Incidence and Survival Rates of Gynecological Malignancies in The United States Before and After the HPV Vaccine

Intoduction:

Gynecological malignancies are one of the most common cancers in women and have high mortality rates in the United States. In this study, we aimed to analyze the incidence and mortality rates of gynecological malignancies in 2011-2015 and compare these data with the corresponding parameters of 2001-2005. We chose these intervals of years for contrasting, as HPV vaccines have been actively used since 2006. HPV vaccine is known to prevent cervical cancer but has unknown impact on other gynecological malignancies. The aim of the is study is to check if incidence and survival of gynecological malignancies has changed before and after application of HPV vaccine

Material and Methods:

The Surveillance, Epidemiology and End Results (SEER) cancer registry 2005-2011 and 2011-2015 database was investigated and patients with gynecological malignancy were identified. Data were obtained using SEER*Stat version 8.3.5. A statistical analysis on the incidence rate and mortality rate was performed. Data were exported using case-listing session in SEER*Stat and were analyzed using SPSS version 25.

Results:

Overall 125,357 cases with a gynecological malignancy were identified in 2011-2015 in comparison with 102,534 cases in the period of 2001-2005. The incidence of cervical cancer decreased in the period of 2011-2015 compared with the period from 2001 to 2005 (median incidence rates 3.9 and 4.3 per 100.000 persons, respectively, p < 0.05), while incidence of uterine (15.3 and 12.0 per 100.000 persons persons, respectively) and vulvar (1.55 and 1.86 per 100.000 persons, respectively) has increased ( p < 0.05). There was no change in the incidence rate of ovarian cancer (7.28 and 7.19 per 100.000 persons). Survival rates for cervix, uterine, ovarian and vulva cancer have increased. However, zero time error couldn’t be avoided in statistical analysis.

Conclusion:

As a result of widespread screening with Pap smear test and availability of human papilloma virus vaccine the incidence of cervix cancer has declined. Increase in vulvar and uterine cancer incidence may be attributed to lack of effective screening program for early detection of these type of cancers and most probably HPV vaccine has no effect on their incidence. Survival of gynecological malignancies has increased over years which may be explained by better treatment options or earlier detection.

Abstract P1-05-06: Endothelial nitric oxide synthase gene intron4 VNTR polymorphism in patients with breast cancer

Background: Endothelial nitric oxide synthase (eNOS), also known as NOS3 is an enzyme that in humans is encoded by the NOS3 gene located in the 7q35-7q36 region of chromosome 7. Nitric oxide (NO) is synthesized from L-arginine by eNOS in the vascular endothelium and plays crucial roles in cellular proliferation. In the present study, it is hypothesized that polymorphisms of the Intron4b/a variable number of tandem repeat (VNTR) polymorphism Intron4b/a in the eNOS gene may be associated with an increased risk in the developing breast cancer.

Methods: We included 38 (38 F/Female) patients with breast cancer and 70 (44M/26F) healthy controls. The VNTR polymorphism in intron4 (intron4b/a) was analyzed by PCR. The results were statistically analyzed by calculating the odds ratios (OR) and 95% confidence intervals using the χ2 test.

Results: The distributions of genotype and allele frequency was compared among the groups. The bb, ab and aa genotypes were observed in 29 [76.3%], 9 [23.7%], 0 [0%] patients with breast cancer and in 33 [47.1%], 15 [21.4%], 22[31.5%] healthy controls respectively. The b and a alleles were observed in 67 [88.2%], 9 [11.8%] patients with breast cancer and in 81 [57.8%], 59 [42.2%] healthy controls respectively. The susceptibility to patients with breast cancer had significantly higher frequencies in bb genotype (p=0.004 OR=3.613). The patients with breastcancer had significantly lower frequencies in aa genotype (p=0.001,OR=1.458). The frequency of the a allele was significantly lower in the patients with breast cancer (p=0.001, OR=4.070).

Comparison of eNOS / VNTR polymorphism between patients with Breast and healthy control subjects.eNOS VNTRBreastHealthy ControlsOR*%95 CI*pGenotypesn=38 (%)n=70 (%)   BB29 (76.3)33 (47.1)3.613 a1.494-8.735 a0.004 a   3.065 b1.440-6.520 b0.004 bAB9 (23.7)15 (21.4)0.879 a0.343-2.252 a0.812 a   0.9020.388-2.096 b0.832 bAA0 (0)22 (31.5)1.458 a1.244-1.709 a0.001 a   12.375 b2.764-55.396 b0.001 bAllele     B67 (88.2)81 (57.8)5.422 a2.505-11.740 a0.001 aA9 (11.8)59 (42.2)4.070 b2.199-7.533 b0.001 b* Fisher's Exact Test a, comparison of genotype and allele frequencies between breast and healthy control groups

Conclusion: We conclude that there was sensible correlation between eNOS gene intron 4b/a VNTR polymorphism and the risk of breast cancer and bb genotype frequency was significantly higher in these patients than healthy controls.

Citation Format: Gunaldi M, Isiksacan N, Pehlivan S, Binboga S. Endothelial nitric oxide synthase gene intron4 VNTR polymorphism in patients with breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-05-06.

Serum nectin-2 levels are diagnostic and prognostic in patients with colorectal carcinoma

INTRODUCTION

Nectins are a family of integral protein and immunoglobulin-like cell adhesion molecules involved in the formation of functioning adherence and tight junctions. Aberrant expression is associated with cancer progression, apoptosis and cell proliferation but little is known how these effects change in cell behavior. The objective of this study was to evaluate the serum levels of nectin-2 with regard to diagnostic, predictive and prognostic value in colorectal cancer (CRC) patients.

MATERIALS AND METHODS

One-hundred and forty CRC patients were enrolled in this study. Serum nectin-2 levels were determined by enzyme-linked immunosorbent assay method. Age- and sex-matched 40 healthy controls were included in the analysis.

RESULTS

Median age of patients was 60 years old, range 24-84 years. The localization of tumor in majority of the patients was colon (n = 81, 58 %). Non-metastatic (stage II and III) and metastatic patients' baseline serum nectin-2 levels were significantly higher than those in the healthy control group (p < 0.001; for two group). However, known clinical variables including response to CTx (chemotherapy) were not found to be correlated with serum nectin-2 concentrations (p > 0.05). While non-metastatic group patients with elevated serum nectin-2 levels showed significant adverse effect on PFS, metastatic group patients with elevated serum nectin-2 levels showed no significant adverse effect on PFS (p = 0.05 and p = 0.29, respectively). On the other hand, our study results did not show statistically significant serum nectin-2 concentrations regarding overall survival rates.

CONCLUSION

Serum levels of nectin-2 may have diagnostic roles for CRC patients. Moreover, our study results show the prognostic role of nectin-2 in non-metastatic group patients.

Efficacy of paclitaxel in the treatment of Kaposi sarcoma

OBJECTIVE

Kaposi sarcoma is an angioproliferative disease. Kaposi sarcoma is clinicopathologically classified into four subgroups based on epidemiological data. For its systemic treatment, in addition to some chemotherapeutics, taxanes have also been used during the recent years for their anti-angiogenic properties. In this study, we aimed to compare paclitaxel and non-paclitaxel chemotherapeutic regimens in terms of efficacy and side effects.

PATIENTS AND METHODS

In our center, demographical, clinical and histopathological characteristics of a total of 13 patients diagnosed with Kaposi sarcoma who received therapy were retrospectively recorded based on their medical files

RESULTS

Among these subjects, 7 have been treated with paclitaxel and 6 with non-paclitaxel therapies. Eleven patients were male. Twelve patients were found to have classical type of Kaposi Sarcoma. The recurrence was observed in 2 patients treated with paclitaxel and in 1 patient treated with non-paclitaxel therapy. No statistically significant difference was found between the therapeutic modality, the stage of the disease and the percentage of the recurrence. Neuropathy developed in 3 patients treated with paclitaxel, whereas there was no neuropathy in the other group. Although the recurrence-free survival was worse in the patients treated with paclitaxel, there was no statistically significant difference.

CONCLUSIONS

Cytotoxic chemotherapy is effective in treating patients with Kaposi Sarcoma, although it is palliative. Taxanes have demonstrated effectiveness against AIDS-associated Kaposi Sarcoma. The experience suggests that paclitaxel is an effective alternative in the treatment of classical form Kaposi's sarcoma. There was no difference in efficacy between paclitaxel and non-paclitaxel therapies whereas difference in occurrence of neuropathy which is one of the side effects, showed borderline statistical significance.