A case of refractory immune checkpoint inhibitor-induced colitis improved by the treatment with vedolizumab and granulocyte-monocyte apheresis combination therapy

A 68-year-old man developed immune-related adverse event (irAE) colitis after the initiation of nivolumab and ipilimumab combination therapy for malignant melanoma. We diagnosed the patient with grade 3 irAE colitis and started prednisolone (1 mg/kg/day). Although the symptom improved once, it worsened along with the tapering of prednisolone. Therefore, we started infliximab (IFX). However, symptoms did not improve after two doses of IFX. We discontinued IFX and initiated vedolizumab (VED). Because VED alone did not improve the symptom, we started granulocyte-monocyte apheresis (GMA). Twelve weeks after the onset, the colitis was in remission. Therefore, in addition to vedolizumab, GMA may be considered in cases refractory to treatment.

Detection of current-sheet and bipolar ion flows in a self-generated antiparallel magnetic field of laser-produced plasmas for magnetic reconnection research

Magnetic reconnection in laser-produced magnetized plasma is investigated by using optical diagnostics. The magnetic field is generated via the Biermann battery effect, and the inversely directed magnetic field lines interact with each other. It is shown by self-emission measurement that two colliding plasmas stagnate on a midplane, forming two planar dense regions, and that they interact later in time. Laser Thomson scattering spectra are distorted in the direction of the self-generated magnetic field, indicating asymmetric ion velocity distribution and plasma acceleration. In addition, the spectra perpendicular to the magnetic field show different peak intensity, suggesting an electron current formation. These results are interpreted as magnetic field dissipation, reconnection, and outflow acceleration. Two-directional laser Thomson scattering is, as discussed here, a powerful tool for the investigation of microphysics in the reconnection region.

Whole-genome analysis of red sea bream iridovirus spread in 2021 in Japan provided epidemiological and viral traits insight

Red sea bream iridovirus (RSIV) is the pathogen that causes red sea bream iridoviral disease. It causes a huge loss to the Japanese aquaculture industry. In 2021, outbreaks of red sea bream iridovirus occurred in South Japan. This study analysed nine whole-genome sequences of RSIV isolated in Oita and Ehime Prefectures in 2021 using a short-read next-generation sequencer. Nine isolates had highly uniform sequences, and there was no variant depending on locations or host species. Phylogenetic analyses with other reported megalocytivirus isolates showed that RSIV isolated in 2021 was genetically different from RSIV previously isolated in Oita and Ehime Prefectures in 2017-2019. These results suggest that RSIV isolated in Oita and Ehime Prefectures in 2021 might spread from a common ancestor different from the recent one. Additionally, it was found that RSIV isolated in 2021 had sequence mutations on protein-coding sequences that may be involved in viral pathogenicity and infectivity.

Sandwich ELISA Using a Mouse/Human Chimeric CSLEX-1 Antibody

BACKGROUND

An assay using a mouse antisialyl Lewis X (sLeX) antibody (CSLEX-1) is used clinically for screening and monitoring patients with breast cancer in Japan. However, the IgM isoform of CSLEX-1 is not preferred for the assay because the bulkiness of IgM generally causes poor accessibility to the antigen. To solve this problem, we developed an antisLeX mouse/human chimeric IgG antibody, CH-CSLEX-1, using transgenic silkworms. The performance of a homologous sandwich ELISA of CH-CSLEX1 was then evaluated.

METHODS

To generate CH-CSLEX-1, we used a GAL4/UAS binary gene expression system in transgenic silkworms. The reactivities of CSLEX-1 and CH-CSLEX-1 were determined in a Biacore analysis. To confirm antigen specificity, 3 antigens [sLeX, sLeA, and Lewis Y (LeY)] were used.

RESULTS

CH-CSLEX-1 formed correctly as an IgG class of immunoglobulin molecule with an isoelectric point close to the predicted value. The best combination for capturing and probing in a sandwich ELISA was determined as a homologous combination of CH-CSLEX-1. The CH-CSLEX-1 assay specifically detected sLeX, but not sLeA and LeY. A correlation analysis with 107 human samples showed good concordance between the conventional CSLEX-1 assay (homologous sandwich ELISA using CSLEX-1) and the CH-CSLEX-1 assay (r = 0.98). Moreover, the CH-CSLEX-1 assay was not affected by either human antimouse IgG antibodies (HAMA IgG) or HAMA IgM.

CONCLUSIONS

The mouse/human chimeric antibody CH-CSLEX-1 allowed the establishment of a highly specific sandwich ELISA for sLeX that was not affected by HAMA.

Abstract P5-02-06: Predicting the response of molecular targeting agents in triple-negative breast cancer cell lines by kinase activities

Introduction

Mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)-AKT pathways are two major hyper-activated cascades in triple-negative breast cancer (TNBC) that critically regulate cancer progression by enhancing cell survival, proliferation, metastasis, EMT, cancer stem cell regulate, and transformation. While many therapeutic agents targeting kinases in these pathways are being developed, the development of predictor of response for such agents are critical to successfully translate them into the clinic. Genomic analysis (amplification, deletion of mutation) is one of the prediction methods. However, these technologies do not always reflect the intrinsic functionalities/activities of the kinase molecules. Therefore, we hypothesized that kinase activity predicts the response to the targeted therapy in TNBC.

Materials and methods

Seventeen TNBC cell lines were used in this study. To analyze cell growth inhibition, cells were incubated for 72 h with various concentrations of trametinib or wortmannin, then processed for sulforhodamine B (SRB) staining assay. To measure MEK or PI3K enzymatic activity, TNBC cell lines were lysed and immunoprecipitated with magnetic beads conjugated with MEK antibody or with PI3K p110α antibody. Kinase reaction buffer including respective substrate and ATP was added to the immunoprecipitates and incubated for 120 minutes at 37 °C. Resultant ADP was quantified by HPLC and determined MEK and PI3K activities. Protein mass of MEK, PI3K, phospho-MEK and phospho-PI3K were determined by Western Blot analysis. Total protein amount was measured by A280. Lactate dehydrogenase (LDH) activity was measured by N-assay L LDH Nittobo. Total protein and LDH were used to normalize MEK and PI3K activities for the further analysis.

Results

Seventeen TNBC cell lines were classified into 4 groups depending on pattern of inhibition to two inhibitors as follows; Wortmannin (PI3K inhibitor) sensitive group (W, 2/17), Trametinib (MEK inhibitor) sensitive group (T, 2/17), Both sensitive group (S, 5/17) and Resistant group (R, 8/17). We found that ratio of PI3K activity and MEK activity showed good agreement to the cell classification (PPV [Wortmannin]: 67 %, PPV [Trametinib]: 33 %, NPV: = 100 %). The other parameters; enzymatic activity of MEK or PI3K, protein mass of MEK, PI3K, phospho-MEK, or phospho-PI3K, ratios of the protein mass, and the phospho-protein did not show statistically significant agreement to the classification. Mutational status and enzymatic activities or cell classification had no correlation. Additionally, MEK activity correlated to downstream phospho-ERK expression level (R = 0.7309).

Conclusion

Our results show that relative activity of two relevant kinases in the signaling cascade could predict the cell lines that will not respond to molecular targeting agents against corresponding cascades. Our concept should be warranted in the clinical study with statistically sufficient number of patients.

Citation Format: Sato N, Wakabayashi M, Lee J, Lim B, Ueno NT, Ishihara H. Predicting the response of molecular targeting agents in triple-negative breast cancer cell lines by kinase activities. [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 P5-02-06.

Abstract P2-08-27: Prediction of bone metastases of breast cancer using combined markers of bone metabolism and inflammation

Introduction

Luminal breast cancer patients show a relatively favorable prognosis when treated with adjuvant hormonal therapy alone. However, some of these patients develop recurrence and they might derive benefit from adjuvant chemotherapy. Although several genomic profilings successfully developed to decide whether to administer adjuvant chemotherapy, clinically practical prediction methods of recurrence sites do not exist. Our previous study showed a possible prediction of bone metastases by using two serum markers; TRACP-5b as a marker of bone metabolism; likelihood of bone metastases, and CRP as a marker of inflammation; likelihood of distant recurrence. The incidence of bone metastases was significantly higher in high risk patients(+/+) than in the others(odds ratio: 10.9, P=0.040). In this study, we examined the potential of the two-marker prediction in the newly enrolled luminal patients.

Patients and methods

One hundred sixty luminal patients who underwent surgery were enrolled in this study. Their serum levels of TRACP-5b and CRP were measured in a blinded manner at the R & D laboratory of Nittobo Medical Co., Ltd. In the preliminary study, we identified that the median value of TRACP-5b in the premenopausal patients was lower than in the postmenopausal patients. We adjusted the value of TRACP-5b in the premenopausal patients and the cutoff value of TRACP-5b from 334 to 396mU/dL. The cutoff value of CRP was same as previous study(0.016 mg/dL). The odds ratio between +/+ and the others were calculated using MedCalc statistical software.

Results

One hundred sixty patients stratified into four classes according to the value of TRACP-5b and CRP: +/+ (n=43), +/- (n=38), -/+ (n=42) and -/- (n=37). Six of the 160 patients developed bone metastases as the initial site of replase within five years from surgery. The Incidence of bone metastases was 9.3%(4/43) in the +/+ patients and 1.7%(2/117) in the others. The incidence was significantly higher in the +/+ patients than in the others(odds ratio: 5.9, 95% CI 1.31 to 33.46, p= 0.045). When the other relapses than bone metastases were included in the analysis, no significant difference was observed between the two groups (odds ratio: 0.4, 95% CI 0.02 to 7.43, P=0.521). TRACP-5b concentration alone could not classify the patients into two groups according to significantly different incidences of bone metastases(odds ratio: 13.7, 95% CI 0.76 to 247.22, P=0.076).

Conclusion

The results in here show that the prediction of bone metastases by the combination of TRACP-5b and CRP concentrations is clinically relevant in the luminal patients. Reliable prediction of bone metastases would be realized by combination of our prediction method and one of genomic profilings. We plan to increase the number of patients to provide sufficient statistical power to confirm this diagnostic potential.

Citation Format: Shimoda M, Nishimukai A, Shibata N, Kikuchi W, Hutawatari H, Ishihara H, Miyoshi Y, Noguchi S. Prediction of bone metastases of breast cancer using combined markers of bone metabolism and inflammation. [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 P2-08-27.

Computer Simulation of Multi filament Air Jet Melt Spinning

Air jet melt spinning for multifilament system was studied both theoretically and experimentally. Basic equations describing the multifilament system of air jet melt spinning were derived by considering air temperature and velocity of cooling flow surrounding the individual spinlines. Numerical computations of the fundamental equations for air jet melt spinning were carried out for various spinning conditions. Steady-state solutions obtained give the spinline cross sectional area, spinline temperature, spinning tension and spinline velocity. These are described as a function of the distance measured downward from the spinneret. Air jet melt spinning experiments were conducted for poly-(ethyleneterephthalate) (PET) having an intrinsic viscosity of 0.61. The spinning variables were changed mainly in terms of throughput, distance from spinneret point to ejector and air pressure in the ejector. Good correlations between theory and experiment were obtained for the final spinline speed or as-spun fiber denier. Further, the molecular orientation of asspun fiber can be estimated using the computed stretching speed at the ejector point. It was found that the simulation program of multifilament air jet spinning is very useful in finding the appropriate spinning conditions for the industrial spinning process and in estimating fiber properties.

Effect of Mold Temperature on Structure and Property Variations of PBT Injection Moldings in the Thickness Direction

During injection molding process, the surface of flowing resin in contact with the mold surface is cooled first followed by the cooling of inner part. This results in the variation of microstructure in moldings through the thickness direction. It has been reported that these phenomena result in the layered structure of injection moldings. Particularly, because of the rapid rate of crystallization, PBT injection moldings have well-defined skin and core layers. The purpose of this study is to investigate the effect of mold temperature on the development of structure and property variations of PBT injection moldings in the thickness direction. Tensile tests were performed using dumbbell specimens that were stamped out from the sliced specimens of moldings. Neck phenomenon occurred irrespective of mold temperature and distance from the surface of moldings. The start point of neck propagation shifted to higher strain with increasing distance from the surface. Tensile modulus increased with increasing distance from the surface. In order to discuss these results from a structural viewpoint, the microstructure of each layer was evaluated by density, wide-angle X-ray diffraction and Fourier transform infrared absorption measurements. The delay in necking start points with increasing distance from the surface is due to the higher crystallinity of the inner layer compared to that of the layer near the surface. Two crystal forms of PBT (α- and β-forms) were developed in injection moldings. The region near the surface, where content of α-form is larger than that of β-form, becomes thinner with increasing mold temperature. It is known that the crystal modulus of α-form is lower than that of β-form. Therefore the portion of moldings with lower tensile modulus and yield strength becomes smaller. It is suggested that the border between the skin and core layers, where tensile property changes, shifts to the surface of PBT injection moldings as mold temperature increases.

Cerebral hemodynamic benefits after contralateral carotid artery stenting in patients with internal carotid artery occlusion

CEA contralateral to an ICA occlusion is considered a surgical risk, and CAS may be an alternative for these patients. Our goal was to examine whether CAS improves cerebral hemodynamics on the treated side and on the side of the ICA occlusion, on the basis of measurement of CBF and CVR by using SPECT. The subjects were 8 patients who underwent contralateral CAS. Resting CBF and CVR to acetazolamide were measured by using (123)I-IMP SPECT before and chronically (3-6 months) after CAS. Resting CBF was also measured immediately (<2 hours) after CAS by using (123)I-IMP SPECT. There were no significant differences in resting CBF in both hemispheres immediately after CAS. However, resting CBF and CVR both significantly increased in the chronic period in both hemispheres. Contralateral CAS in patients with ICA occlusion resulted in cerebral hemodynamic improvement on the treated side and on the side of ICA occlusion.

P5-13-02: Prediction of Dasatinib Sensitivity of Breast Cancer Based on a Novel Tyrosine Kinase-Activity Profiling Assay

Background: Receptor tyrosine kinases and other membrane-associated tyrosine kinases are frequently overexpressed, activated, or mutated in cancer cells and cause aberrant signal transduction, which leads to cellular proliferation, angiogenesis, metastasis, and antiapoptosis. Blockage of these signals is considered an efficient strategy in cancer therapy, and to date, several tyrosine kinase inhibitors (TKIs) and antibody drugs targeting such kinases have been developed and are routinely used in clinics. However, the efficacy rates of the drugs are, unfortunately, limited. To provide optimum care for individual patients, an accurate prediction method for drug efficacy is now strongly demanded. Recent studies have shown that alteration of multiple kinases is involved in both primary and acquired drug resistance. Advantages of multi-targeted TKIs have also been reported. These findings indicate the need for a comprehensive evaluation of multiple kinases for predicting drug response. To achieve this, we developed a novel method of comprehensively profiling kinase activity.

Materials and methods: We characterized the membranous tyrosine kinases of breast cancer cell lines using a newly established profiling assay. Briefly, crude membrane fractions were prepared and directly subjected to the assay with nonspecific substrate (Poly(Glu4-Tyr)). The profile of the kinases in the crude membrane fraction was obtained by inhibiting the total activity with 13 selected kinds of adenosine triphosphate antagonists, independently. The residual activity (RA) of membranous kinases was defined as the percentage of activity with/without TKI.

Results: Nineteen breast cancer cell lines were classified as “sensitive” (n = 6) and “resistant” (n = 13) to dasatinib according to the definition in the publication (Cancer Res., 67 2226–38. 2007). The RA of tyrosine kinases targeted by different types of TKIs was determined by our assay, and we found that two RAs (src inhibitor 1 and PP1) showed statistically significant differences between the “sensitive” and “resistant” groups (p=0.017, and p=0.002, respectively, Student's t-test). The RA of the two TKIs were also significant predictors for dasatinib sensitivity in a receiver operating characteristic curve analysis (area under the curve: 0.846 for src inhibitor 1 and 0.910 for PP1). Since the major target of dasatinib are src family kinases, protein expressions of the src family of the cell lines were quantified by a Western blotting and compared between the groups. We found that the protein expression is not a statistically significant predictor of dasatinib sensitivity.

Conclusion: We have shown that a comprehensive tyrosine kinase activity profiling assay of cancer cells can predict dasatinib sensitivity. We plan to validate this assay prospectively in patients with breast cancer who receive dasatinib.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-13-02.

Specific activity of cyclin-dependent kinase I is a new potential predictor of tumour recurrence in stage II colon cancer

Background:

There are no established biomarkers to identify tumour recurrence in stage II colon cancer. As shown previously, the enzymatic activity of the cyclin-dependent kinases 1 and 2 (CDK1 and CDK2) predicts outcome in breast cancer. Therefore, we investigated whether CDK activity identifies tumour recurrence in colon cancer.

Methods:

In all, 254 patients with completely resected (R0) UICC stage II colon cancer were analysed retrospectively from two independent cohorts from Munich (Germany) and Leiden (Netherlands). None of the patients received adjuvant treatment. Development of distant metastasis was observed in 27 patients (median follow-up: 86 months). Protein expression and activity of CDKs were measured on fresh-frozen tumour samples.

Results:

Specific activity (SA) of CDK1 (CDK1SA), but not CDK2, significantly predicted distant metastasis (concordance index=0.69, 95% confidence interval (CI): 0.55–0.79, P=0.036). Cutoff derivation by maximum log-rank statistics yielded a threshold of CDK1SA at 11 (SA units, P=0.029). Accordingly, 59% of patients were classified as high-risk (CDK1SA ⩾11). Cox proportional hazard analysis revealed CDK1SA as independent prognostic variable (hazard ratio=6.2, 95% CI: 1.44–26.9, P=0.012). Moreover, CKD1SA was significantly elevated in microsatellite-stable tumours.

Conclusion:

Specific activity of CDK1 is a promising biomarker for metastasis risk in stage II colon cancer.

Combination of rare right arterial variation with anomalous origins of the vertebral artery, aberrant subclavian artery and persistent trigeminal artery. A case report

A 32-year-old woman hospitalized for subarachnoid hemorrhage showed rare arterial variation on the right side with anomalous origins of the vertebral artery, aberrant subclavian artery and persistent trigeminal artery. Angiography showed the right vertebral artery to originate from the right common carotid artery, the right subclavian artery to arise separately from the descending aorta, and persistent trigeminal artery on the right side. The possible embryonic mechanism of this previously unreported variant combination is discussed.

Recurrence risk score based on the specific activity of CDK1 and CDK2 predicts response to neoadjuvant paclitaxel followed by 5-fluorouracil, epirubicin and cyclophosphamide in breast cancers

BACKGROUND

We established the cell cycle profiling (C2P) assay for specific activity (SA; activity/expression) of cyclin-dependent kinases (CDKs). C2P risk score (C2P-RS) based on CDK1 and CDK2 SAs was significantly associated with relapse in breast cancer (BC). This study was conducted to investigate the predictive value of C2P-RS for neoadjuvant chemotherapy (NAC).

PATIENTS AND METHODS

Among 124 eligible patients, 122 were treated with weekly paclitaxel followed by 5-fluorouracil, epirubicin and cyclophosphamide (P-FEC) and 2 were treated with paclitaxel monotherapy. C2P-RS was determined via C2P using frozen biopsy samples before NAC.

RESULTS

Negative estrogen receptor (ER), negative progesterone receptor (PR), positive human epidermal growth factor receptor 2 (HER2), high Ki-67 expression and intermediate + high C2P-RS were significantly associated with high pathological complete response (pCR) rates compared with positive ER (30% versus 9%), positive PR (25% versus 6%), negative HER2 (34% versus 11%), low Ki-67 expression (24% versus 7%) or low C2P-RS (24% versus 9%), respectively. The combination of C2P-RS and Ki-67 had a stronger impact on pCR than each parameter alone, and a multivariate analysis showed that the combination was an independent predictor of pCR (odds ratio 3.3, 95% confidence interval 1.1-9.5).

CONCLUSIONS

C2P-RS was significantly associated with pCR after P-FEC and may be a useful predictor for chemotherapy in BCs.

Development of indirect cavernous dural arteriovenous fistula after trapping for direct carotid cavernous fistula. A case report

SUMMARY

A 60-year-old man with direct carotid cavernous fistula (CCF) due to a motor vehicle accident underwent internal carotid artery trapping following high-flow external carotid to internal carotid artery bypass (EC-IC bypass). Follow-up angiography revealed ipsilateral complex indirect cavernous arteriovenous fistula. Although the traumatic indirect CCF angioarchitecture differs from cavernous-sinus dural arteriovenous fistula (CS-DAVF), the present indirect fistula was similar to the latter. Complex indirect CCF can occur after treatment of direct CCF caused by severe head injury.

Endovascular treatment of a vertebral artery aneurysm via puncture of the surgically exposed vertebral artery

We describe a case of subarachnoid hemorrhage due to a ruptured right vertebral artery (VA) aneurysm where endovascular therapy via a trans-femoral route was not feasible. Therefore we surgically exposed the VA and directly punctured it at the C4 level, followed by successful coil embolization. Direct access to the vertebral artery using an anterior surgical approach is an alternative in cases where the proximal side of the artery is occluded.

Use of CDK1 and CDK2 activity to predict renal cell cancer recurrence

341

Background: We established original methods enabling simultaneous analysis of protein expressions and kinase activities of the CDK (cyclin-dependent kinase) molecules in lysate of tumor tissue in a clinical setting (C2P technology, Ishihara et al: Biochim Biophys Acta. 1741; 226-233, 2005). The clinical utility of the technology was first evaluated in breast cancer, and combination analysis of CDK1 and CDK2 activity was shown to be a significant prognostic indicator for relapse (Kim et al. Ann Oncol. 19;68-72,2009). The objective of our study is to evaluate the efficacy of CDK1 and CDK2 activity as a prognostic marker in human renal cell carcinoma (RCC).

Methods: Surgical specimens were obtained from 115 patients with RCC without metastasis. These patients were selected randomly for this study. Protein expression and kinase activity of CDKs and cyclins were analyzed using a newly developed assay system. The system to measure the CDK specific activity (SA) is named C2Ps (Sysmex, Kobe, Japan). We then examined the specific activities of CDK1 and CDK2 and calculated CDK2/CDK1 ratio in RCC. Also, risk score (RS) was examined as described in previous study (JGH van Nes et al: Br J Cancer. 100; 494-500, 2009). Cut off value was calculated by ROC analysis.

Results: 115 cases were tested, though 32 cases were excluded of low sample quality (30 cases) and of assay failure (2 cases). 83 cases were analyzed. They included 63 male and 20 female patients, ranging in age from 19 to 83 years. At a median follow up of 33 months (1-109M), tumor with low CDK2/CDK1 ratio showed significantly better 5-year progression-free survival (PFS) than those with high CDK2/CDK1 ratio (91.2% vs. 51.6%, p=0.0016). Also, RS enabled the classification of RCCs into high-risk and low-risk groups, patients with tumors classified as low RS showed better PFS than patients with tumors with high RS (88.9% vs. 63.9%, p=0.0488).

Conclusions: CDK1 specific activity of tumors and the CDK2 specific activity are both associated with recurrence and prognosis. Analysis of cyclin-dependent kinase activity in the clinical setting could be a powerful approach for predicting cancer recurrence and prognosis in RCC after surgery and has potential for use as a routine laboratory test.

No significant financial relationships to disclose.

Specific activity of cyclin dependent kinase 1 as a novel predictor of recurrence risk in stage II colon cancer

402

Background: Altered cell cycle dynamics and check points are typical features of solid tumors, and cyclin dependent kinases (CDKs) play pivotal roles in these processes. Previously we have demonstrated that CDK-based analysis, composed of CDK1 and CDK2, is useful in the prediction of outcomes in early breast cancer patients (Ann Oncol. 19(1):68-72, 2008, Br J Cancer. 100(3):494-500, 2009). Clinically, there is a need for risk stratification in patients with stage II colon cancer who have a recurrence risk of 20 to 30%. Therefore we investigated the use of CDK-based analysis for recurrence prediction of stage II colon cancer patients.

Methods: Fresh frozen tissue samples of 254 patients with histologically confirmed adenocarcinoma of the colon, UICC stage II, who received primary tumor resection in Munich (217 cases), and Leiden (37 cases) were used. Protein expression and activity of CDK1 and CDK2 were determined by in vitro assays as previously described. Specific activity (SA) of CDKs was calculated as kinase activity in relation to its corresponding mass concentration.

Results: Development of distant metastasis was observed in 27 patients (10.6%) after a median follow up of 86 months. We found that predictive performance of CDK1SA, but not CDK2SA, for the metastasis was substantial and almost constant for long-term event prediction (average area under the curve (AUC) = 0.69). Tumor recurrence risk analysis in association with CDK1SA identified a low- (41% of population) and high- risk group (59%). Cox proportional hazard model analysis retained the CDK-based patient classification as an independent prognostic factor for distant metastases-free survival (low vs. high-risk group: Hazard ratio = 6.2, 95% CI: 1.45 to 26.9, p=0.0049). Clinical parameters such as grading, T-categories, age, and sex were excluded as confounding factors for CDK1SA-risk.

Conclusions: CDK1SA allows stratification of different risk subgroups of stage II colon cancer patients. CDK1SA-based analysis is useful for predicting patients with high risk of distant recurrence, who should be treated with chemotherapy.

No significant financial relationships to disclose.

Abstract P2-09-29: Cyclin-Dependent Kinase-Based Risk Score Predicts Both Clinical and Pathological Response to Neoadjuvant Paclitaxel Followed by FEC in Early Breast Cancers

Background: We have reported that breast tumors with a high ratio of cyclin-dependent kinase (CDK) 2 to CDK 1 are associated with high tumor cell proliferation and poor clinical outcome in Japanese. In addition, we have developed risk score based on CDK2/1 ratio (CDK-RS), and have demonstrated a high risk group showed a significantly poor prognosis in Hollanders (van Nes, et al: Br J C 2009: 100: 494). The aim of the present study is to evaluate the correlation of CDK-RS with response to neoadjuvant paclitaxel followed by fluorouracil + epirubicin + cyclophosphamide (FEC) in breast cancers.

Material and Methods: Of 131 primary breast cancer patients (age: 25-73y, mean: 51.7y), 126 were treated with paclitaxel (80 mg/m2, weekly) for 12 cycles followed by FEC (500/75/500 mg/m2, q3w) for four cycles and 5 were treated with paclitaxel-monotherapy (5 — 29 cycles) in the NAC or primary chemotherapy setting. Frozen tumor tissues were obtained from core needle biopsy before NAC, and CDK-RS was determined by the Cell Cycle Profiling (C2P) assay as previously reported. Clinical response was evaluated with MRI before NAC and after paclitaxel and FEC. Patients were classified into responders showing ≥80 % in reduction rates and non-responders showing &lt; 80 %. Pathological CR (pCR) was defined as no residual invasive foci and no axillary lymph node metastasis. Results: Patients characteristics were as follows: menopausal status: pre-47%, post-53%; Stage: II 68%, III 27%, IV 7%; Tumor size (cm): ≥5 cm 73%, &gt; 5 cm 27%; histologic grade (HG): I 16%, II 60%, III 24%; ER: (+) 56%, (-) 44%; PR: (+) 39%, (-) 61%; HER2: (+) 28%, (-) 72%. Of 131 patients, 22 (18%) attained pCR but 100 (82%) did not pCR (9 were excluded from evaluation of pathologic response because of stage IV diseases, no operations, and not available pathologic examination). In CDK-RS, 47% of 131 tumors were classified into high, 17% intermediate, and 37% low. In combination with high + intermediate risk score groups, that group had a tendency to show high HG (grade 2 or 3) (87% vs 78%), ER negativity (49% vs 35%), and PR negativity (65% vs 54%) compared with a low risk group, but their differences were not statistically significant. Tumors in the high + intermediate group were significantly more likely to show clinical response after the completion of not only paclitaxel (52% vs 27%, p=0.006) but also FEC (75% vs 52%, p=0.011) as well as to show pCR (24% vs 9%, p=0.037) compared with a low risk score group. In univariate analysis, CDK-RS showed a significant correlation with pCR (high + intermediate vs low, Odds ratio 4.03, 95%CI 1.03 — 10.3, p=0.045).

Discussion: CDK-RS in tumor samples before NAC is significantly associated with clinical and pathological response to paclitaxel followed by FEC. Thus CDK-RS seems to be a novel and useful predictive factor for paclitaxel — FEC in breast cancers.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-09-29.

Polymorphism and multiple twinning of (Et4N)2ZnCl4

The phase sequence of The phase sequence of (Et4N)2ZnCl4 has been determined based on thermal analysis and 35Cl NQR spectroscopy. On cooling two phase transitions are observed at 223.0(5) and 217.7(9)K, respectively. On heating only one phase transition is found at 228.4(3)K. Therefore three phases are distinguished below the decomposition point (556(5)K) with a metastable phase in the temperature region 217-229K, a twinned low-temperature phase below and a disordered high-temperature phase above this region, respectively. The structure of the low-temperature phase has been determined from X-ray 4-circle diffraction data. The space group of this phase is C2ca(Aba2) with a = 11.366(6)Å, b = 13.347(4)Å and c = 15.246(6)Å at T = 190K. From the group-subgroup relations between the high- and the low-temperature phase the structure of the intermediate phase has been derived and confirmed by the analysis of the transition entropies.

Endoscopic submucosal dissection for colorectal tumors

BACKGROUND

Endoscopic submucosal dissection (ESD) is a state-of-the-art method that enables resection of larger tumors than those resectable by conventional endoscopic mucosal resection (EMR). However, the individual role of each method in the treatment of colorectal tumors remains undetermined.

OBJECTIVE AND METHODS

To consider the respective indications of ESD and EMR for colorectal tumors, we analyzed the results of the two treatments retrospectively.

RESULTS

Tumors treated by ESD (44 tumors) were significantly larger, more often located in the rectum and more often coexistent with cancer than those treated by EMR (512 tumors). EMR was used in the majority of adenomas, and showed high rates of both one-piece resection (OPR) and complete resection (CR) for adenomas less than 20 mm. However, for adenomas and cancers greater or equal to 20 mm, the CR rate for EMR was significantly lower than that for ESD because of the incidence of OPR with a positive lateral margin (16% vs 0% with ESD vs EMR). Histopathology (cancer), size (> or =20 mm) and macroscopic type (laterally spreading tumors) were shown to be significant risk factors for that incidence. For tumors with these factors, ESD showed a higher CR rate than did EMR. However, ESD required longer operating times and tended to have a higher rate of perforation compared with EMR. ESD was aborted halfway in seven cases due to technical difficulties and perforation.

CONCLUSION

ESD and EMR have different characteristics as treatment for colorectal tumors. Careful evaluation of the lesion and of the balance between benefits and risks are mandatory before selecting either of these treatments for colorectal tumors.