatology, allergy and primary care clinics, and there is a lack of information available to clinicians regarding the proper diagnosis and management of these patients. Although the elderly are described as having a distinct presentation of AD and important comorbidities, most investigations and clinical care guidelines pertaining to AD do not include patients aged 60 years and older as a separate group from younger adults.

OBJECTIVES

To summarize current information on pathophysiology, diagnosis and management of AD in the elderly population and identify areas of insufficient information to be explored in future investigations.

METHODS

We carried out a systematic review of published literature, which assessed changes in the skin barrier and immune function with ageing and current information available for physicians to use in the diagnosis and treatment of AD in elderly patients.

RESULTS

Many age-related changes overlap with key hallmarks observed in AD, most notably a decline in skin barrier function, dysregulation of the innate immune system, and skewing of adaptive immunity to a type-2 T helper cell response, in addition to increased Staphylococcus aureus infection.

CONCLUSIONS

While general physiological alterations with ageing overlap with key features of AD, a research gap exists regarding specific ageing-related changes in AD disease development. More knowledge about AD in the elderly is needed to establish firm diagnostic and treatment methodologies. What's already known about this topic? Atopic dermatitis (AD) is a common inflammatory skin disease that causes significant burden worldwide. Recently, elderly patients have been considered a subgroup of patients with distinct AD manifestation. Limited studies have characterized the clinical presentation and role of IgE-mediated allergy in elderly patients with AD. What does this study add? This review offers a summary of age-related skin and immune alterations that correspond to pathogenic changes noted in patients with AD. The role of itch, environmental factors and skin microbiota in AD disease presentation in ageing patients is explored.

Studies of Beauty Suppression via Nonprompt D^{0} Mesons in Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

The transverse momentum spectra of D^{0} mesons from b hadron decays are measured at midrapidity (|y|<1) in pp and Pb-Pb collisions at a nucleon-nucleon center of mass energy of 5.02 TeV with the CMS detector at the LHC. The D^{0} mesons from b hadron decays are distinguished from prompt D^{0} mesons by their decay topologies. In Pb-Pb collisions, the B→D^{0} yield is found to be suppressed in the measured p_{T} range from 2 to 100  GeV/c as compared to pp collisions. The suppression is weaker than that of prompt D^{0} mesons and charged hadrons for p_{T} around 10  GeV/c. While theoretical calculations incorporating partonic energy loss in the quark-gluon plasma can successfully describe the measured B→D^{0} suppression at higher p_{T}, the data show an indication of larger suppression than the model predictions in the range of 2<p_{T}<5  GeV/c.

Abstract 2337: Changes in GDF15 (growth/differentiation factor 15) expression and M2 macrophages during prostate carcinogenesis

GDF15 (growth/differentiation factor 15), also known as MIC-1 (Macrophage inhibitory cytokine 1), is a divergent member of the TGFβ superfamily of cytokines and is highly expressed in prostate tumors, but its role in prostate carcinogenesis and utility as a prognostic biomarker is unclear. We studied 91 prostate cancer cases that underwent surgery as their primary treatment and were then subsequently followed for biochemical recurrence (BCR). These cases also had a benign prostate biopsy at least one year before their prostate cancer diagnosis. In both the benign biopsy and tumor specimens, we quantified the intensity of GDF15 expression and characterized the presence of tumor associated macrophages by measuring the density of CD68-positive stained cells, and the M2 macrophage marker CD204 by immunohistochemical analysis. Marker expression was measured in prostate a) benign biopsy (BS), b) tumor-adjacent benign (BGS) and c) tumor tissue (MGS) using an automated multi-image processing macro developed in the ImageJ software. A Cox proportional hazards model was used to test the association of time to BCR of the low expression group compared with medium or high biomarker expression. The risk of BCR differed with the extent of GDF15 expression in the prostatic epithelial tissue of benign and tumor regions of the prostate. For instance, in BGS, high expression of GDF15 was associated with increased risk of BCR (hazard ratio (HR)=2.58, p=0.07). After controlling for PSA at diagnosis, Gleason grade and pathologic stage, high expression of GDF15 in BGS had a stronger association with BCR (HR=3.30, p=0.04). The risk of BCR increased with increasing level of infiltration of CD204/CD68 positive macrophages in BGS (HR=4.19, p=0.02) and MGS (HR=4.16, p=0.01) even after controlling for PSA at diagnosis, Gleason grade and pathologic stage. The combined expression levels of GDF15 and CD204/CD68 showed that prostate cancer cases with small GDF15 expression changes between BGS and MGS and high CD204/CD68 expression in BGS were at 3-fold higher risk of BCR (HR=3.67, p=0.05). In summary, expression levels of GDF15 and CD204 M2 macrophages in different regions of the prostate can change as the disease progresses from benign to a tumorigenic state and serve as markers for aggressive disease. Further evaluation of these dynamic differences in the prostate immune cellular profile in the pre-malignant and malignant state may offer additional insight into inflammatory-mediated prostate carcinogenesis.

Citation Format: Sudha M. Sadasivan, Yalei Chen, Nilesh Gupta, Sean Williamson, Dhananjay Chitale, Xiaoxia Han, Kevin Bobbitt, Andrew Rundle, Deliang Tang, Benjamin A. Rybicki. Changes in GDF15 (growth/differentiation factor 15) expression and M2 macrophages during prostate carcinogenesis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2337.

Abstract 915: Pseudogene-associated recurrent gene fusion in prostate cancer

Pseudogenes are a class of non-coding genes that are dysfunctional relatives of known functional genes. Often considered as junk DNA, pseudogenes have recently emerged as functional units in the form of non-coding RNA transcripts and micropeptides with regulatory roles in gene expression. Notably, association of some pseudogenes with oncogenes and tumor suppressor genes have been observed, indicating a possible role in cancer formation. Although many genetic aberrations in prostate cancer (PCa) have been identified, the expression of pseudogenes in PCa has not been well explored. We surveyed the transcriptional landscape of pseudogenes using next generation paired-end sequencing data and observed the formation of a recurrent gene fusion by trans-splicing event between a protein coding gene KLK4 and a noncoding pseudogene KLKP1 and its cognate fusion protein. RNA in situ analysis of 649 cases using tissue microarray identified high Gleason grade specific expression (&gt;6) in 24% of cases compared to benign, high grade prostate intraepithelial neoplasia and atypical lesions, confirming cancer specific expression and with significantly high expression in Caucasian American compared with African American PCa. Furthermore, KLK4-KLKP1 expression was seen to be associated with ERG+ and ETV1+ cases. However, no association was observed with SPINK1+, ETV4+ and ETV5+ tumors, suggesting mutually exclusive expression with distinct PCa markers. Using expression constructs transfected into RWPE, PrEc and HEK293 cells, we confirmed the expression of a ~15 KD KLK4-KLKP1 fusion protein. RT-PCR analysis of 33 PCa derived xenografts identified 15 with endogenous expression of KLK4-KLKP1 fusion transcript. We generated a polyclonal antibody using antigenic peptide from the pseudogene part of the fusion protein and confirmed its specificity by western blot analysis using cell lysates from RWPE, PrEc, HEK293 and PDX models with and without the fusion gene. Immunohistochemistry analysis also confirmed the specificity of the antibody to the fusion protein. To explore the oncogenic properties of KLK4-KLKP1, we analyzed the effects on cell proliferation and invasion using RWPE cells transfected with KLK4-KLKP1. Increased cell proliferation and invasion was observed and Chicken chorioallantoic membrane (CAM) assay also revealed increased cell migration to lower CAM suggesting a role for KLK4-KLKP1 in cancer development. Notably, KLK4-KLKP1 transcripts could be detected in urine samples obtained from PCa patients, indicating the potential for noninvasive detection for early diagnosis. Taken together, we showed the oncogenic role of a new recurrent gene fusion in prostate cancer. In conclusion, our study highlights the underexplored functional roles of pseudogenes and establishes KLK4-KLKP1 as a novel player in PCa development with potential uses as a biomarker and a therapeutic target.

Citation Format: Balabhadrapatruni V. S. K. Chakravarthi, Shanker Kalyana-Sundaram, Pavithra D. Arachchige, Shannon Carskadon, Satya S. Pathi, Mireya Diaz-Insua, Craig Rogers, James Peabody, Clara Hwang, Mani Menon, Sean Williamson, Gupta Nilesh, Sooryanarayana Varambally, Nallasivam Palanisamy. Pseudogene-associated recurrent gene fusion in prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 915.

Abstract 4693: Evaluation of prostate tumor molecular heterogeneity using whole mount radical prostatectomy by dual immunohistochemistry and dual RNA in situ hybridization

Prostate cancer (PCa) remains the second most common cancer among American men. Morphological heterogeneity in prostate cancer is well recognized, however, recent investigations revealed molecular heterogeneity with the existence of unique molecular aberrations among patient sub groups. Molecular heterogeneity may be associated with distinct routes of disease progression, thereby, enabling the use of molecular profiling to facilitate targeted therapy. Importantly, African Americans (AA) are known to develop more aggressive forms of PCa compared to Caucasian Americans (CA). Therefore, the identification of distinct molecular profiles between the two groups may lead to more precise treatment options for PCa patients. Given that a comprehensive molecular mapping, encompassing both AA and CA patients is lacking, we carried out an extensive profiling of multiple molecular markers in a large cohort of AA and CA PCa patients. Whole-mounted post-prostatectomy tissues were obtained from 1117 patients who underwent radical prostatectomy surgery at our institute. The selected cases included 575 (52%) CA and 453 (41%) AA patients. The presence of ERG, SPINK1, ETV1, ETV4 and ETV5 was evaluated using dual IHC and dual RNA ISH. The racial disparity in the molecular marker incidence was analyzed. The incidence of ERG was observed in 52.0% (436/839) of cases while SPINK1 incidence occurred in 45.1% (378/838) cases. The incidence of other ERG family rearrangements, ETV1, ETV4 and ETV5 was low with 9.9% (78/791), 3.8 % (28/733) and 0.6% (2/350) cases respectively. A total of 260 cases showed the incidence of multiple markers on a single prostate. Of these, ERG+/SPINK1+ was prominent with an incidence of 18% (151/838), followed by ERG+/ETV1+ which occurred in 5.2% cases (41/790). In most cases, multiple marker incidence was detected in separate foci, supporting the independent clonal origin of tumor foci in patients with multi focal disease. In a subset of cases, the co-occurrence of ERG and SPINK1 in the same foci was observed, suggesting intra tumor heterogeneity, however, in majority of the cases mutually exclusive pattern of expression was observed, indicating the presence of unique driver molecular aberrations in each tumor foci.. Statistical analysis revealed significant incidence of ERG+ in CA (P=0.00) and SPINK1 in AA patients (P=0.00). Additionally, the incidence of ERG/SPINK1 and SPINK1/ETV1 were more frequent among AA patients compared to CA patients (P=0.0124 and P=0.0417). In conclusion, our study highlights the existence of significant molecular heterogeneity among PCa patients in a racially disparate perspective. Consequently, a thorough understanding of the clinical association between distinct molecular sub groups and disease progression in each racial group will significantly aid the treatment efforts in combatting PCa disease.

Citation Format: Pavithra D. Arachchige, Shannon Carskadon, Gaury Dhamdhere, Mireya Diaz-Insua, Hans Stricker, Craig Rogers, James Peabody, Mani Menon, Sean Williamson, Nilesh Gupta, Nallasivam Palanisamy. Evaluation of prostate tumor molecular heterogeneity using whole mount radical prostatectomy by dual immunohistochemistry and dual RNA in situ hybridization [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4693.

Abstract 4688: Evaluation of tumor heterogeneity in prostate biopsy samples

Prostate cancer (PCa) is the second most common cancer among men with more than 25,000 deaths each year. A significant number of PCa patients are known to present with multifocal disease characterized by the presence of more than one tumor nodule. Currently, management decisions for active surveillance are made based on the Gleason grade, tumor stage and volume on initial prostate biopsies. Although morphological heterogeneity has been well recognized, recent studies have revealed that PCa is a heterogeneous disease at the molecular level as well. Importantly, some molecular aberrations have been associated with aggressive disease and clinical outcomes, suggesting that tumor heterogeneity may be a determining factor in the success of active surveillance and other PCa management options. Therefore, we evaluated the incidence of several molecular markers on prostate biopsy samples to understand tumor molecular heterogeneity among PCa cases. A total of 626 biopsy cores were collected from 130 consecutive patients undergoing either standard or double sextant biopsies from July to October 2016 at our institute. Selected cores included benign (n=13), high grade intraepithelial neoplasia (HGPIN, n=124), atypical/ASAP (n=33) and Gleason grade 6-9 tissues (n=447). Of the 626, 119 cores included discontinuous (intervening benign tissue) tumor foci. The presence of the molecular markers, ERG, SPINK1, ETV1 and ETV4 was simultaneously evaluated using a novel, combined approach by dual Immunohistochemistry and RNA in situ hybridization. A total of 281 cores (44.9%) were positive for at least one molecular marker. Of these, ERG+ was more prominent (22.0%), followed by SPINK1+ (14.1%). The incidence of ETV1+ and ETV4+ was low (4.5% and 2.1%, respectively). 253 biopsy cores (56.6%) with Gleason 6-9 cancer were positive for at least one marker. Notably, only 12 cores (9.7%) of HGPIN were positive for any one of the markers while all benign cores were negative. Of note, 13 atypical/ASAP cores (39.4%) were positive for at least one marker, suggesting the potential use of molecular analysis to eliminate ambiguities associated with the diagnosis of cancer in atypical lesions. Of the 119 cores with discontinuous tumor foci, 14 (11.7%) dual marker positive with discordant marker status in each foci. Additionally, 99 cores (83.2%) showed the presence of a single marker either in one or both foci, further emphasizing the independent clonal origin and the presence of distinct driver molecular aberrations in different tumor foci in a subset of PCa cases. Finally, 345 of the 626 cores (55.1%) were negative for all the tested molecular markers indicating hitherto unidentified driver molecular aberrations. In conclusion, our study highlights the presence of significant tumor molecular heterogeneity identified in biopsy samples and emphasizes the importance of considering all tumor nodules in multi focal disease in making clinical decision on active surveillance.

Citation Format: Pavithra D. Arachchige, Shannon Carskadon, Gaury Dhamdhere, Mireya Diaz-Insua, Rogers Craig, James Peabody, Mani Menon, Sean Williamson, Nilseh Gupta, Nallasivam Palanisamy. Evaluation of tumor heterogeneity in prostate biopsy samples [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4688.

Combined measurements of Higgs boson couplings in proton-proton collisions at s = 13 Te

Combined measurements of the production and decay rates of the Higgs boson, as well as its couplings to vector bosons and fermions, are presented. The analysis uses the LHC proton-proton collision data set recorded with the CMS detector in 2016 ats = 13 Te , corresponding to an integrated luminosity of 35.9fb - 1 . The combination is based on analyses targeting the five main Higgs boson production mechanisms (gluon fusion, vector boson fusion, and associated production with a W or Z boson, or a top quark-antiquark pair) and the following decay modes: H → γ γ , Z Z , W W , τ τ , b b , and μ μ . Searches for invisible Higgs boson decays are also considered. The best-fit ratio of the signal yield to the standard model expectation is measured to be μ = 1.17 ± 0.10 , assuming a Higgs boson mass of 125.09 Ge . Additional results are given for various assumptions on the scaling behavior of the production and decay modes, including generic parametrizations based on ratios of cross sections and branching fractions or couplings. The results are compatible with the standard model predictions in all parametrizations considered. In addition, constraints are placed on various two Higgs doublet models.

Jet Shapes of Isolated Photon-Tagged Jets in Pb-Pb and pp Collisions at sqrt[s_{NN}]=5.02 TeV

The modification of jet shapes in Pb-Pb collisions, relative to those in pp collisions, is studied for jets associated with an isolated photon. The data were collected with the CMS detector at the LHC at a nucleon-nucleon center-of-mass energy of 5.02 TeV. Jet shapes are constructed from charged particles with track transverse momenta (p_{T}) above 1  GeV/c in annuli around the axes of jets with p_{T}^{jet}>30  GeV/c associated with an isolated photon with p_{T}^{γ}>60  GeV/c. The jet shape distributions are consistent between peripheral Pb-Pb and pp collisions, but are modified for more central Pb-Pb collisions. In these central Pb-Pb events, a larger fraction of the jet momentum is observed at larger distances from the jet axis compared to pp, reflecting the interaction between the partonic medium created in heavy ion collisions and the traversing partons.

Measurement of exclusive Υ photoproduction from protons in p Pb collisions at s NN = 5.02 TeV

The exclusive photoproduction of Υ ( nS ) meson states from protons, γ p → Υ ( nS ) p (with n = 1 , 2 , 3 ), is studied in ultraperipheral p Pb collisions at a centre-of-mass energy per nucleon pair ofs NN = 5.02 TeV . The measurement is performed using the Υ ( nS ) → μ + μ - decay mode, with data collected by the CMS experiment corresponding to an integrated luminosity of 32.6nb - 1 . Differential cross sections as functions of the Υ ( nS ) transverse momentum squared p T 2 , and rapidity y, are presented. The Υ ( 1 S ) photoproduction cross section is extracted in the rapidity range | y | < 2.2 , which corresponds to photon-proton centre-of-mass energies in the range 91 < W γ p < 826 GeV . The data are compared to theoretical predictions based on perturbative quantum chromodynamics and to previous measurements.

Measurement of associated production of a W boson and a charm quark in proton-proton collisions at s = 13 Te

Measurements are presented of associated production of a W boson and a charm quark ( W + c ) in proton-proton collisions at a center-of-mass energy of 13Te . The data correspond to an integrated luminosity of 35.7fb - 1 collected by the CMS experiment at the CERN LHC. The W bosons are identified by their decay into a muon and a neutrino. The charm quarks are tagged via the full reconstruction ofD ∗ ( 2010 ) ± mesons that decay viaD ∗ ( 2010 ) ± → D 0 + π ± → K ∓ + π ± + π ± . A cross section is measured in the fiducial region defined by the muon transverse momentump T μ > 26 Ge , muon pseudorapidity| η μ | < 2.4 , and charm quark transverse momentump T c > 5 Ge . The inclusive cross section for this kinematic range is σ ( W + c ) = 1026 ± 31 (stat) + 76 - 72 (syst) pb . The cross section is also measured differentially as a function of the pseudorapidity of the muon from the W boson decay. These measurements are compared with theoretical predictions and are used to probe the strange quark content of the proton.

Search for Narrow Hγ Resonances in Proton-Proton Collisions at sqrt[s]=13 TeV

A search for heavy, narrow resonances decaying to a Higgs boson and a photon (Hγ) has been performed in proton-proton collision data at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9  fb^{-1} collected with the CMS detector at the LHC in 2016. Events containing a photon and a Lorentz-boosted hadronically decaying Higgs boson reconstructed as a single, large-radius jet are considered, and the γ+jet invariant mass spectrum is analyzed for the presence of narrow resonances. To increase the sensitivity of the search, events are categorized depending on whether or not the large-radius jet can be identified as a result of the merging of two jets originating from b quarks. Results in both categories are found to agree with the predictions of the standard model. Upper limits on the production rate of Hγ resonances are set as a function of their mass in the range of 720-3250 GeV, representing the most stringent constraints to date.

Study of the underlying event in top quark pair production in p p collisions at 13 Te

Measurements of normalized differential cross sections as functions of the multiplicity and kinematic variables of charged-particle tracks from the underlying event in top quark and antiquark pair production are presented. The measurements are performed in proton-proton collisions at a center-of-mass energy of 13 Te , and are based on data collected by the CMS experiment at the LHC in 2016 corresponding to an integrated luminosity of 35.9 fb - 1 . Events containing one electron, one muon, and two jets from the hadronization and fragmentation of b quarks are used. These measurements characterize, for the first time, properties of the underlying event in top quark pair production and show no deviation from the universality hypothesis at energy scales typically above twice the top quark mass.

Search for rare decays of Z and Higgs bosons to J / ψ and a photon in proton-proton collisions at s = 13 TeV

A search is presented for decays of Z and Higgs bosons to a J / ψ meson and a photon, with the subsequent decay of the J / ψ toμ + μ - . The analysis uses data from proton-proton collisions with an integrated luminosity of 35.9fb - 1 ats = 13 TeV collected with the CMS detector at the LHC. The observed limit on the Z → J / ψ γ decay branching fraction, assuming that the J / ψ meson is produced unpolarized, is 1.4 × 10 - 6 at 95% confidence level, which corresponds to a rate higher than expected in the standard model by a factor of 15. For extreme-polarization scenarios, the observed limit changes from - 13.6 to + 8.6 % with respect to the unpolarized scenario. The observed upper limit on the branching fraction for H → J / ψ γ where the J / ψ meson is assumed to be transversely polarized is 7.6 × 10 - 4 , a factor of 260 larger than the standard model prediction. The results for the Higgs boson are combined with previous data from proton-proton collisions ats = 8 TeV to produce an observed upper limit on the branching fraction for H → J / ψ γ that is a factor of 220 larger than the standard model value.

Search for the Higgs Boson Decaying to Two Muons in Proton-Proton Collisions at sqrt[s]=13 TeV

A search for the Higgs boson decaying to two oppositely charged muons is presented using data recorded by the CMS experiment at the CERN LHC in 2016 at a center-of-mass energy sqrt[s]=13  TeV, corresponding to an integrated luminosity of 35.9  fb^{-1}. Data are found to be compatible with the predicted background. For a Higgs boson with a mass of 125.09 GeV, the 95% confidence level observed (background-only expected) upper limit on the production cross section times the branching fraction to a pair of muons is found to be 3.0 (2.5) times the standard model expectation. In combination with data recorded at center-of-mass energies sqrt[s]=7 and 8 TeV, the background-only expected upper limit improves to 2.2 times the standard model value with a standard model expected significance of 1.0 standard deviation. The corresponding observed upper limit is 2.9 with an observed significance of 0.9 standard deviation. This corresponds to an observed upper limit on the standard model Higgs boson branching fraction to muons of 6.4×10^{-4} and to an observed signal strength of 1.0±1.0(stat)±0.1(syst).

Search for Dark Matter Particles Produced in Association with a Top Quark Pair at sqrt[s]=13 TeV

A search is performed for dark matter particles produced in association with a top quark pair in proton-proton collisions at sqrt[s]=13  TeV. The data correspond to an integrated luminosity of 35.9  fb^{-1} recorded by the CMS detector at the LHC. No significant excess over the standard model expectation is observed. The results are interpreted using simplified models of dark matter production via spin-0 mediators that couple to dark matter particles and to standard model quarks, providing constraints on the coupling strength between the mediator and the quarks. These are the most stringent collider limits to date for scalar mediators, and the most stringent for pseudoscalar mediators at low masses.

Measurement of differential cross sections for inclusive isolated-photon and photon+jet production in proton-proton collisions at s = 13 TeV

Measurements of inclusive isolated-photon and photon+jet production in proton-proton collisions ats = 13 TeV are presented. The analysis uses data collected by the CMS experiment in 2015, corresponding to an integrated luminosity of 2.26fb - 1 . The cross section for inclusive isolated photon production is measured as a function of the photon transverse energy in a fiducial region. The cross section for photon+jet production is measured as a function of the photon transverse energy in the same fiducial region with identical photon requirements and with the highest transverse momentum jet. All measurements are in agreement with predictions from next-to-leading-order perturbative QCD.

Observation of Medium-Induced Modifications of Jet Fragmentation in Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV Using Isolated Photon-Tagged Jets

Measurements of fragmentation functions for jets associated with an isolated photon are presented for the first time in pp and Pb-Pb collisions. The analysis uses data collected with the CMS detector at the CERN LHC at a nucleon-nucleon center-of-mass energy of 5.02 TeV. Fragmentation functions are obtained for jets with p_{T}^{jet}>30  GeV/c in events containing an isolated photon with p_{T}^{γ}>60  GeV/c, using charged tracks with transverse momentum p_{T}^{trk}>1  GeV/c in a cone around the jet axis. The association with an isolated photon constrains the initial p_{T} and azimuthal angle of the parton whose shower produced the jet. For central Pb-Pb collisions, modifications of the jet fragmentation functions are observed when compared to those measured in pp collisions, while no significant differences are found in the 50% most peripheral collisions. Jets in central Pb-Pb events show an excess (depletion) of low (high) p_{T} particles, with a transition around 3  GeV/c. This measurement shows for the first time the in-medium shower modifications of partons (quark dominated) with well-defined initial kinematics. It constitutes a new well-controlled reference for testing theoretical models of the parton passage through the quark-gluon plasma.

Search for Leptoquarks Coupled to Third-Generation Quarks in Proton-Proton Collisions at sqrt[s]=13 TeV

Three of the most significant measured deviations from standard model predictions, the enhanced decay rate for B→D^{(*)}τν, hints of lepton universality violation in B→K^{(*)}ℓℓ decays, and the anomalous magnetic moment of the muon, can be explained by the existence of leptoquarks (LQs) with large couplings to third-generation quarks and masses at the TeV scale. The existence of these states can be probed at the LHC in high energy proton-proton collisions. A novel search is presented for pair production of LQs coupled to a top quark and a muon using data at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9  fb^{-1}, recorded by the CMS experiment. No deviation from the standard model prediction has been observed and scalar LQs decaying exclusively into tμ are excluded up to masses of 1420 GeV. The results of this search are combined with those from previous searches for LQ decays into tτ and bν, which excluded scalar LQs below masses of 900 and 1080 GeV. Vector LQs are excluded up to masses of 1190 GeV for all possible combinations of branching fractions to tμ, tτ and bν. With this analysis, all relevant couplings of LQs with an electric charge of -1/3 to third-generation quarks are probed for the first time.

Evidence for the Associated Production of a Single Top Quark and a Photon in Proton-Proton Collisions at sqrt[s]=13 TeV

The first evidence of events consistent with the production of a single top quark in association with a photon is reported. The analysis is based on proton-proton collisions at sqrt[s]=13  TeV and recorded by the CMS experiment in 2016, corresponding to an integrated luminosity of 35.9  fb^{-1}. Events are selected by requiring the presence of a muon (μ), a photon (γ), an imbalance in transverse momentum from an undetected neutrino (ν), and at least two jets (j) of which exactly one is identified as associated with the hadronization of a b quark. A multivariate discriminant based on topological and kinematic event properties is employed to separate signal from background processes. An excess above the background-only hypothesis is observed, with a significance of 4.4 standard deviations. A fiducial cross section is measured for isolated photons with transverse momentum greater than 25 GeV in the central region of the detector. The measured product of the cross section and branching fraction is σ(pp→tγj)B(t→μνb)=115±17(stat)±30(syst)  fb, which is consistent with the standard model prediction.

Measurement of differential cross sections for Z boson production in association with jets in proton-proton collisions at s = 13 TeV

The production of a Z boson, decaying to two charged leptons, in association with jets in proton-proton collisions at a centre-of-mass energy of 13TeV is measured. Data recorded with the CMS detector at the LHC are used that correspond to an integrated luminosity of 2.19fb -1 . The cross section is measured as a function of the jet multiplicity and its dependence on the transverse momentum of the Z boson, the jet kinematic variables (transverse momentum and rapidity), the scalar sum of the jet momenta, which quantifies the hadronic activity, and the balance in transverse momentum between the reconstructed jet recoil and the Z boson. The measurements are compared with predictions from four different calculations. The first two merge matrix elements with different parton multiplicities in the final state and parton showering, one of which includes one-loop corrections. The third is a fixed-order calculation with next-to-next-to-leading order accuracy for the process with a Z boson and one parton in the final state. The fourth combines the fully differential next-to-next-to-leading order calculation of the process with no parton in the final state with next-to-next-to-leading logarithm resummation and parton showering.

Studies of B s 2 ∗ ( 5840 ) 0 and B s 1 ( 5830 ) 0 mesons including the observation of the B s 2 ∗ ( 5840 ) 0 → B 0 K S 0 decay in proton-proton collisions at s = 8 TeV

Measurements ofB s 2 ∗ ( 5840 ) 0 andB s 1 ( 5830 ) 0 mesons are performed using a data sample of proton-proton collisions corresponding to an integrated luminosity of , collected with the CMS detector at the LHC at a centre-of-mass energy of 8 TeV . The analysis studies P-waveB s 0 meson decays intoB ( ∗ ) + K - andB ( ∗ ) 0 K S 0 , where theB + andB 0 mesons are identified using the decaysB + → J / ψ K + andB 0 → J / ψ K ∗ ( 892 ) 0 . The masses of the P-waveB s 0 meson states are measured and the natural width of theB s 2 ∗ ( 5840 ) 0 state is determined. The first measurement of the mass difference between the charged and neutralB ∗ mesons is also presented. TheB s 2 ∗ ( 5840 ) 0 decay toB 0 K S 0 is observed, together with a measurement of its branching fraction relative to theB s 2 ∗ ( 5840 ) 0 → B + K - decay.

Measurement of the top quark mass with lepton+jets final states using p p collisions at s = 13 TeV

The mass of the top quark is measured using a sample of t t ¯ events collected by the CMS detector using proton-proton collisions ats = 13 TeV at the CERN LHC. Events are selected with one isolated muon or electron and at least four jets from data corresponding to an integrated luminosity of 35.9fb - 1 . For each event the mass is reconstructed from a kinematic fit of the decay products to a t t ¯ hypothesis. Using the ideogram method, the top quark mass is determined simultaneously with an overall jet energy scale factor (JSF), constrained by the mass of the W boson in q q ¯ ' decays. The measurement is calibrated on samples simulated at next-to-leading order matched to a leading-order parton shower. The top quark mass is found to be 172.25 ± 0.08 (stat+JSF) ± 0.62 (syst) GeV . The dependence of this result on the kinematic properties of the event is studied and compared to predictions of different models of t t ¯ production, and no indications of a bias in the measurements are observed.

Observation of the Z→ψℓ^{+}ℓ^{-} Decay in pp Collisions at sqrt[s]=13 TeV

This Letter presents the observation of the rare Z boson decay Z→ψℓ^{+}ℓ^{-}. Here, ψ represents contributions from direct J/ψ and ψ(2S)→J/ψX, ℓ^{+}ℓ^{-} is a pair of electrons or muons, and the J/ψ meson is detected via its decay to μ^{+}μ^{-}. The sample of proton-proton collision data, collected by the CMS experiment at the LHC at a center-of-mass energy of 13 TeV, corresponds to an integrated luminosity of 35.9  fb^{-1}. The signal is observed with a significance in excess of 5 standard deviations. After subtraction of the ψ(2S)→J/ψX contribution, the ratio of the branching fraction of the exclusive decay Z→J/ψℓ^{+}ℓ^{-} to the decay Z→μ^{+}μ^{-}μ^{+}μ^{-} within a fiducial phase space is measured to be B(Z→J/ψℓ^{+}ℓ^{-})/B(Z→μ^{+}μ^{-}μ^{+}μ^{-})=0.67±0.18(stat)±0.05(syst).

Search for Pair-Produced Resonances Each Decaying into at Least Four Quarks in Proton-Proton Collisions at sqrt[s]=13 TeV

This Letter presents the results of a search for pair-produced particles of masses above 100 GeV that each decay into at least four quarks. Using data collected by the CMS experiment at the LHC in 2015-2016, corresponding to an integrated luminosity of 38.2  fb^{-1}, reconstructed particles are clustered into two large jets of similar mass, each consistent with four-parton substructure. No statistically significant excess of data over the background prediction is observed in the distribution of average jet mass. Pair-produced squarks with dominant hadronic R-parity-violating decays into four quarks and with masses between 0.10 and 0.72 TeV are excluded at 95% confidence level. Similarly, pair-produced gluinos that decay into five quarks are also excluded with masses between 0.10 and 1.41 TeV at 95% confidence level. These are the first constraints that have been placed on pair-produced particles with masses below 400 GeV that decay into four or five quarks, bridging a significant gap in the coverage of R-parity-violating supersymmetry parameter space.

Search for new physics in dijet angular distributions using proton-proton collisions at s = 13 TeV and constraints on dark matter and other models

A search is presented for physics beyond the standard model, based on measurements of dijet angular distributions in proton-proton collisions ats = 13 TeV . The data collected with the CMS detector at the LHC correspond to an integrated luminosity of 35.9fb - 1 . The observed distributions, corrected to particle level, are found to be in agreement with predictions from perturbative quantum chromodynamics that include electroweak corrections. Constraints are placed on models containing quark contact interactions, extra spatial dimensions, quantum black holes, or dark matter, using the detector-level distributions. In a benchmark model where only left-handed quarks participate, contact interactions are excluded at the 95% confidence level up to a scale of 12.8 or 17.5TeV, for destructive or constructive interference, respectively. The most stringent lower limits to date are set on the ultraviolet cutoff in the Arkani-Hamed-Dimopoulos-Dvali model of extra dimensions. In the Giudice-Rattazzi-Wells convention, the cutoff scale is excluded up to 10.1TeV. The production of quantum black holes is excluded for masses below 5.9 and 8.2TeV, depending on the model. For the first time, lower limits between 2.0 and 4.6TeVare set on the mass of a dark matter mediator for (axial-)vector mediators, for the universal quark couplingg q = 1.0 .