Abstract P3-04-26: Establishment and characterization of ST941/C; an ESR1-mutant ER+ breast cancer cell line and xenograft from a patient with acquired resistance to endocrine therapy

Background: The estrogen receptor (ERα) plays an integral role in the progression of luminal type breast cancers and while targeted endocrine therapies provide effective initial treatment many patients develop acquired resistance to treatment even with continued ER receptor expression. Recently studies identified ER mutations as a possible mechanism for acquired resistance and several activating point mutations have been identified including Y537S (ESR1Y537S) resulting in hormone independent proliferation in preclinical studies. However, lack of validated ESR1-mutant cell lines has limited detailed mechanistic studies of these mutations in endocrine-resistant ER+ breast cancer. Previously we established and evaluated a patient derived xenograft (PDX) designated ST941 representing ESR1Y537S-mutated ER+ breast cancer (Wick et al, SABCS 2015). To better understand the role of ESR1-mutations in endocrine resistant breast cancer we established an immortalized cell line from ST941 designated ST941/C to use for in vitro mechanistic assays and correlative in vivo studies.

Methods: The ST941/C cell line was generated from harvested low-passage ST941 PDX tissue using published methods. Once established the line was characterized by immunohistochemistry and NGS and its tumorigenicity assessed. Drug sensitivity studies were carried out evaluating relevant endocrine and chemotherapy agents and results compared with in vivo drug studies. Timepoints for cell proliferation assays were Days 4, 7 and 10 following cell plating using standard MTS assay. Endpoints for in vivo studies were a mean group tumor volume of ~1 cm3 or sixty days following treatment initiation.

Results: Subcutaneous cell injection into athymic nude mice produced xenografts which grew in the absence of exogenous hormone. The ST941/C cell line and resulting xenograft retained immunohistologic and NGS characteristics of the parent model including receptor expression and ER mutation. Both the cell line and xenograft were insensitive to most endocrine therapies including tamoxifen, fulvestrant and aromatase inhibitors and reported correlative activity towards docetaxel and other chemotherapies.

Conclusion: We have established and evaluated an ESR1-mutant cell line designated ST941/C which is tumorigenic in nude mice and potentially useful for mechanistic and correlative in vivo studies to better understand acquired resistance in endocrine-treated ER+ breast cancer.

Citation Format: Wick MJ, Diaz A, Thomas M, Moriarty A, Quinn M, Guerra M, Zhu P, Smith P, Tolcher AW, Puyang X, Patnaik A, Korpal M, Rasco D, Papadopoulos KP. Establishment and characterization of ST941/C; an ESR1-mutant ER+ breast cancer cell line and xenograft from a patient with acquired resistance to endocrine therapy [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 P3-04-26.

Social health and dementia: a European consensus on the operationalization of the concept and directions for research and practice

BACKGROUND

Because the pattern of illnesses changes in an aging population and many people manage to live well with chronic diseases, a group of health care professionals recently proposed reformulating the static WHO definition of health towards a dynamic one based on the ability to physically, mentally and socially adapt and self-manage. This paper is the result of a collaborative action of the INTERDEM Social Health Taskforce to operationalize this new health concept for people with dementia, more specifically the social domain, and to formulate directions for research and practice to promote social health in dementia.

METHOD

Based on the expertise of the Social Health Taskforce members (N = 54) three groups were formed that worked on operationalizing the three social health dimensions described by Huber et al.: (1) capacity to fulfil potential and obligations; (2) ability to manage life with some degree of independence; (3) participation in social activities. For each dimension also influencing factors, effective interventions and knowledge gaps were inventoried. After a consensus meeting, the operationalizations of the dimensions were reviewed by the European Working Group of People with Dementia (EWGPWD).

RESULTS

The social health dimensions could be well operationalized for people with dementia and are assessed as very relevant according to the Social Health Taskforce and EWGPWD. Personal (e.g. sense of coherence, competencies), disease-related (e.g. severity of cognitive impairments, comorbidity), social (support from network, stigma) and environmental factors (e.g. enabling design, accessibility) that can influence the person with dementia's social health and many interventions promoting social health were identified.

CONCLUSION

A consensus-based operationalization of social health in dementia is proposed, and factors that can influence, and interventions that improve, social health in dementia identified. Recommendations are made for research and practice.

Ageing and obesity similarly impair antibody responses

Ageing is characterized by increased low-grade chronic inflammation, which is a significant risk factor for morbidity and mortality of elderly individuals. Similar to ageing, obesity is considered to be an inflammatory predisposition associated with chronic activation of immune cells and consequent local and systemic inflammation. Both ageing and obesity are characterized by reduced innate and adaptive immune responses. This review focuses on B cells, how they may contribute, at least locally, to low-grade chronic inflammation in ageing and obesity and on the mechanisms involved.

Synthesis of vinyl-terminated Au nanoprisms and nanooctahedra mediated by 3-butenoic acid: direct Au@pNIPAM fabrication with improved SERS capabilities

Here we describe the first seedless synthesis of vinyl-terminated Au nanotriangular prisms (AuNTPs) and nanooctahedra (AuNOC) in aqueous media. This synthesis is performed by chemical reduction of chloroauric acid (HAuCl4) with 3-butenoic acid (3BA) in the presence of benzyldimethylammonium chloride (BDAC). The principal novelties of the presented method are the use of a mixture of 3BA and BDAC, the synthesis of gold prisms and octahedra with controllable size, and the presence of terminal double bonds on the metal surface. Initially this method produces a mixture of triangular gold nanoprisms and octahedra; however, both morphologies are successfully separated by surfactant micelle induced depletion interaction, reaching percentages up to ∼90%. Moreover, the alkene moieties present on the gold surface are exploited for the fabrication of hybrid core@shell particles. Gold octahedra and triangular prisms are easily encapsulated by free radical polymerization of N-isopropylacrylamide (NIPAM). Finally, in order to obtain a gold core with the most number of tips, AuNTP@pNIPAM microgels were subjected to gold core overgrowth, thus resulting in star-shaped nanoparticles (AuSTs@pNIPAM). We use 4-amino-benzenethiol as the model analyte for SERS investigations. As expected, gold cores with tips and high curvature sites produced the highest plasmonic responses.

Supportive care needs among Indigenous cancer patients in Queensland, Australia: less comorbidity is associated with greater practical and cultural unmet need

Little is known about the supportive care needs (SCN) of Australian Indigenous cancer patients. This cross-sectional study investigated the association between comorbidity and SCN among newly diagnosed Indigenous cancer patients in Queensland. Comorbidity was ascertained from medical chart review using the Charlson Comorbidity Index (CCI) and SCN were measured using the Supportive Care Needs Assessment Tool for Indigenous Peoples (SCNAT-IP). Of 183 participants, 76 (42%) had no comorbidity (CCI = 0), 60 (33%) had had a CCI score of 1 and 47 (26%) had a CCI of two or more, with the most common condition being diabetes (30%). The most common moderate-high unmet need items varied between comorbidity groups, although all patients most frequently reported moderate-high unmet need in the Physical and Psychological and the Practical and Cultural needs domains. Patients with the greatest comorbidity (CCI ≥ 2) had significantly more reduced odds of practical and cultural needs than patients without comorbidity (OR 0.28, 95% CI 0.11-0.75). This appeared to be partially explained by time since diagnosis, age, whether they were receiving current treatment and residential remoteness. Patients' experience of chronic disease, hospitals and the healthcare system may better prepare them for the practical and cultural aspects of their cancer journey.

Abstract P5-08-37: Intraductal papillomas: Risk of cancer, immediate and delayed

Introduction

The management of Intraductal papillomas (IP) of the breast diagnosed on core needle biopsy (CNBx) is still controversial. For IP with atypia, excision is generally recommended. For IP w/o atypia, data for excision vs. observation are variable. A clearer understanding of the risk of the presence of invasive or in situ malignancy (IDC or DCIS) coincident with IP, as well as the long-term risk for cancer would be helpful in managing these patients. The aim of this study is to evaluate the rate of malignancy on immediate excision or with prolonged follow-up. We hypothesized that IP w/o atypia do not require excision, as the risk of malignancy is low. Conversely, we hypothesized that IP w/ atypia should be excised because of a significant rate of concomitant malignancy. We also evaluated the long-term risk of malignancy in either breast with excision or observation of women with IP.

Methods

266 women who underwent a CNbx between 1995 and 2010 were identified from surgical pathology and breast imaging records. Four groups were defined based on the CNBx diagnosis (IP w/o atypia, IP with atypia, IP + ADH/ALH and Papillomatosis) and were also separated on the basis of immediate excision versus observation. For the 15-year period, it was generally the policy to excise IP lesions with atypia or ADH/ALH. Management of IP w/o atypia was more variable, but in the most recent 5 years, patients with IP w/o atypia were usually observed. For those who underwent immediate excision, the proportions with IDC or DCIS were calculated and compared using Fisher's exact test. Kaplan Meier curves were determined for each group's estimated time to cancer diagnosis, and significance was evaluated by the log-rank test.

Results

When surgical excision was performed for IP w/ atypia or IP + ADH/ALH on CNBx, cancer was found in 32% and 38.5% respectively. Of the 109 excisions for IP w/o atypia, cancer was found in 8.3%, significantly different from IP w/ atypia (p=0.004) and IP + ADH/ALH (p=0.007). For patients without atypia or ADH/ALH at the time of biopsy and no cancer on excision, the probability of remaining cancer-free was not significantly different for patients who had immediate surgical excision versus those that were observed (93.8% and 91.5% cancer-free at 10 years, p= 0.773). For patients with atypia or ADH/ALH at the time of biopsy but no cancer on excision, the probability of remaining cancer-free in both breasts was 85.9% at 10 years, and did not differ between patients who were excised or observed (p= 0.518). However, those w/atypia or ADH/ALH were significantly less likely to remain cancer-free than those w/o atypia (85.9% versus 92.8% at 10 years, respectively, p=0.008).

Conclusions

After a CNBx showing IP w/ atypia or IP + ADH/ALH, surgical excision is clearly justified, based on a 30-40% risk of concomitant invasive or in situ cancer. For IP w/o atypia, the likelihood of cancer is much lower. Moreover, even with excision, the finding of IP with atypia carries a significant risk of developing cancer long-term, and such patients should be followed carefully and perhaps should be considered for chemoprevention.

Citation Format: Khan S, Diaz A, Archer KJ, Lehman RR, Mullins TC, Cardenosa G, Bear HD. Intraductal papillomas: Risk of cancer, immediate and delayed. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-08-37.