Day 1 :
Keynote Forum
Oliver Micke
Franziskus Hospital Bielefeld, Germany
Keynote: Magnesium in oncology – Update 2017
Time : 10:05-10:45
Biography:
Oliver Micke has completed his PhD from Muenster University Hospital in 2006. He is Head of the Department for Radiotherapy and Radiation Oncology at Franziskus Hospital Bielefeld since 2006. In addition, he is the Medical Director of Franziskus Hospital Bielefeld, a premier teaching hospital of the Medical University of Hanover (MHH). He has published more than 200 papers in reputed national and international journals and has been serving as Reviewer as well as an Editorial Board Member of repute.
Abstract:
Oncology had not paid much attention to the electrolyte magnesium so far. However, it plays an important role in numerous physiological and pathophysiological processes, e.g. in anti-cancerogenesis, regulation DNA- and RNA synthesis, mitosis, metastasis, nuclear repair mechanisms, and apoptosis. Therefore, magnesium definitely earns far more medical interest.In particular, in oncological therapies negatively influencing renal function, as cisplatinum, severe hypomagnesaemia can occur, as shown by own studies, which often requiring treatment. A new aspect arose from the introduction of the epidermal growth factor receptor (EGFR) antibodies cetuximab and panitumumab in the oncological therapy, particularly in colorectal cancers. These lead by an interaction with the transient receptor potential cation channel TRPM6 in the majority of patients to a clinical hypomagnesaemia and in up to 10% to 36% of cases to severe Grad III/IV hypomagnesaemia. Thereby, interestingly it appeared that there is a significant positive correlation between hypomagnesaemia clinical response to the antibody therapy as well as to a significantly better survival. The underlying mechanism is nearly unknown, but maybe similar factors, as we postulated in hypomagnesaemia and radiotherapy, for example the inhibition of DNA repair in tumor cells. Therefore, under special circumstances a low magnesium level may be more useful for tumor patients. Another new and exciting aspect of magnesium is the treatment of hot flashes due to hormonal deprivation therapy. Magnesium is known for its neuro- and vasoactive effects. Even though there are uncountable hints in the internet on the treatment of hot flashes with magnesium – the digital search engine Google alone yields more than 253,000 hits -, only two smaller scientific studies on this topic have been carried out so
far. So far, there are only some small clinical studies and few case reports on this topic. In an own pilot study with six patients suffering from breast cancer and hot flashes under hormonal deprivation were treated with 300 to 600 mg magnesium orally over 4 to 6 weeks. In 5/6 (83%) of patients a marked improvement of symptoms was observed. Thereby the strength as well as the frequency of hot flashes was alleviated significantly. As side effects, only in one case stronger diarrhoea was observed. The exact biological mechanism of magnesium action is not yet elucidated. Recent studies from literature support our findings. In the light of the recent study data, magnesium remains a highly interesting ion for oncology, whose different facets should be more and more enlightened.
Break: Networking and Refreshments Break 10:45 -11:05 @ Foyer
Keynote Forum
Angiolo Gadducci
University of Pisa, Italy
Keynote: PARP inhibitors alone and in combination with other biological agents in homologous recombination deficient epithelial ovarian cancer: From the basic research to the clinic
Biography:
Angiolo Gadducci is currently working as Professor at Department of Obstetrics and Gynecology, University of Pisa, Italy. He has extended his valuable service as oncologist has been a recipient of many award and grants. His international experience includes various programs, contributions and participation in different countries for diverse fields
of study. His research interests reflect in his wide range of publications in various national and international journals.
Abstract:
Hereditary epithelial ovarian cancer in germline BRCA mutation(gBRCAm) carriers has a distinct clinical behavior characterized by younger age, high- grade serous histology, advanced stage, visceral distribution of disease, high response to platinum and other non-platinum agents and better clinical outcome. Sporadic epithelial ovarian cancer with homologous recombination deficiency [HDR] but no gBRCAm has the same biological and clinical behavior as epithelial ovarian cancer in gBRCAm carrier (“BRCAness”phenotype). Biomarkers are in development to enable an accurate definition of molecularnfeatures of BRCAness phenotype, and trials are warranted to determine whether such HDR signature will predict sensitivity to poly (adenosine diphosphate[ATP-ribose] polymerases [PARP] inhibitors in sporadic epithelial ovarian cancer. Moreover, the link between PARP inhibition and angiogenesis suppression, the immunologic properties of epithelial ovarian cancer in gBRCAm carriers, the HRD induced by PI3K inhibition in epithelial ovarian cancer cells in vitro strongly support novel clinical trials testing the combination of PARP inhibitors with other biological agents.
- Organ Specific Cancers | Cancer Treatment & Therapies | Cancer Vaccines | Cancer Diagnosis & Diagnostics
Location: Olimpica 3+4
Chair
Oliver Micke
Franziskus Hospital Bielefeld, Germany
Co-Chair
Syed Azizur Rahman
University of Sharjah, UAE
Session Introduction
Karen A Beningo
Karen A Beningo
Title: The mechanical enhancement of cancer cell invasion
Biography:
Karen A Beningo received her PhD in Cell, Development and Neural Biology from the University of Michigan Medical School, Ann Arbor, MI USA. She completed her Post-doctoral studies with Dr. Yuli Wang at University of Massachusetts Medical School in Worcester, MA. She is currently an Associate Professor in the Department of Biological Sciences at Wayne State University and a Member of the Tumor Biology and Microenvironment subgroup of the Karmanos Cancer Institute. She has reviewed for numerous national cancer institute study sections, has authored 25 manuscripts and has received over 2800 citations.
Abstract:
The ability of a cell to invade surrounding tissues is an abnormal cellular process for most cells and is only acquired during the stages of tumor progression and metastasis. What initiates this dramatic change is not fully understood nor is the signals that guide the invasion process. This study has focused on the influence of mechanical cues from the environment that guide the invasive process. We have discovered number mechanical parameters, aside from environmental stiffness that can direct this cellular process. One surprising mechanical signal was the enhancement of invasion of fibrosarcoma cells 2-4 fold above normal levels by simply tugging on the extracellular matrix at magnitudes that mimic those of cellular movements made by fibroblasts within the ECM (Extra Cellular Matrix). We further identified genes that were differentially expressed upon receiving the mechanical cue. Of particular interest was the down-regulation of the beta3-integrin. We have further discovered that this mechanical signal results in the inactivation of PAK1 and the subsequent activation of cofilin, a key protein in the formationmof the invasive structures known as invadopodia. Through confocal microscopy we have determined that tugging on the ECM results in a maturation of invadopodia, as determined by elongation and proteolytic degradation of fluorescent ECM surrounding the invadopodia. In summary, we have identified that tugging on ECM fibers at magnitudes equivalent to a cell migrating or remodeling the microenvironment can elevate effective invasive behavior of highly invasive cancer cells.
Oliver Micke
Franziskus Hospital Bielefeld, Germany
Title: Re-irradiation in cancer - Can amifostine help us?
Biography:
Oliver Micke has completed his PhD from Muenster University Hospital in 2006. He is Head of the Department for Radiotherapy and Radiation Oncology at Franziskus Hospital Bielefeld since 2006. In addition, he is the Medical Director of Franziskus Hospital Bielefeld, a premier teaching hospital of the Medical University of Hanover (MHH). He has published more than 200 papers in reputed national and international journals and has been serving as Reviewer as well as an Editorial Board Member of repute.
Abstract:
A second irradiation course has been established for the treatment of recurrent head and neck cancer since more than 5 decades. 24-month survival rates are limited to 30-40%. Severe acute and late toxicities are observed in up to 50% of all treated patients. Does selective cytoprotection with amifostine offer a way to reduce the high toxicity profile? We reanalyzed the data of three earlier published mono-centric studies which had combined re-irradiation of a solid tumor with the application of 500 mg amifostine IV before daily radiotherapy. 42/53 patients received re-irradiation because of head and neck cancer disease. 11 have had other solid tumors (rectal cancer 5, cervical cancer 2, endometrial cancer 2, uterus sarcoma 1, and prostate cancer 1). All head and neck cancer patients received additional chemotherapy for radio-sensitizing. The therapy was possible in all patients without serious adverse events due to amifostine. The combination of chemo- and radiotherapy was possible in all treated patients. The total irradiation doses were >110 Gy for both courses. Acute mucosal and skin toxicities (mucositis, stomatitis, diarrhea, dermatitis, cystitits and proctitis) were reduced to grade 1 / 2 level in 49/53 patients. Grade 3
/4 toxicities were seen in only <10% (n=4). No objective data were available for late toxicities and survival. In conclusion, we suggest initiating new research on the combination of amifostine and re-irradiation of solid tumors. We await the reduction of acute toxicity and positive impact on late toxicity profile as well as effect of irradiation in this situation.
Biography:
Syed Azizur Rahman has completed his PhD in 2001 from the London School of Hygiene and Tropical Medicine, University of London. He is currently working at University of Sharjah, UAE as a Chairman of the Health Services Administration Department. Prior to that, he worked for the London School of Hygiene and Tropical Medicine, Research Scientist at British Columbia Cancer agency, Canada and as Clinical Assistant Professor at University of British Columbia. He has published good number of papers in reputed journals and has been serving as an editorial board member of the Journal of Public Health Issues and Practice.
Abstract:
Background: According to the World Health Organization, breast cancer is the most common cancer among women worldwide, claiming the lives of hundreds of thousands of women each year and affecting countries at all levels of modernization. Breast cancer is considered the most common cancer in the UAE. The average age of women who get breast cancer in the UAE is about 10 years younger than women in Europe and USA. Breast self-examination (BSE) is a screening technique that can be done at home which allows the woman to examine her breast tissue for any physical or visual changes.
Aim: This study aimed to assess the awareness of breast cancer and breast self-examination and practice among the female students at the University of Sharjah.
Method: A cross sectional study was conducted to explore the awareness level of breast cancer and breast self-examination and practice among the female students at the University of Sharjah. Data were organized and analyzed using Statistical Package for Social Sciences.
Results: The majority of the student has heard about breast cancer and breast self-examination. Social media is the main sources of information. Less than half of the participants have knowledge about the risk factor of breast cancer. Difference of knowledge on both the breast cancer and BSF were found among the student of three campuses. Only 28% of the participants perform breast self-examination. This finding suggests organizing comprehensive awareness program among the female student to reduce cancer episode in UAE.
Break: Lunch Break 13:15- 14:15@Hotel Restaurants
Mohammed Y Almaghrabi
King Abdullah Medical City, Saudi Arabia
Title: Holism and stereotactic body radiation therapy
Biography:
Mohammed Y Almaghrabi is a currently working as Radiation Oncologist at King Abdullah Medical City, Saudi Arabia. He is leading stereotactic radiosurgery/ stereotactic body radiation therapy task groups at the same hospital. He was Head of Radiation Oncology department at Prince Faisal Cancer Centre, Saudi Arabia. He has his research experience from University of Ottawa Canada and Nantes University, France. He has been a recipient of many awards and grants. He was selected as a Sectional Editor (Radiation Oncology, Biomarkers) for Journal of Cancer Treatment and Diagnosis, Reviewer for British Journal of Radiology and CARO annual scientific meeting. His research experience includes various programs, contributions and participation in different countries for diverse fields of study.
Abstract:
Holism is a new concept dealing with Stereotactic Body Radiation Therapy (SBRT) settings. SBRT experts concern with lessening organ toxicity. Use of DVH (dose-volume histogram) solely in SBRT treatment care plan/ protocols might cause grave consequences if other factors ignored. Correlation between specific injury and radiation dose is still uncertain. Sometimes there are discrepancies between studies in defining the injury. There is little known about most of the toxicity mechanisms. Use of biologically equivalent dose model is still controversial. It seems inevitable that SBRT delivery, patient factors (including comorbidities, patient's BMI, gender, habits, age, and ECOG PS score), tumor factors and treatment factors should carefully be examined.
Song Han
University of Florida, USA
Title: Stroma-derived extracellular vesicles deliver tumor-suppressive mi-RNAs to pancreatic cancer cells
Biography:
Song Han completed her MD in 1987 and PhD in 1996, both from Shanghai Jiao Tong University School of Medicine, China. She received Postdoctoral training (1996-2008) at Cardiff University, UK. She is currently a Research Faculty at the University of Florida. Her research interest includes the understanding and translational application of extracellular vesicle transporting microRNAs in the cross-talk between tumor-associated stroma (TAS) and cancer cells in pancreatic cancer tumor microenvironment. She has published more than 45 papers in reputed journals and has been serving as reviewer of several high-impact journals.
Abstract:
The biology of tumor-associated stroma (TAS) in pancreatic ductal adenocarcinoma (PDAC) is not well understood. The paradoxical observation that stroma-depletion strategies lead to progression of PDAC reinforced the need to critically evaluate the functional contribution of TAS in the initiation and progression of PDAC. PDAC and TAS cells are unique in their expression of specific miRNAs, and this specific miRNA expression pattern alters host to tumor microenvironment interactions. Using primary human pancreatic TAS cells and primary xenograft PDAC cells co-culture, we provided evidence of miRNA trafficking and exchanging between TAS and PDAC cells, in a two way, cell-contact independent fashion, via extracellular vesicles (EVs) transportation. Selective packaging of miRNAs into EVs led to enrichment of stromal specific miR-145 in EVs secreted by TAS cells. Highly-concentrated exosomes, but not micro-vesicles, derived from human TAS cells demonstrated a tumor suppressive role by inducing PDAC cell apoptosis. This effect was mitigated by anti-miR-145 sequences. Our data suggest that TAS-derived miRNAs are delivered to adjacent PDAC cells via exosomes and suppress tumor cell growth. These data highlight that TAS cells secrete exosomes carrying tumor suppressive genetic materials, a possible anti-tumor capacity. Future work of the development of patient-derived exosomes could have therapeutic implications for unresectable PDAC.
- Young Researchers Forum
Location: Olimpica 3+4
Session Introduction
Claudio Luchini
University and Hospital Trust of Verona, Italy
Title: New molecular insights of pancreatic ductal adenocarcinoma
Biography:
Claudio Luchini is a Surgical Pathologist with expertise in the field of next-generation sequencing and of systematic review with meta-analysis. He has studied at Verona University, Italy and then Indiana University, USA and Johns Hopkins University as Research Fellow. He has published his important works in Journal of Clinical Oncology and Cancer Cell. With the tool of meta-analysis, he has highlighted the prognostic role of important morphological and molecular alterations in cancer. The main goal of his research is to find morphological and molecular markers for early diagnosis of tumors or to better stratify cancer prognosis.
Abstract:
Pancreatic ductal adenocarcinoma (PDAC) is a high malignant neoplasm that will represent the second cause for cancer death in the next 20 years. Recent molecular studies have better clarified its complex genetic landscape. However, many mechanisms of tumorigenesis of such tumor remain still unclear and of difficult comprehension. The study of peculiar variants of this tumor type may help in the comprehension of the biology of PDAC. To this aim, we have studied with immunohistochemistry, FISH (Fluorescent in situ hybridization) analysis and whole-exome sequencing the rare PDAC variant named undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UCOGC). Firstly, we observed some clinical and prognostic peculiarities in this PDAC variant. Then we report strikingly molecular similarities of UCOGC to those known to drive conventional PDAC, including activating mutations in the oncogene KRAS, and inactivating mutations in the tumor suppressor genes CDKN2A, TP53, and SMAD4. Lastly, we describe a new potential PDAC driver gene which we found in 25% of UCOGC studied with whole-exome sequencing: the SERPINA3 gene.
Carla Lettieri
University Federal Fluminense, Brazil
Title: Is universal and quality cancer treatment a human right?
Biography:
Carla Lettieri is a PhD student of Law and Sociology at University Federal Fluminense and completed her Master’s degree in International Relations at Pontifícia Universidade Católica do Rio de Janeiro- PUC-Rio. She works as Program Coordinator at Instituto Ronald McDonald which, among other actions, advocates for the right of children with cancer to have access to free, universal treatment with the highest quality as possible.
Abstract:
This paper aims at discussing the access to cancer treatment through the less of the International Covenant on Human Rights and answering to the question: Is free, universal and quality treatment considered a human right? And if so, how it could be implemented? The Universal Declaration of Human Rights states in the article 25 that everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. Cancer can affect any person indistinctly, but obviously, not every person has the same capability to pursue the cure and quality of life. The global epidemiology of cancer demonstrates that not every human being have access to cancer treatment. In fact, according to the World Health Organization, even though Cancer is the second leading cause of death globally and was responsible for 8.8 million deaths in 2015, 70% of them occurred in low- and middle-income countries. Many factors contribute to the number of deaths: late diagnosis, unavailability of hospitals, the quality of the hospitals available, presence of behavioral or environmental risks, among others. The consequences of the disease are severe not only for the patients, but also for their families and society. According to the World Cancer Report 2014, the economic impact of cancer is significant and increasing. The economic losses of the cancer were estimated in U$ 1.6 billion in 2010. In this scenario, is there any space for an International Covenant on the Rights of Persons with Cancer?
Break: Networking and Refreshments Break 15:55-16:15 @ Foyer
M N Vidanapathirana
University of Colombo, Sri Lanka
Title: Documentation in palliative care: Audit on completeness of medical records at a palliative care setting in Sri Lanka
Biography:
M N Vidanapathirana is a final year medical student currently studying at Faculty of Medicine, University of Colombo. She has completed internships at World Bank Sri Lanka(Health Sector) and Doctors of the World(Médecins du Monde), a French NGO. Her research interests include palliative care, oncology and endocrinology.
Abstract:
Introduction & Aim: Medical documentation in palliative care is important for information dissemination within the multidisciplinary team and for medico-legal purposes. This study aimed to assess the completeness of the ‘Patient Assessment Form’ (PAF) within two timeframes at the Palliative Care Clinic, Maharagama and compare them for differences in completeness. Methods: This study was a retrospective internal desk research. All PAFs stored in the clinic were reviewed for two timeframes, which were the first four months since starting the clinic (September-December 2015) and the last four months prior to data collection (October 2016 -January 2017). Data analysis was done with SPSS 23 using descriptive statistics.
Results: There were 56 and 42 PAFs for the two timeframes, respectively. In both timeframes, only clinic number showed 100% documentation. In the first timeframe, age (94.6%) was the best documented and psychosocial section was the most poorly documented (48.2%). Reason for referral (55.4%), presenting conditions (60.7%) and problems (73.2%) were inadequately documented. For the second-time frame, primary diagnosis was the best recorded (97.6%) while site of metastases was the worst (59.5%). Documentation of presenting conditions (73.8%) and treatment plan (69%) were insufficient. There was no improvement in overall documentation of PAF with time (p=0.061). However, significant improvements were noted in the documentation of religion (p=0.007) and caregiver information (p=0.002). No difference in documentation between medical and nursing officers was seen for either timeframe (p=0.243, p=0.082).
Conclusions: Documentation in the PAF is incomplete. Training health personnel in this regard would improve documentation and care provision.
Perla Pérez Treviño
Tecnologico de Monterrey (ITESM), Mexico
Title: 3D imaging detection method of HER2: Application of dual conjugated affibody-quantum dots probes and ratiometric analysis
Biography:
Perla Pérez-Treviño is a PhD student in Biotechnology from the Tecnologico de Monterrey (ITESM), Mexico. Since 2012 to the present, she has been working as Research Assistant at Institute of Cardiology and Vascular Medicine, Zambrano-Hellion Hospital, School of Medicine, ITESM. She has published two papers as first author in important peer reviewed journals and two more that are in revision. Her work is focused in the study of molecular and microstructural cell alterations during various chronic pathologies, and currently, she is working in assessing the expression of biomarkers in 3D models of cancer cells growth and tumors.
Abstract:
HER2 overexpression is associated with Breast Cancer (BC) poor prognosis, due to increased metastases and angiogenesis, and decreased apoptosis. HER2 is commonly assessed by immunohistochemistry. Technique that requires extensive sample processing to get thin fixed samples (3-5 ïm) that are analyzed using standard HER2 detection probes, and subjective algorithms for HER2 interpretation. Consequently, lacks accuracy and reproducibility, and could lead to misdiagnosis. Therefore, we developed a 3D imaging detection method of HER2 using affibody molecules conjugated with quantum dots (Aff QDs) and ratiometric analysis (RMA). Affibody anti-HER2 and affibody negative control were conjugated by the maleimide reaction with QD605 and QD545, respectively. Fixed HER2+ and HER2-BC spheroids were incubated with a mixture (1:1) of both Aff- QDs, and confocal image stacks were recorded in the z-axis. Images were processed by RMA (AffantiHER2 QD605/Affneg- D545 fluorescence), to assess the specific HER2 signal. We found that the non-specific accumulation for both Aff-QDs was the same within HER2-spheroids. However, the AffantiHER2-QD605 signal in HER2+ spheroids, was significantly higher (5.910.81 F/F0) than that of Affneg-QD545 (2.670.56 F/F0, p<0.05) and was optimally resolved up to 50 depth. After RMA, non-specific signals were removed in HER2+ and HER2- spheroids, and no false HER2 signal was found. Therefore, Aff-QDs can efficiently penetrate in spheroids, used as 3D BC models, with minimal sample manipulation; after RMA, specific and objective 3D HER2 result can be obtained. The method proposed here, could reduce the typical problems associated with traditional immunohistochemistry and improves HER2 detection by 3D analysis.
D M Gomez
University of Colombo , Sri Lanka
Title: Temporal trends in patient characteristics and treatment at a palliative care setting, Sri Lanka
Biography:
D M Gomez is a final year undergraduate at the Faculty of Medicine, University of Colombo, Sri Lanka’s most elite medical school. He has so far performed excellently, being awarded first class honors in the basic and applied sciences streams. A six week elective he did on palliative care, along with his internship at
‘Medecins du Monde’(Doctors of the World) inspired him and has sparked a flame for research on the topic.
Abstract:
Introduction & Aim: Palliative needs of cancer patients in Sri Lanka remain unclear. Aim of this study is to identify the temporal trends in patient characteristics and treatment at a main palliative care setting in Sri Lanka.
Methodology: This was a retrospective study conducted at the Palliative Care Clinic, National Cancer Institute Maharagama. All Patient Assessment Forms (PAFs) in the clinic were reviewed for two timeframes i.e. the first four months since starting the clinic (September-December 2015) and the last four months prior to data collection (October 2016 -January 2017). An expertdeveloped audit tool was used and trends evaluated under four thematic areas: socio demographic characteristics, disease characteristics, palliative-care problems and treatment.
Results: There were 56 and 42 PAFs for the two timeframes, respectively. The median age of patients seeking palliative care increased from 55 to 58.5 years. Presentation of unmarried individuals (p=0.044) without caregivers (p=0.002) for care decreased significantly with time. The most common cancers in the first timeframe were upper gastrointestinal (17.9%) and oro-pharyngeal carcinoma (12.5%) and those in the second timeframe were oro-pharyngeal (33.3%) and lung carcinoma (14.3%). Most patients at presentation for palliative care had metastasis in both timelines. Over time, pain increased as a presenting complaint (p=0.039). Other physical problems (p=0.039) and social problems (p=0.011) were also more frequently identified. Treatment-wise, symptom control was the most frequent problem addressed in both timeframes, however, there was a temporal improvement in the address of financial problems (p=0.008).
Conclusions: In patients presenting for palliative care, significant time trends were identified in all four thematic areas. These trends require consideration when refining palliative care services..