Gender-specific perception of socio-psychological risks during the Covid-19 pandemic

Introduction

The article is devoted to the study of adaptation to the covid-19 pandemic conditions in Russian men and women in the first part of 2020. Respondents assessed the degree of potential danger of various types of social threats caused by the pandemic, as well as the level of their adaptation to changed living conditions during the first lockdown.

Objectives

The purpose of this study was to identify key differences in adaptation to pandemic conditions in groups of men and women.

Methods

The author’s methodology was developed to assess the level of adaptation to COVID-19. The questionnaire included 6 scales on different aspects of life during the lockdown (for example, physical and emotional state, communication, employment during the pandemic, etc.). The sample was N = 80 (residents of Russia age 18-37).

Results

Men significantly higher estimated the potential danger of an epidemic threat to themselves than women. The level of adaptation to conditions caused by the COVID-19 pandemic also differed in two gender groups according to t-test on the scale “Employment in a pandemic”: men were better adapted to work or study in conditions caused by the COVID-19 pandemic than women.

Conclusions

This can be interpreted from the point of view of the stereotype existing in Russian culture which postulates the performance of household duties and child care is more perceived as a woman’s responsibility. The adaptation of women to remote work during the lockdown was forced to be combined with an increased workload in the family and household sphere.

Disclosure

No significant relationships.

POS0649 EFFICACY AND SAFETY OF LEVILIMAB IN COMBINATION WITH METHOTREXATE IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS: 1-YEAR RESULTS OF PHASE III, DOUBLE-BLIND, PLACEBO-CONTROLLED, RANDOMIZED TRIAL

Background

Previously, 24-week results of phase III double-blind, placebo-controlled randomized clinical study (SOLAR) of levilimab in subjects with active rheumatoid arthritis (RA) proved a superiority of levilimab over placebo1. Here we present 1-year efficacy and safety data of the open-label period of the SOLAR study.

Objectives

To evaluate the efficacy and safety of levilimab in combination with methotrexate (MTX) in subjects with MTX resistant active RA.

Methods

The study was conducted at 21 clinical sites in Russia and Belarus. All randomized subjects had completed the study between November 2019 and October 2021.

154 adults, aged ≥ 18 years with confirmed diagnosis of RA1 were randomly assigned (2:1) to receive either levilimab, 162 mg, SC (LVL QW) + MTX (n=102) or placebo (PBO) + MTX (n=52).

After W24 of the study all subjects continued to receive open label levilimab +MTX. Subjects who had achieved DAS28-CRP ≤ 2.6 at W24 were switched to maintenance (Q2W) regimen of levilimab + MTX at W28: LVL QW/Q2W arm (n=27) and PBO/LVL Q2W arm (n=1). Those with DAS28-CRP > 2.6 at W28 continued with levilimab QW regimen + MTX: LVL QW/QW arm (n=75) and PBO/LVL QW arm (n=51).

The efficacy analysis was done in a population of all randomized subjects (n=154). Those with missing data due to study discontinuation or rescue therapy prescription were considered non-responders. Otherwise, the analysis was performed on complete cases.

Safety was assessed through monitoring of adverse events (AEs) in a population of those, who received at least one dose of LVL (n=152). Two subjects randomized to receive placebo were discontinued within first 24 weeks of the study, thus did not received any dose of levilimab and were excluded from safety analysis.

Results

Obviously, better response to the treatment was observed in LVL QW/Q2W arm as it was composed of those who had reached DAS28-CRP ≤ 2.6 at W24. At this time point 15/27 (55.6%) of them achieved ACR70; 23/27 (85.2%) achieved DAS28-CRP remission (< 2.6) and 7/27 (25.9%) achieved ACR/EULAR2011 remission of RA. After switching to LVL Q2W, rates of ACR70 and DAS28-CRP < 2.6 did not significantly changed until W52: 17/27 (63.0%) and 21/27 (77.8%), respectively, yet the proportion of subject with ACR/EULAR 2011 remission further increased and reached 12/27 (44.4%).

LVL QW/QW arm was diminished by subjects who had achieved high response to treatment at W24 and composed LVL QW/Q2W arm. Thus, the ACR70, and remissions rate in this arm were close to zero at W24. However, continuation of LVL QW in those who had not achieved DAS28-CRP ≤ 2.6 at W24 induced ACR70 response in 37/75 (36.0%), DAS28-CRP remission in 35/75 (46.7%) and ACR/EULAR 2011 remission in 8/75 (10.7%) at W52.

The most common adverse events (reported in ≥5% of subjects) were blood cholesterol increase (30.3%), ALT increase (23.0%), lymphocyte count decrease (17.1%), ANC decrease (16.4%). blood triglycerides increase (13.8%), bilirubin increase (11.2%), AST increase (9.9%), WBC decrease (9.9%), IGRA with M.tb antigen positive (7.2%) and injection site reactions (5.9%). No deaths were occurred.

Conclusion

Open label period confirmed the lasting efficacy and safety of levilimab in combination with MTX in subjects with MTX resistant active RA and suggested the possibility of switching to maintenance (Q2W) regimen of levilimab in those who achieved remission of RA at week 24.

Trial registration: Clinicaltrials.gov identifier NCT04397562

References

[1]Mazurov V, Korolev M, Kundzer A, et al POS0624 EFFICACY AND SAFETY OF LEVILIMAB IN COMBINATION WITH METHOTREXATE IN SUBJECTS WITH ACTIVE RHEUMATOID ARTHRITIS: PHASE III, DOUBLE-BLIND, PLACEBO-CONTROLLED, RANDOMIZED TRIAL Annals of the Rheumatic Diseases 2021;80:550-551.

Acknowledgements

We thank all contributors to the SOLAR clinical trial

Disclosure of Interests

V Mazurov: None declared, Maxim Korolev: None declared, Andrei Pristrom: None declared, Alena Kundzer: None declared, Nikolaj Soroka: None declared, Aleksander Kastanayan: None declared, Tatyana Povarova: None declared, Tatyana Plaksina: None declared, Olga Antipova: None declared, Diana Kretchikova: None declared, Svetlana Smakotina: None declared, Oksana Tciupa: None declared, Ekaterina Puntus: None declared, Tatiana Raskina: None declared, Ludmila Shilova: None declared, Tatyana Kropotina: None declared, Olga Nesmeyanova: None declared, Tatiana Popova: None declared, Irina Vinogradova: None declared, Iulia Linkova Employee of: JSC BIOCAD, Aleksandra Plotnikova Employee of: JSC BIOCAD, Polina Pukhtinskaia Employee of: JSC BIOCAD, Arina Zinkina-Orikhan Employee of: JSC BIOCAD, Anna Eremeeva Employee of: JSC BIOCAD, Anton Lutckii Employee of: JSC BIOCAD

Homocystamide Conjugates of Human Serum Albumin as a Platform to Prepare Bimodal Multidrug Delivery Systems for Boron Neutron Capture Therapy

Boron neutron capture therapy is a unique form of adjuvant cancer therapy for various malignancies including malignant gliomas. The conjugation of boron compounds and human serum albumin (HSA)-a carrier protein with a long plasma half-life-is expected to extend systemic circulation of the boron compounds and increase their accumulation in human glioma cells. We report on the synthesis of fluorophore-labeled homocystamide conjugates of human serum albumin and their use in thiol-'click' chemistry to prepare novel multimodal boronated albumin-based theranostic agents, which could be accumulated in tumor cells. The novelty of this work involves the development of the synthesis methodology of albumin conjugates for the imaging-guided boron neutron capture therapy combination. Herein, we suggest using thenoyltrifluoroacetone as a part of an anticancer theranostic construct: approximately 5.4 molecules of thenoyltrifluoroacetone were bound to each albumin. Along with its beneficial properties as a chemotherapeutic agent, thenoyltrifluoroacetone is a promising magnetic resonance imaging agent. The conjugation of bimodal HSA with undecahydro-closo-dodecaborate only slightly reduced human glioma cell line viability in the absence of irradiation (~30 μM of boronated albumin) but allowed for neutron capture and decreased tumor cell survival under epithermal neutron flux. The simultaneous presence of undecahydro-closo-dodecaborate and labeled amino acid residues (fluorophore dye and fluorine atoms) in the obtained HSA conjugate makes it a promising candidate for the combination imaging-guided boron neutron capture therapy.

POS0624 EFFICACY AND SAFETY OF LEVILIMAB IN COMBINATION WITH METHOTREXATE IN SUBJECTS WITH ACTIVE RHEUMATOID ARTHRITIS: PHASE III, DOUBLE-BLIND, PLACEBO-CONTROLLED, RANDOMIZED TRIAL

Background:

Previously, the results of phase II AURORA clinical study of levilimab in subjects with active rheumatoid arthritis (RA) have been reported1. Here we report topline 24-weeks results of preliminary primary efficacy and safety analysis of phase 3 double-blind, placebo-controlled randomized clinical study (SOLAR).

Objectives:

To confirm that levilimab in combination with methotrexate is superior to placebo in combination with methotrexate in achieving ACR20 at week 12 and low disease activity (LDA) at week 24 in subjects with methotrexate (MTX) resistant active RA.

Methods:

The study is ongoing at 21 clinical sites in Russia and Belarus. All randomized subjects have completed 24 weeks of study between November 2019 and January 2021.

154 adults, aged ≥18 years with the diagnosis of RA (ACR 2010) for at least 24 weeks, and confirmed disease activity at screening despite treatment with MTX for the last 12 weeks (in a stable dose 15-25 mg/week, for at least 4 weeks) were randomly assigned (2:1) to receive either levilimab (162 mg, SC, QW) + MTX (n=102) or placebo + MTX (n=52). The randomization and treatment allocation were carried out by a central computer-based system. Subjects, caregivers, and those assessing the outcomes were blinded to group assignment.

The hypothesis of superiority of levilimab over placebo was tested for two co-primary efficacy outcomes: proportion of subjects who achieved ACR20 at week 12 and proportion of subjects who achieved LDA of RA (DAS28-CRP <3.2) at Week 24 of the study.

For ethical reasons, subjects who haven’t achieved minimal clinical response at week 12 (≥20% reduction in the number of tender/swollen joints; 66/68) received rescue therapy at the discretion of the Investigator, and all subsequent efficacy assessments for those were considered missing.

For the primary efficacy analysis, subjects with missing data due to study discontinuation or rescue therapy prescription were considered non-responders (non-responder imputation, NRI). Otherwise, the analysis was performed on observed cases.

Safety was assessed through monitoring of adverse events (AEs).

Results:

The primary analysis was based on 149 randomized subjects (n=99 and n = 50) for ACR20 and 154 randomized subjects (n= 102 and n = 52) for LDA.

70/99 (71%) of subjects who received levilimab and 20/50 (40%) who received placebo achieved ACR20 response at week 12. The difference in proportion was 30% with a lower bound of 97.5% CI 12.8%; p=0.0003 (Pearson’s chi-squared test).

53/102 (52%) of subjects received levilimab and 3/52 (6%) received placebo achieved LDA at week 24. The difference in proportion was 46% with a lower bound of 97.5% CI 31.2 %; p<0.0001 (Pearson’s chi-squared test).

The safety population included all subjects, who received investigational product (n=154).

The most common adverse events (reported in ≥5% of subjects) in levilimab and placebo arms, respectively were: blood cholesterol increase (19% vs. 10%), ALT increase (11% vs. 8%), lymphocyte count decrease (9% vs. 8%), blood bilirubin increase (11% vs. 0%), blood triglycerides increase (9% vs. 2%), AST increase (7% vs. 4%), IGRA with M.tuberculosis antigen positive (5% vs. 6%), ANC decrease (8% vs. 0%). No deaths were occurred.

Conclusion:

The study confirmed superior efficacy of levilimab + MTX over placebo + MTX in subjects with MTX resistant active RA. No new safety signals were detected.

Trial registration: Clinicaltrials.gov identifier NCT04397562

References:

[1]Mazurov V, Zotkin E, Ilivanova E, et al. FRI0114 EFFICACY OF LEVILIMAB, NOVEL MONOCLONAL ANTI-IL-6 RECEPTOR ANTIBODY, IN COMBINATION WITH METHOTREXATE IN PATIENTS WITH RHEUMATOID ARTHRITIS: 1-YEAR RESULTS OF PHASE 2 AURORA STUDY. Annals of the Rheumatic Diseases 2020;79:637-638.

Acknowledgements:

We thank all contributors to the SOLAR clinical trial

Disclosure of Interests:

V Mazurov: None declared, Maxim Korolev: None declared, Alena Kundzer: None declared, Nikolaj Soroka: None declared, Aleksander Kastanayan: None declared, Tatyana Povarova: None declared, Tatyana Plaksina: None declared, Olga Antipova: None declared, Diana Kretchikova: None declared, Svetlana Smakotina: None declared, Oksana Tciupa: None declared, Tatiana Raskina: None declared, Tatyana Kropotina: None declared, Olga Nesmeyanova: None declared, Tatiana Popova: None declared, Ekaterina Dokukina Employee of: JSC BIOCAD, Aleksandra Plotnikova Employee of: JSC BIOCAD, Anton Lutskii Employee of: JSC BIOCAD, Arina Zinkina-Orihan Employee of: JSC BIOCAD

PSYCHOPHYSIOLOGICAL STATUS OF MEN AND WOMEN IN COMBAT SPORTS

Aim. The article aims to assess the psychophysiological characteristics of skilled athletes in combat sports (boxing, freestyle wrestling, judo). Materials and methods. 18–23-year-old skilled combat athletes were examined. All athletes were divided into the following groups: the first group - female athletes (n = 15); the second group - male athletes (n = 17); the third and fourth groups - control groups consisted of males and females of the same age and not involved in sports (15 people each). The following methods were used: a pulse measurement, psychological tests, self-assessment of the psychoemotional status, electroencephalography, cardiointervalography with the calculation of statistical indicators of heart rate. Examinations were performed before and after the relaxation exercise, which was a three-minute concentration of attention at a specific point on the body. Results. The results revealed that female athletes had lower indicators of psychoemotional status than males but higher than untrained females. The indicators of psychoemotional stress were lower in female athletes than in male athletes and untrained women. For example, the indicator of personal anxiety in female athletes was 41.0 ± 1.8 versus 47.2 ± 2.5 in untrained women (P < 0.05). In female athletes, heart rate, the amplitude of the mode and voltage index (77.15 ± 2.05) in the structure of heart rate were slightly higher than in males (73.10 ± ± 1.07), which indicated greater functional stress of the heart. Relaxation led to favorable changes in EEG indicators and decreased functional stress of the heart in all subjects. Conclusion. It is recommended to extend the terms of sports training in female combat athletes to ensure a smooth transition to sports specialization and reduce injuries.

PSYCHOPHYSIOLOGICAL STATUS IN OVERWEIGHT INDIVIDUALS

Aim. The article deals with establishing psychophysiological features in overweight women to develop a set of measures for weight decrease and psychocorrection. Materials and methods. We studied two groups of women who were willing to participate in the study: the first group – mean age 54.2 ± 3.0; the second group – mean age 25.0 ± 1.7. The average BMI of the first group corresponded with obesity values (32.3 ± 1.6), while an average BMI of the second group was within the upper limit of reference values (23.7 ± 0.9). However, according to body composition data, there was a risk of BMI increase. As far as the percentage of adipose tissue exceeded the recommended values, recommended weight loss was 18.2 ± 2.6 kg for the older group and 5.6 ± 1.4 kg for the young group. Two groups of women of the same age with normal weight were examined as control groups. Results of the study revealed both age-related and psychophysiological features in women of different weight. EEG analysis showed that alpha rhythm amplitude in women from the first group was higher on average and frequency was lower compared to the second group. In the experimental group, we also revealed a higher level of delta activity in the frontal region at rest. The study of a psychoemotional status revealed that all participants hardly coped with stress. However, young participants overcame stress more easily compared to the older group. Anxiety assessment showed increased values of anxiety. In all participants, personal anxiety was almost at the same level within 48 points. Situational anxiety was higher in young women (51.2 ± 1.3 and 49.6 ± 2.1 points, respectively). Conclusion. The most psychophysiological indicators identified functional stress, particularly in overweight older women. To preserve the optimal psychophysiological status of persons participating in weight correction programs, it is also necessary to correct a psychophysical status in accordance with age-related features.

Abstract P2-05-09: Withdrawn

This abstract was withdrawn by the authors.

Abstract P1-03-05: A comprehensive molecular analysis of medullary breast carcinoma: A model of immunomodulatory triple negative breast cancer subtype

Medullary breast carcinoma (MBC) is a rare subtype of triple negative breast cancer (TNBC)with specific genomic features within the spectrum of basal-like carcinoma. The frequent association between BRCA constitutive mutation and MBC phenotype has been reported previously. In this study including 19 MBC and 36 non-MMB basal-like carcinoma (BLC), we refine the genomic and transcriptomic knowledge about this entity. Using pan genomic Affymetrix genome-wide human SNP6.0 array, we show that i/ MBC harbour more copy number alterations and losses of heterozygocity than BLC and that ii/ the high frequency of BRCAness genomic trait among MBC. Unsupervised and supervised analysis of GeneChip Uman Genome U133 Plus 2.0 Array transcriptomic generated data confirmed that MBC clearly differ from BLC in terms of gene expression level, with 92 genes overexpressed and 154 genes underexpressed in MBC over BLC. Immune response and inflammatory response are the most differentially represented pathways in MBC over BLC. Pro apoptotic gene BCLG is by far the more overexpressed gene in MBC. A validation study conducted with RT-QPCR among 526 breast tumors form all molecular subtype confirmed the specificity of BCLG overexpression in MBC, which was confirmed at protein level using immunohistochemisytry. Moreover, we show that a vast majority of MBC belong o the immunomodulatory TNBC subtype according to Lehman et al. Finally, we confirm the better prognosis of MBC toward BLC. Our observations epitomize the importance of developing DNA repair targeting drugs and immunotherapy based trials in order to improve the outcome of such a specific entity.

Citation Format: Romero P, Deniziaut G, Benhamo V, Fuhrmann L, Berger F, Bhalshankar J, Gruel N, MacGrogan G, Popova T, Manié E, Stern M-H, Stoppa-Lyonnet D, Rouzier R, Delattre O, Bieche I, Vincent-Salomon A. A comprehensive molecular analysis of medullary breast carcinoma: A model of immunomodulatory triple negative breast cancer subtype [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-03-05.

Silver containing sorbents: Physicochemical and biological properties

New silver containing sorbents, based on mineral carriers, such as alumina and silica systems with a meso- and macro- porous structure, have a higher mechanical resistance and, hydrophilic and hydrophobic chemical composition of the surface. These sorbents are easy to find and relatively inexpensive, compared to their known equivalents. They are furthermore characterised by high specific surface and simple preparation, whilst the addition of silver considerably increases their antiseptic activity. The results of research of the physical, chemical and biological properties of the developed substances, as well as bio-comparability of sorbents with biological tissues, are presented in this paper. The modified material acts simultaneously as the carrier for active substances to the area of therapeutic application and as a sorbent used to remove toxic agents from such areas. This approach led us to modify the sorbent, and prolong the delivery of substances such as silver, as an effective antibacterial and antimycotic agent.

Abstract P4-04-05: Molecular subtyping reveals the heterogeneity of metaplastic breast cancers

Introduction: Metaplastic breast carcinoma (MBC) is a rare (1%) and aggressive histological special type of breast cancer, which often (&gt;90%) displays a triple-negative (TN) phenotype. Microarray-based gene expression classifications of breast cancer have been described, including the ‘intrinsic subtypes’ (i.e. luminal A, luminal B, basal-like, HER2-enriched, normal breast-like and claudin-low) and the six TN molecular subtypes with therapeutic implications in preclinical models (i.e. basal-like I, basal-like II, mesenchymal-like, mesenchymal stem-like, immunomodulatory and luminal androgen receptor). In addition, single nucleotide polymorphism (SNP) array analyses have led to the development of classifiers to define whether TN breast cancers would have genomic aberrations consistent with those found in tumors arising in BRCA1 germline mutation carriers. Here we sought to define i) the heterogeneity of MBCs using distinct microarray-based classifiers and ii) whether MBCs display gene copy number profiles consistent with those of BRCA1 breast cancers.

Material and Methods: Thirty consecutive MBCs were retrieved from the tumor banks of the authors’ institutions, reviewed by two pathologists and classified into three groups: carcinomas with spindle cell metaplasia (n = 12), with squamous metaplasia (n = 10), and with heterologous elements (n = 8). RNA and DNA were extracted from representative frozen sections containing &gt;50% of cancer cells from each tumor and subjected to gene expression profiling using the HumanHT-12 v4 platform (Illumina) and gene copy number analysis using SNP 6.0 arrays (Affymetrix), respectively. ‘Intrinsic subtyping’ was performed according to the UNC guidelines, and subtyping into the six TN types using a dedicated website (https://cbc.mc.vanderbilt.edu/tnbc/). Classification of MBCs into BRCA1-like or non-BRCA1-like was performed using an algorithm to identify and quantify large-scale state transitions.

Results: PAM50/claudin-low subtyping of MBCs revealed that all spindle cell carcinomas (n = 12) were consistently of claudin-low subtype, whereas MBCs with heterologous elements were classified as of basal-like (n = 6) and normal breast-like (n = 2), and squamous cell carcinomas as of basal-like (n = 5), claudin-low (n = 4) and normal-like (n = 1). Using the six TN subtypes, spindle cell MBCs were classified as mesenchymal stem-like (n = 4), immunomodulatory (n = 3), basal-like 2 (n = 3), or mesenchymal (n = 2) subtype. Carcinomas with heterologous elements were classified as basal-like 1 (n = 5) or mesenchymal (n = 3) subtype, whereas carcinomas with squamous metaplasia were of immunomodulatory (n = 5), basal-like 1 (n = 2), basal-like 2 (n = 2) or mesenchymal (n = 1) subtype. Out of the 26 samples where SNP 6.0 arrays were successfully performed, only 9 (35%) were classified as BRCA1-like, including two spindle cell carcinomas, two carcinomas with heterologous elements and five carcinomas with squamous metaplasia.

Conclusion: MBCs constitute a heterogeneous group of tumors and the histological subclassification of these cancers is of importance, given that tumors with distinct metaplastic elements are classified differently according to current molecular subtyping methods. Only 35% of MBCs display BRCA1-like patterns of gene copy number aberrations.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-04-05.

Real life clinical study design supporting the effectiveness of extra-fine inhaled beclomethasone/formoterol at the level of small airways of asthmatics

BACKGROUND

In an attempt to establish how treatment with inhaled extra-fine beclomethasone/formoterol (I-EF-BDP/F) formulation differs from other combinations of inhaled corticosteroid (ICS) and long acting beta-agonist (LABA), we studied lung function and markers of airway inflammation upon switching to the extra-fine formulation and after 8 weeks of treatment with it.

METHODS

We carried out a real-life clinical observation of undercontrolled asthmatic patients switched over from dry powder inhalers of fluticasone/salmeterol and budesonide/formoterol to I-EF-BDP/F (Foster(®), Chiesi Farmaceutici S.p.A., Italy). The effects of 8-weeks of treatment were documented by means of visual analog scale (VAS), quality of life by Asthma Quality of Life Questionnaire (AQLQ), spirometry and markers of airway or systemic inflammation: exhaled breath temperature (EBT), blood eosinophils (Eos), and high sensitivity C-reactive protein (CRP). Before/after treatment differences between forced vital capacity percent of predicted (%FVC), a simple indicator of small airways involvement, were calculated and subjects were ranked accordingly to reflect the magnitude of the therapeutic response. Subjects above the 75th percentile (n = 15), "top responders", were then compared with those below the 25th percentile (n = 15) "poor responders".

RESULTS

On average, the 59 patients completing the study (mean age ± SD 51 ± 12 years, 38 women) had significant improvement in VAS and QLQ scores at the end of the treatment period (49.1 ± 2.4 vs. 73.1 ± 2.05 and 146.1 ± 2.7 vs. 176.7.1 ± 3.4 respectively, P < 0.001), but not in the inflammatory indicators (EBT, CRP and Eos). However, when comparing the "top responders" with the "poor responders", significant improvement in these inflammatory indicators was observed: EBT significantly decreased from 34.04/mean/± 0.30/s.e.m./[°C] to 33.57 ± 0.33, P = 0.003, Eos in blood fell from 381.7 ± 91.2 [cells/μL] to 244.2 ± 43.2, P = 0.02. Before/after treatment differences in hsCRP decreased significantly in the top responders compared with the poor responders (Mann-Whitney test, P = 0.04).

CONCLUSION

Asthmatic subjects who had the most improvement in FVC after transition to I-EF-BDP/F from other combined ICS/LABA preparations also demonstrated a significant decrease in some indicators of airway/systemic inflammation. These results support the notion that I-EF-BDP/F exerts an effect also at the level of the small airways through a reduction of the level of air trapping. Patients in whom inflammation of the small airways plays an important clinical role are the ones to derive most benefit from this small airways tailored treatment. However, improved compliance due to the "promise of a new drug" effect should also be considered as contributing to the treatment results.

Abstract P5-02-03: Large-scale genomic instability consistently identifies BRCA1/2 inactivation in breast cancers

The goal of this study was to identify genomic markers predicting actual BRCA1/2 inactivation in breast cancers. By comparing genomic profiles of BRCA1/2 mutated and wildtype basal-like carcinomas (BLC) we developed a signature of BRCAness. The signature accounts for the level of the large scale genomic instability and was demonstrated to predict BRCA1/2 impairment with 100% sensitivity and 90% specificity in the large series of BLCs. We introduced a bioinformatics procedure evaluating the number of large scale rearrangements (denoted as Large Scale Transition or LST) in the genome and showed that the number of LSTs discriminate homologous recombination deficient and proficient tumors (Popova et al, Cancer Research 2012 Aug).

The efficiency of the signature of BRCAness represented by the number of LSTs was then evaluated for the luminal breast tumors and ovarian carcinomas. Luminal breast tumors and ovarian carcinomas could be stratified into two groups according to the number of LSTs. The performance of the LST signature in all types of breast cancers will be presented.

Measurement of LST is a highly reliable, simple and cost effective method to identify patients who should benefit of a BRCA1/2 testing, and to select tumors which may respond to treatment targeting DNA repair deficiencies (platinium salts, PARP inhibitors).

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-02-03.

P3-06-03: Hypodiploidy, 1pter Loss and Inactive X Chromosome Retention Are Associated with BRCA1 Somatic or Germline Inactivation in Basal-Like Breast Carcinomas: Proposal for a New BRCAness Genomic Signature

Basal-Like Carcinomas (BLCs) are high grade ductal carcinomas identified by large scale transcriptomic analyses among carcinomas with triple-negative phenotype (ER- PR- HER2−). A particular relationship between this phenotype and the BRCA1 breast cancer susceptibility gene has been described based on several observations including high genomic similarities of sporadic and BRCA1 BLCs. BRCA1 mutated patients have been shown to strongly benefit from treatments using PARP inhibitors. However, significant benefit of this treatment was not demonstrated in sporadic triple-negative breast cancers in association to standard chemotherapy in phase III clinical trials, which emphasizes the necessity for a better selection of DNA repair deficient tumors. The goal of this study was to determine whether BRCA1 inactivation leads to particular genomic alterations that could be used to identify BRCA1 deficient sporadic BLCs.

Genomic profiling was performed using SNP-arrays (Affymetrix and Illumina) and high quality profiles were obtained for 60 BLCs with more than 35% of tumor cells. The series contained 28 BRCA1 BLCs and 32 sporadic BLCs consisting in 10 sporadic BLCs with BRCA1 somatic inactivation by promoter methylation (BRCA1-like BLCs) and 22 sporadic tumors without BRCA1 methylation (nonBRCA1 BLCs). Genomic data was mined with GAP methodology (Popova et al, Genome Biol 2009), which allows absolute copy-number evaluation with DNA content calculation and clarification of Loss Of Heterozygosity (LOH) status.

Genomic patterns of BLCs were characterized by frequent and highly recurrent allelic losses. Comparison between BRCA1, BRCA1-like and nonBRCA1 BLCs confirmed their overall similarity, and identified few significant differences enhanced when BRCA1 and BRCA1-like BLCs were considered as one group. Firstly, hypodiploidy characterized BLCs with BRCA1 germline and/or somatic inactivation. Secondly, the lpter region was found more often lost in BRCA1 and BRCA1-like BLCs than in nonBRCA1 BLCs. Thirdly, retention of inactive X chromosome was a characteristic of BLCs with BRCA1 germline and/or somatic inactivation. Finally, a BRCA1ness score based on the above described difference is proposed.

In conclusion, despite a strong similarity of genomic patterns in BLCs, BRCA1 inactivation leads to few key genomic aberrations which constitute a new BRCA1 molecular signature namely hypodiploidy, 1pter loss and inactive X chromosome retention. This signature needs to be further evaluated in terms of response to PARP inhibitors in order to evaluate its capacity to identify patients that will benefit from this treatment.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-06-03.

Influence of complex formation with tetraantraquinoporphyrazines and tetrasulphophthalocyanine on thermal stability of bovine serum albumin

Interaction between bovine serum albumin (BSA) and tetraantraquinoporphyrazines (TAP) and tetrasulphophthalocyanine (Pc) aluminum hydroxide was studied by means of electron absorption spectroscopy, IR spectroscopy, fluorescence spectroscopy and differential scanning calorimetry. It was found that the complex formation of BSA with the TAPs results in increase of thermal stability of the protein while Pc does not have remarkable influence on the protein thermal denaturation.

[The age as risk factor for pre-eclampsia]

Pre-eclampsia is a serious complication during pregnancy. It occurs after 20 weeks of pregnancy. The condition is defined by the following symptoms: hypertension, excess protein in the urine, oedema. The aim of this research is to determine the influence of age as risk factor for pre-eclampsia. The study was made at University Hospital-Pleven. Documentary method is used to collect information - medical history of patients. For the period of 2005/2010 the share of the hospitalized patients is relatively low, between 1,9-4,9% of the whole pathology The share of patients with pre-eclampsia after 30 years age is increasing.

The Bulgarian Emergency Response System for dose assessment in the early stage of accidental releases to the atmosphere

The Bulgarian Emergency Response System (BERS) is being developed in the Bulgarian National Institute of Meteorology and Hydrology since 1994. BERS is based on numerical weather forecast meteorological information and a numerical long-range dispersion model accounting for the transport, dispersion, chemical and radioactive transformations of pollutants. In the present paper, the further development of this system for a mixture of radioactive gaseous and aerosol pollutants is described. The basic module for the BERS, the numerical dispersion model EMAP, is upgraded with a "dose calculation block". Two scenarios for hypothetical accidental atmospheric releases from two NPPs, one in Western, and the other in Eastern Europe, are numerically simulated. The effective doses from external irradiation, from air submersion and ground shinning, effective dose from inhalation and absorbed dose by thyroid gland formed by 37 different radionuclides, significant for the early stage of a nuclear accident, are calculated as dose fields for both case studies and discussed.

[Family planning among gipsy women]

Family is the major social unit of gipsy society. The basic value in ethno-culture of gypsies is children. As in almost all aspects of health, regarding the reproduction health and access to health care gipsy population do not have good enough indexes. The purpose of this research is to determine the information gipsy women have about family planning. The inquiry is conducted through 100 gipsy women in different ages in the village Bukovlak, Pleven municipality.

[Nutrition specification for babies with Down syndrome]

Trisomy 21 is the most frequent chromosomal disorder. Each year in Bulgaria 100-120 babies with this syndrome are born. These children have anatomical and physiological specialties. As a sequence of this it is necessary to use specific technique of feeding.

Cell wall deficiency and its effect on methicillin heteroresistance in Staphylococcus aureus

Clinical strains of Staphylococcus aureus with different phenotypic methicillin susceptibility characteristics, bearing or lacking the mecA gene, were tested for their ability to transform into a cell wall-deficient state under special conditions of cultivation. Conversion to L-form growth with formation of typical L-form 'fried egg' colonies and expression of oxacillin resistance was observed in sensitive (mecA-negative) and heteroresistant (mecA-positive) strains. Transmission electron microscopy observation of these strains revealed pleomorphic populations of cell wall-deficient cells with ultrastructure morphology similar to that of a control stable L-form strain of S. aureus. The results demonstrate that expression of phenotypic methicillin resistance could be associated with cell wall deficiency in S. aureus strains and could underlie the phenomenon of heteroresistance.