Prognostic role of insulin-like growth factor receptor-1 (IGFR-1) and insulin-like growth factor binding protein-3 (IGFBP-3) expression in small cell lung cancer

e22155

Background: Insulin-like growth factor receptor-1 (IGFR-1) is a cellular membrane receptor overexpressed in many tumor cell lines and in some human tumors that seems to play a critical role in anti-apoptosis by enhancing cell survival. Also, insulin-like growth factor binding protein-3 (IGFBP-3) was reported to be a growth suppressor in variable pathways. Purpose of this study was to evaluate the state IGFR-1 and IGFBP-3 expression in patients with small cell lung cancer (SCLC) and its prognostic value. Methods: We analyzed IGFR-1 and IGFBP-3 expression in 194 SCLC tissues specimens by immunohistochemical stain. The relationship between IGFR-1 and IGFBP-3 expression and cliniopathological factors was evaluated. Univariate and multivariate analyses were performed to define its prognostic significance. Results: Median age was 63 years (range 38–85), 84% were men. One hundred-seventeen patients had extensive disease (60.3%), and 77 had limited disease (39.7%). With the median follow- up duration of 49.5 months (24–82), the median progression free survival (PFS) and overall survival (OS) were 8 months (95% CI: 7.3–8.7 months), and 14.4 months (95% CI: 12.7–16 months), respectively, The IGFR-1 expression was observed in 154 of 190 tumor tissues (79.4%), whereas there was no tissue stained by IGFBP-3. Multivariate analysis showed that stage (p<0.001), response to treatment (p<0.001), LDH level (p<0.001) were the independent prognostic factors for PFS, and age (p=0.014), LDH level (p<0.001), and stage (p<0.001) for OS. The IGFR-1 positivity was not associated with PFS or OS in the whole cohort. However, 84% of 115 extensive disease patients showed IGFR-1 positivity. The subgroup analysis revealed that OS was significantly longer for patients with IGFR-1 positive compared to those with IGFR-1 negative in extensive disease (11.3% vs 0% at 2year, p=0.034). Conclusions: These results suggest that IGFR-1 expression may be useful as a prognostic marker in patients with extensive disease of SCLC.

No significant financial relationships to disclose.

Phase III trial of adjuvant capecitabine/cisplatin (XP) versus capecitabine/cisplatin/RT (XPRT) in resected gastric cancer with D2 nodal dissection (ARTIST trial): Safety analysis

4537

Background: Although the adjuvant chemoradiation therapy has gained popularity and has become the standard of care in patients with resected gastric cancer in U.S., the role of chemoradiation therapy after extended D2 dissection has been questioned. We conducted a phase III trial to compare capecitabine/cisplatin (XP) vs XP + radiotherapy (RT) in curatively D2 resected gastric cancer patients in terms of disease free survival and overall survival. Methods: Eligibility criteria were as follows: stage Ib (T1N1, T2bN0) - IV (M1 excluded), curatively ≥ D2 resected gastric adenocarcinoma. XP only: X 2,000 mg/m2/d D1∼14, CDDP 60 mg/m2 D1 repeated every 3 weeks, 6 cycles; XP + RT: X 2,000 mg/m2/d D1∼14, CDDP 60 mg/m2 D1 x 2 cycles ⋄ RT 45 Gy (25 fractions) + X 1,650 mg/m2/d during RT ⋄ X 2,000 mg/m2/d D1∼14, CDDP 60 mg/m2 D1 x 2 cycles. The primary endpoint is 3-year disease-free survival. Results: From October 2004 to April 2008, 458 patients (XP arm: 228 patients; XP/RT arm: 230 patients) were enrolled. In XP arm, 172 (75%) of 228 enrolled patients completed 6 cycles of chemotherapy. In XP + RT arm, 188 (82%) of 230 patients completed the full course of XP 2 cycles - X + RT - XP 2 cycles. Conclusions: Safety and feasibility analysis of the two arms will be reported at the meeting.

No significant financial relationships to disclose.

Prognostic impact of response to second-line chemotherapy on overall survival of patients with advanced gastric cancer

e15551

Background: It has been debated on whether tumor response to first-line chemotherapy (CT) would be reliable predictor for overall survival (OS) of cancer patients (pts). In case of advanced gastric cancer (AGC), many pts receive 2nd line CT after failure to 1st line treatment, so response to 2nd line CT as well as 1st line could affect OS. Methods: We retrieved clinical data of a total of 1,335 pts with AGC treated with palliative CT from January 2000 to December 2006 in National Cancer Center, Korea, including 757 pts who also received 2nd line CT. Responses to 1st and 2nd line CT were evaluable in 504 pts. Retrospective analysis was done to find correlation between objective tumor response to 1st and 2nd line CT and OS of the 504 pts, whom we divided into 4 groups: responders to both 1st and 2nd line CT (RR group); responders to 1st but not to 2nd line CT (RN group); responders to 2nd but not to 1st line CT (NR group); and nonresponders to both 1st and 2nd line CT (NN group). Results: Objective response rate of 1st and 2nd line CT was 41.7% and 12.3%, respectively. Responders to 1st line CT had a trend to respond to 2nd line CT (ORR of 2nd line CT in responders vs nonresponders to 1st line CT: 15.7% vs 9.9%, p = 0.049). 33/177/29/265 pts were assigned to each of RR/RN/NR/NN group, respectively. With median follow-up of 48.7 mo (range 23.2 - 93.7), median OS was 12.7 mo (95% CI 11.8–13.6). Baseline characteristics were balanced between 4 groups except higher hemoglobin and serum albumin level in RR group, younger median age in NN group, and fewer pts with poor performance status or poorly differentiated histology in NR group. Overall survival of RR, RN, NR, and NN group was 31.8 mo, 15.5 mo, 18.9 mo, and 9.2 mo, respectively (p<0.001). Multivariate analysis revealed relapsed disease after curative surgery, well-differentiated histology, absence of pulmonary metastasis, higher serum albumin level, lower serum bilirubin and alkaline phosphatase level, response to both of 1st line and 2nd line CT were reliable factors for favorable survival. Conclusions: Among the patients who received 2nd line chemotherapy for AGC, response to 2nd line CT was strongly associated with OS regardless of previous response to 1st line CT.

No significant financial relationships to disclose.

The role of oophorectomy for colon cancer with ovarian metastasis

e15113

Background: A recent study demonstrated that colorectal cancer with ovarian metastases were less responsive to chemotherapy compared to extraovarian metastases. Hence, the ovary may actually represent a “sanctuary” for metastatic cells from CRC. The aim of the study was to investigate the impact of oophorectomy on survival of colorectal cancer patients with ovarian metastasis. Methods: Between 1996 and 2008, 83 colorectal cancer patients underwent oophorectomy. For the historical control, 47 colorectal cancer patients without oophorectomy were included in the analysis. Survival and its associated factors were analyzed using Kaplan-Meier method, log-rank test and Cox-regression analysis. Results: The median age was younger (48 years) in the oophorectomy group when compared to the historical control (54 years) (P =.012). The proportion of synchronous metastasis was higher in the oophorectomy than the control group (57% vs 30%, respectively; P=.003). After a median follow-up duration of 60.8 months (range, 7.4 - 169.7 months), the median OS was significantly longer in the oophorectomy group (28.1 vs 21.2 months, oophorectomy vs non-oophoreectomy; P=.038). For ovary-specific survival (date of ovarian metastasis diagnosis to death), colorectal cancer patients with oophorectomy showed significantly favorable survival than the control group (20.8 vs 10.9 months, respectively; P<.001). At univariate analyses, no oophorectomy (P=.038), bilaterality of ovarian metastasis (P=0.032), the presence of extraovarian metastasis (P<0.001), elevated CEA (p<0.001), poor performance status (p=0.001), no palliative chemotherapy(p=0.001), no primary disease resection(p=0.005) were identified as significantly poor prognostic factors for overall survival. The no oophorectomy, no chemotherapy, extraovarian metastasis, elevated CEA, poor performance status retained statistical significance at multivariate level. (p=0.003, p=0.004, p=0.005, p=0.015, p=0.029, respectively). Conclusions: Based on this retrospective analysis, the oophorectomy significantly prolonged survival in colorectal cancer patients with ovarian metastases. A potential role of oophorectomy in the management of colorectal cancer should be prospectively studied.

No significant financial relationships to disclose.

Dynamics of gas-fluidized granular rods

We study a quasi-two-dimensional monolayer of granular rods fluidized by a spatially and temporally homogeneous upflow of air. By tracking the position and orientation of the particles, we characterize the dynamics of the system with sufficient resolution to observe ballistic motion at the shortest time scales. Particle anisotropy gives rise to dynamical anisotropy and superdiffusive dynamics parallel to the rod's long axis, causing the parallel and perpendicular mean-square displacements to become diffusive on different time scales. The distributions of free times and free paths between collisions deviate from exponential behavior, underscoring the nonthermal character of the particle motion. The dynamics show evidence of rotational-translational coupling similar to that of an anisotropic Brownian particle. We model rotational-translational coupling in the single-particle dynamics with a modified Langevin model using nonthermal noise sources. This suggests a phenomenological approach to thinking about collections of self-propelling particles in terms of enhanced memory effects.

Long-period-fiber-grating-based filter configuration enabling arbitrary linear filtering characteristics

The filtering scheme proposed here is based on transmission through a dual long-period-fiber-grating (LPFG) configuration and enables implementation of arbitrary spectral transfer functions using available inverse-scattering design algorithms, such as those widely used for fiber Bragg gratings (FBGs) operating in reflection. Besides the important technical advantage of operation in transmission, the proposed device can reach large spectral bandwidths that would be extremely challenging to reach by, e.g., FBG devices. The proposed concept is demonstrated by designing and fabricating a LPFG-based filter for synthesis of transform-limited 1.5-ps-long square-like pulses.

Sensorless control for a sophisticated artificial myocardial contraction by using shape memory alloy fibre

The authors have been developing an artificial myocardium, which is capable of supporting natural contractile function from the outside of the ventricle. The system was originally designed by using sophisticated covalent shape memory alloy fibres, and the surface did not implicate blood compatibility. The purpose of our study on the development of artificial myocardium was to achieve the assistance of myocardial functional reproduction by the integrative small mechanical elements without sensors, so that the effective circulatory support could be accomplished. In this study, the authors fabricated the prototype artificial myocardial assist unit composed of the sophisticated shape memory alloy fibre (Biometal), the diameter of which was 100 microns, and examined the mechanical response by using pulse width modulation (PWM) control method in each unit. Prior to the evaluation of dynamic characteristics, the relationship between strain and electric resistance and also the initial response of each unit were obtained. The component for the PWM control was designed in order to regulate the myocardial contractile function, which consisted of an originally-designed RISC microcomputer with the input of displacement, and its output signal was controlled by pulse wave modulation method. As a result, the optimal PWM parameters were confirmed and the fibrous displacement was successfully regulated under the different heat transfer conditions simulating internal body temperature as well as bias tensile loading. Then it was indicated that this control theory might be applied for more sophisticated ventricular passive or active restraint by the artificial myocardium on physiological demand.

Long-term follow-up results of endoscopy-assisted breast surgery (EBS) for early breast cancer

Abstract #4145

Introduction: Although endoscopy-assisted breast surgery(EBS) for early breast cancer had shown the excellent cosmetic outcomes, the application of ESSB is still controversial because of the scanty evidence of long-term safety and feasibility. This study is to evaluate the long-term outcome of endoscopy-assdisted breast surgery compared to conventional breast surgery for early breast cancer.&#x2028; Patients and Methods: Between January 2002 through December 2006, 76 patients(Group E) who had diagnosed breast cancer underwent EBS at Sungkyunkwan University Kangbuk Samsung Hospital. 52 patients(Group O) not greater than stage 2A who had undergone conventional breast surgery during same period were enrolled in this study. The clinicopathologic characteristics, postoperative outcomes, hospital courses, and long-term outcomes including cancer recurrence and 5 year survival were retrospectively compared between two groups. The survivals of all the patients were confirmed with 58.4 month median follow up duration. Results: Tumor sizes were larger in Group O than in Group E(p=0.000). Harvested lymph nodes were more in Group O than in Group E(p=0.000). Postoperative recovery was significantly faster in the Group E; drain was removed earlier(p=0.001) and the postoperative hospital stay was shorter(p=0.001). The mean operation time was significantly longer in the Group E(p=0.000). There were no differences in the operation related morbidity and mortality between the two groups. In comparison of adjuvant therapy, Group O were received more chemotherapy than Group E(p=0.018), but there were no statistical differences of radiotherapy and hormonal therapy between two groups. Subjective cosmetic results were excellent in 63.6% and good in 18.2% more than 1 year after surgery. There was follow-up loss in 3 cases. Cancer-related death occurred in only 1 patient(0.7%) in Group O. The overall 5-year survival rate(5YSR) of the Group O and Group E were 98.2% and 100% , repectively. The disease-free 5YSR of Group O and Group E was 91.3% and 86.9%, repectively. There were no statistical differences on the overall and disease-free 5YSR between the two groups(p=0.446, p=0.205). Cancer recurrence occurred in 5 cases including 2 local recurrences, 2 distant metastases, and 1 second non-breast primary cancer in Group O and 6 cases including 2 local recurrences, 2 regional recurrences, 1 distant metastasis and 1 second non-breast primary cancer in Group E and there was no statistical significance between two groups(p=0.787).&#x2028; Conclusions: Although the number and the qualification of the patients were so limited, our data suggest that endoscopy-assisted skin sparing breast surgery for early breast cancer is feasible and safe comparing to conventional breast surgery. We expect the results of the present study to be confirmed by prospective randomized analysis.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4145.

Metabotropic Glutamate Receptor-mediated LTD Involves two Interacting Ca2+ Sensors, NCS-1 and PICK1

There are two major forms of long-term depression (LTD) of synaptic transmission in the central nervous system, which require activation of either N-methyl-D-aspartate receptors (NMDARs) or metabotropic glutamate receptors (mGluRs). In synapses in the perirhinal cortex we have directly compared the Ca2+ signalling mechanisms involved in NMDAR-LTD and mGluR-LTD. Whilst both forms of LTD involve Ca2+ release from intracellular stores the Ca2+ sensors involved are different; NMDAR-LTD involves calmodulin, whilst mGluR-LTD involves the neuronal Ca2+ sensor (NCS) protein NCS-1. In addition, there is a specific requirement for IP3 and PKC as well as protein interacting with C-kinase (PICK-1) in mGluR-LTD. NCS-1 binds directly to PICK1, via its BAR domain, in a Ca2+-dependent manner. Furthermore, the NCS-1-PICK1 association is stimulated by activation of mGluRs, but not NMDARs, and introduction of a PICK1 BAR domain fusion protein specifically blocks mGluR-LTD. Thus, NCS-1 is a component of a novel mechanism involved in mGluR-LTD.

Visual attention deficits contribute to impaired facial emotion recognition in boys with attention-deficit/hyperactivity disorder

The purpose of the present study was to examine whether attention deficits contribute to dysfunctional facial emotion recognition in boys with ADHD. The first hypothesis was that ADHD patients would commit more errors in facial emotion recognition than the control group. The second hypothesis was that attention deficits, which were measured by a computerized continuous performance test (CPT), would be responsible for the errors in facial emotion recognition in boys with ADHD. A revised emotional recognition test (ERT) was used to assess the subjects' ability to recognize emotions. The ADHD diagnostic system (ADS), a computerized continuous performance test (CPT), was used to evaluate attention performance. Subjects with ADHD showed significantly lower scores of contextual understanding than the controls (t=-2.569, df=67, P=0.012). Among age, IQ, and ADS scores, only the score of omission errors on the ADS accounted significantly for the score of contextual understanding in ADHD (effect size 3.4%, P<0.05). Attention deficits in boys with ADHD seemed to account for their difficulty in recognizing facial expressions of emotion. Effective treatment for attention deficits is expected to have a beneficial effect on facial emotion recognition in boys with ADHD.

UV-induced modification of stress distribution in optical fibers and its contribution to Bragg grating birefringence

This paper discusses the importance of stress-induced contributions to the photo-induced birefringence observed in fiber Bragg gratings. Optical tomography measurements are performed in exposed and unexposed fibers to extract the stress profiles induced by UV-writing of fiber Bragg gratings for various exposure levels. A photoelastic analysis and a high-order isoparametric finite elements method are then used to calculate the birefringence caused by stress profile modifications. The results are compared to the birefringence directly measured by spectral analysis of a chirped fiber grating with multiple phase-shifts. We can therefore estimate the fraction of the photo-induced birefringence due to stress-induced anisotropy following UV exposure.

Light-extraction enhancement of vertical-injection GaN-based light-emitting diodes fabricated with highly integrated surface textures

We report on the fabrication of high-efficiency vertical-injection GaN-based light-emitting diodes (LEDs) fabricated with integrated surface textures. An optical ray-tracing simulation shows that the high integration of surface textures can effectively enhance the light-extraction efficiency. The integrated surface textures are fabricated on the top surface of LEDs by generating hexagonal cones on the periodically corrugated surfaces of n-GaN. Compared to reference LEDs without textures, LEDs fabricated with integrated surface textures show an enhancement of the output power by a factor of 2.59, which is in agreement with the calculated results.