15^th Asia Pacific Oncologists Annual Meeting September 5-6, 2018 Tokyo, Japan

Biography:

Dr. Juan Pablo Marquez Manriquez, M.D. is a Medical Oncologist with training in Mexico, California and Seattle, Washington. His passion for Immunology and Oncology emerged from the very early stages of his life, as he prepared in pre-medicine by studying first Clinical Pharmacy and later medicine. He is currently developing projects for the prevention of gastrointestinal cancer in the CICS USA Seattle campus. He is currently specializing in the prevention of recurrence of tumors of high clinical impact such as ovarian, triple negative breast cancer, inflammatory breast cancer, colorectal and multiple myeloma. Since 2002, he has presented his scientific achievements at multiple international conferences led by AACR, ASCO, AAI, SITC and ESMO. He worked as a medical doctor at the Tumor Vaccine Group of the University of Washington. Dr. Marquez Manriquez is Binational Medical Director of the Binational Alliance in ImmunoOncology of Seattle, Sonora and Miami, including the Cancer Research Center in Sonora (CICS Sonora) both at the Ciudad Obregon Sonora campus and at the Seattle Washington campus (CICS USA), although his based in Seattle. In coordination with CICS and various institutions at the international level, CICS is developing through the investigations of Dr. Juan Pablo Marquez and CICS scientific medical team preventive vaccines to prevent pediatric and adult cancer and their recurrences. Importantly he is focus on combo therapies including but not limited to multi peptide immunotherapy targeting clinically relevant targets such as Ape-1, Fascin, RCAS1, EGFR, Survivin, VCP, Bcl-2, etc. in refractory and progressive tumors. The Binational Immuno Oncology of Seattle, Sonora and Miami are also generating combination of therapies that will allow for longer remissions and fewer recurrences for different types of tumors such as ovarian, sarcomas, neurotumors and gastrointestinal tumors.

Abstract:

Background: Despite the recent understanding that refractory cancer is immunogenic and the level of tumor infiltrating T-cells identified is associated with disease outcome; few studies evaluate the multi peptide immunotherapy of the refractory disease.  Antigen-specific active immunotherapy targeting refractory cancer is limited and focus on only a few antigens clinically irrelevant antigens.  Overexpression of self-proteins that are involved in cancer proliferation has been shown to be a mechanism by which self-proteins become immunogenic.  We questioned whether overexpressed proteins that are found in high incidence in several refractory malignancies and associated with poor prognosis could be refractory tumor clinically relevant targets to develop multi peptide immunotherapies in combination with other approaches such as immunogenic chemotherapy.  We questioned whether multi peptide immunotherapy targeting twenty antigens could be an approach to the development of refractory cancer immunotherapy in patients with good ECOG despite their prognosis.

Methods:  Forty proteins overexpressed in refractory cancer and associated with these clinical conditions were identified.  Indirect ELISA was used to evaluate antibody immunity directed against these proteins in 25 refractory cancer patients and 100 age-matched controls.  Web-based algorithms were used to identify long peptides including both Class I and Class II binding epitopes derived from the native protein sequences.  Peptide reactivity was assessed using Granzyme B ELISPOT.  Peptides that were highly immunogenic by ELISA and ELISPOT were formulated into multi-peptide immunotherapy and patients were enrolled in a pilot clinical trial approved by the local ethic committee.  25 patients were treated with intradermal peptide injections in 8 times in the area of the axillary and inguinal lymph nodes and afterwards we administered the peptides in the areas with tumor activity according with the CT scans along with doxorubicin and oxaliplatin as immunogenic chemotherapy after dose-response of both drugs was tested in vitro using autologous PBMC’s and the patients were monitored for the development of Th1 and CD8 immune response and clinical response.  At specific time points, subjects were evaluated clinically by CT scans.  Tumor sections from the original surgery were stained for CD8 and Th1 positive cells by immunohistochemistry.  CD8 T-cell and Th1 quantitation was based on the mean of three 40X fields per section.

Results: Bcl-2, RCAS1, VCP, FAP, Survivin, fascin, EGFR and Ape-1 are immunogenic in refractory cancer patients.  Serum IgG + IgM + IgA responses for all the peptides derived from the mentioned proteins were significantly elevated in refractory cancer patients sera when compared to donor controls (Bcl-2 p=0.0001, RCAS1 p=0.0001, VCP p= 0.005, FAP = 0.0001, survivin 0.003, fascin p= 0.001, EGFR p=0.005 and Ape-1 p=0.0001).  ELISPOT screening yielded epitopes that were immunogenic in refractory cancer.  Tumors were significantly inhibited after the treatment with the combination of the multipeptide antigen specific active immunotherapy and immunogenic chemotherapy with significantly increased in tumor infiltrating CD8 T-cells and Th1 cells and decreased Foxp3 positive cells. 

Discussion: Refractory cancer is immunogenic and overexpressed proteins involved in important clinically relevant pathways could serve as immunotherapy immunogens in refractory cancer with ECOG 0-1.  Active multi peptide immunotherapy against refractory cancer antigens can destroy tumors and inhibit new tumor growth refractory cancer patients including sarcoma n=10, ovarian cancer n=8, triple negative breast cancer n=5 and PDAC n=2.  Multi peptide immunotherapy and immunogenic chemotherapy was associated with no adverse events in the treated patients and could significantly increase tumor infiltrating CD8 and Th1 cells.  These data lay the foundation for the development of multi-peptide immunotherapy in combination with immunogenic chemotherapy for the treatment of refractory cancer patients and overcome chemo resistance.

Biography:

Phung Thi Huyen is working at Vietnam National Cancer Hospital, Vietnam.

Abstract:

Biography:

Karlo Fidel has completed his medical degree at the age of 23 from University Of Santo Tomas and is currently taking his residency in internal medicine at Cardinal Santos Medical Center. He is currently in his senior year and plans to take gastroenterology for fellowship.

Abstract:

Objective: To present a case of Disseminated Intravascular Large B-cell Lymphoma presenting as fever of unknown origin.

Method: Case Report

Background: Intravascular large B-cell lymphoma (IVLBCL) is a rare type of non-Hodgkin’s lymphoma (NHL) characterized by the selective growth of neoplastic cells within blood vessel lamina. The precise mechanisms responsible for this distinctive behavior are at the moment largely unknown. By the time of presentation, most patients have advanced, disseminated disease, and often the diagnosis is made at autopsy. Diagnosis requires skin, liver, lung, bone marrow, renal, meningeal, or brain vessel biopsy but is often made only when the illness has progressed or post mortem because early involvement of organs was not evident.

Case Discussion: We report a case of Intravascular lymphoma who presented as fever of unknown origin. In this case, initial laboratory test results were unremarkable. Computed Tomography of the chest and abdomen as well as bone marrow aspiration and biopsy were negative for malignancy. Patient developed neurologic symptoms and expired due to complications. Autopsy was done which revealed Disseminated Intravascular Diffuse Large B-cell Lymphoma.

Conclusion: Without treatment, intravascular lymphoma is rapidly fatal. Ante-mortem diagnosis is challenging and indefinable.  A high index of suspicion followed by biopsy of the organs suspected to be involved, together with early institution of treatment are of utmost importance in approaching these kinds of patients.

Biography:

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Biography:

Abstract:

The transcription factor GATA3 plays a significant role in mammary gland development and differentiation. We analyzed expression of GATA3 in breast cancer (BC) cell lines and clinical specimens from BC patients in Taiwan. Semi-quantitative reverse transcriptase (RT)-polymerase chain reaction (PCR), quantitative real-time PCR carried out to determine the mRNA level of GATA3 from 241 pairs of matched tumor and adjacent normal issues from anonymous female donors. GATA3 immunohistochemistry (IHC) staining and H-score were performed (n=25). Inducing and silencing of GATA3 were done by exposure MCF-7 cell line to nicotine or curcumin, respectively. GATA3 expression was detected in most of the estrogen receptor-positive (ER+) tumor specimens (176/241, 73%) compared with paired normal issues (65/241, 27%) (p= <0.001). The GATA3 level was highest in Luminal A and independent t-tests revealed higher GATA3 were associated with ER+ (p = 0.018) and BC stages (stage II, and stage IV). Nuclear protein expression of GATA3 was detected in tumor issues (p=<0.001) with higher H-score in Luminal A patients (p=0.012). Kaplan–Meier survival analyses showed that ER+/progesterone receptor (PgR) + and lower grade BC patients with relatively high GATA3 had better clinical overall survival (OS). GATA3 regulate ERa and BCL-2 as BC luminal subtype markers. Cox univariate and multivariate analyses demonstrated that the expression of GATA3 was an effective predictor of the risk of death. We demonstrated a correlation between GATA3 expression and only ER+ and suggest that a higher GATA3 expression is a good prognostic factor for OS for ER+/ BC patients.

Biography:

Gordon Moffat has his experience in life sciences with honors in biology with training in radiology. His passion for science and the humanity lead him to pursue and obtain a Doctor of Medicine(MD). Currently he is training at the State University of New York Brooklyn Health Sciences Center as an internal medicine resident and incumbent medicine chief resident. His interests are in medical oncology, hospice and palliative medicine and geriatrics. He is currently working on research projects at Memorial Sloan Kettering Cancer Center in Manhattan, New York that are expected to be published.

Abstract:

Purpose:

Identifying mutations in breast cancer genes (BRCA1, BRCA2, PABL2) has important clinical implications on a woman's lifetime susceptibility to breast cancer development. Nearly 10% of immigrants to the United States come from the Caribbean and few studies exist that examine breast cancer gene mutations in African-Caribbean women with existing breast cancer. The purpose is to specifically describe breast cancer epidemiology statistics and review prevalence of BRCA mutations in this cohort.

Methods:

Epidemiologic data on select Caribbean countries and USA was abstracted from GLOBOCAN 2012, a database of estimated global cancer statistics produced by the International Agency for Research on Cancer and World Health Organization. Sex-specific age standardized incidence and mortality rates for breast cancer in specific countries are presented in Table 1. A Literature Search was also conducted through PubMed database using following terms: Caribbean , (familial breast cancer), (hereditary breast cancer), and (BRCA breast cancer) that was subsequently narrowed to epidemiologic relevance resulting in five citations and presented in Table 2.

Conclusions:

The GLOBOCAN 2012 data provides an estimate of breast cancer incidence and mortality in Caribbean women. This study summarizes the known prevalence of BRCA1/2 and PALB2 breast cancer gene mutations in select Caribbean cohorts. This is critical as part of a formal genetic risk assessment and counseling of patients with breast cancer, particularly in areas that serve a Caribbean population. Further research and understanding the contributions of inherited gene mutations will guide the optimal health policy in breast cancer screening and risk management.

Biography:

Diana Alrumhi is working at Orbsen Therapeutics, Ireland.

Abstract:

Introduction:

Syndecan-2(Sdc-2) is a transmembrane heparin sulphate proteoglycan that is upregulated in breast tumours. Preliminary data indicates that overexpression of Sdc2 peptides in BCC’s increases their migratory and immunosuppressive properties. Sdc-2 fragments were designed and cloned into a vector to mimic a component of endogenous Sdc-2. Overexpression of TGF-β results in pro-tumorigenic modifications to cells in the tumour microenvironment. Therefore, inhibition of the TGF-β pathway would be a rational approach in breast cancer therapies. Our objective was to determine the role of Sdc-2 on the TGF-β pathway in MDA-MB-231 BCC’s.

Method:

Cultured MDA-MB-231 breast cancer cells were transfected with Fc empty vector, Sdc-F1 or Sdc-F2. A serum starvation and a TGF-β3 time course were carried out. RNA was harvested from the cells at 0, 1, 2, 4, 6 after TGF- β3 treatment. The RNA was purified and quantified, followed by cDNA synthesis via reverse transcription. qPCR was carried out to determine the effect of Sdc-2 fragments on TGF-β induced genes such as SMAd7, Serpine1 and CTGF.

Results:

Promising data was collected from all three experiments, however due to sensitivity of qPCR the figures were different preventing statistical significance. Throughout all three experiments consistent trends were observed such as SMAD7 and Serpine1 downregulation by Sdc-2-Fc-peptides indicating TGF-β suppression especially at the 6 hour time point.

Conclusions:

Further investigation of Sdc-2-Fc-peptides is imperative since data collected revealed Sdc-2 interaction with TGF-β induced genes.

Biography:

Mel Valerie C. Ordinario is a current medical oncology fellow-in-training at St. Luke’s Medical Center, one of the premier hospitals in the Philippines. She has a passion for research and teaching and believes in endless pursuit of learning.

Abstract:

Primary malignant melanoma of the oral cavity is a rare malignancy with an incidence of 0.2 to 8% of all melanomas. Melanoma arises from the malignant transformation of the melanocyte and cutaneous melanomas are the most common followed by ocular, mucosal and melanoma of unknown primary site. Here we present a case of a 54 year old male who presented with a pigmented lesion on the palate, a type of mucosal melanoma. Due to the rarity of this disease, it is infrequently studied. Hence, epidemiology, etiology, pathogenesis and prognosis still remains to be less understood than cutaneous melanoma. Early diagnosis is warranted as therapeutic options are limited for advanced and metastatic disease. Surgery is the primary therapeutic management and complete resection is the main goal. If not feasible, radiotherapy may also be employed to achieve local control and enhance locoregional response. Prognosis is generally poor for metastatic disease and there are no guidelines yet on the use of systemic therapy.

Biography:

Soo Rah Angelle R. Kwak, is a diplomate in internal medicine, residing in Davao City, Philippines. She had her medical degree at Davao Medical School Foundation and completed residency training in Southern Philippines Medical Center (SPMC). She has received recognitions with her case report entitled, “A Rare Case of a 19-year old with Carney Complex”. She is dedicated in the Cancer Institute of SPMC, as acting junior consultant.

Abstract:

In the Philippines, breast cancer has a rising mortality rate despite improvement in diagnosis and treatment. Inexpensive screening tools have been advocated including Breast Self Examination (BSE), however, not many have adapted to this practice.

Objectives. It has been demonstrated that the influence of healthcare professionals affects the patients’ knowledge, attitude and practice (KAP) towards BSE. Hence, the researchers investigated on the KAP of BSE in a tertiary hospital among healthcare workers. The impact of a standard brochure-distribution as a means of advocating BSE, as compared to providing a planned awareness program was also determined.

Methodology. Through convenience sampling, ninety-eight (98) healthcare workers were enrolled. Respondents were randomly distributed to either the control (brochure only) or interventional (brochure with awareness program) group. A structured validated questionnaire assessed the knowledge and attitude of the respondents, while practice scores were determined through performing BSE. All domains were reassessed after six weeks and the scores were compared.

Results. The mean knowledge scores of all participants were good and significantly improved after intervention. However, there was no significant difference in the scores between study groups. There was a significant difference in the attitude of the respondents after undergoing the awareness program. Hence, the awareness program, had a greater impact in the improvement of attitude towards BSE as compared to providing brochure alone. Lastly, practice scores of the participants were poor at baseline and became impressively improved post intervention. But between study groups, there was no significant different of practice scores.

Conclusion. There was a significant improvement after intervention in the knowledge, attitude and practice of BSE. However, the awareness program made a greater impact on the attitude and the practice domains. Hence, this study recommends a well-planned awareness program for the advocacy of BSE among healthcare workers and possibly to the patients.  

Biography:

Arun Shahi is working at National Institiute of Cancer Research & Hospital, Bangladesh.

Abstract:

BACKGROUND: The aim of this study was to assess the level of knowledge of cervical cancer among Bangladeshi women and to determine the source of information.

METHOD: A total of 250 women aged 17 to 55 years, were interviewed using a structured questionnaire. It is a population-based, cross-sectional survey which was conducted in a tertiary cancer hospital, National Institute of Cancer Research and Hospital (NICRH), Mohakhali, Dhaka, Bangladesh from September 2017 to March 2018. Data on socio-demographic characteristics, knowledge of cervical cancer and source of information were collected. The bivariate analysis was completed using a quantitative data collected.

RESULT: The majority of our study participants reported to have very poor Knowledge about cervical cancer. Mostly it is related with women’s low level of formal education, illiterate (OR: 5.653, 95% CI: 0.021-0.257, p-value <0.001).Very few women reported to have detailed knowledge about cervical cancer (Education above primary level P- value< 0.001) .Other factors associated with poor knowledge were Occupation (OR: 6.543, 95% CI: 2.213-19.206, p-value <0.001) monthly family income (p-value<0.001), Husband’s education level (p-value <0.001). We found age of the women was significantly responsible for poor knowledge, women aged more than 40 years (p-value <0.005) old having cervical cancer were unaware about cervical cancer.

CONCLUSION: Knowledge about cervical cancer is found to be poor among Bangladeshi women, unlike findings in developed countries. There is need to educate our women on the early warning signs of cervical cancer as failure to recognize the early symptoms and signs contribute to the late presentation and poor prognosis.

Biography:

Dr. Fararjeh has his expertise in molecular biology and human genetic. He is doing his PhD in cancer biology and drug discovery with focusing on the molecular basis of breast cancer. He recently published one review paper in 2016 and another is original research in human pathology 2018. In addition, he has been submitted another in environmental toxicology journal. Dr. Fararjeh devote his time for research.

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Biography:

Hemish Kania is working at department of surgical oncology, Dr B Borooah Cancer Institute, India.

Abstract:

Purpose: To report our early experience in chemo port insertion without image guidance by surgeons.

Materials And Methods: This was a cross-sectional study conducted in a tertiary center with 19 chemo port insertions done from November 2017 to May 2018. The chemo ports were inserted at the operation theater unit. All the chemo ports had right internal jugular vein (IJV) as the entry site. Other entry sites included the left IJV, subclavian veins and the inferior vena cava were not used. Immediate and early complications were recorded. None of the port insertions were performed under image guidance with the aid of ultrasound and fluoroscopy.

Results: The technical success rate was 100%. In terms of immediate complications, there were only two cases of arterial puncture that resolved with local compression. No pneumothorax or air embolism was documented. No case of early complications was recorded. The most common early complication was catheter blockage (2/19; 10.52% ), followed by catheter-related infection (2/19; 10.52%). No incidence of catheter malposition, venous thrombosis and catheter dislodgement or leak was recorded. A total of 1 (5.26%) chemo ports had to be removed within 30 days; most of them were due to infections that failed to respond to systemic antibiotic therapy. In terms of place of procedure, there were no significant differences in complication rates between the chemo port catheter placements via image guidance in comparison to the one done without image guidance.

Conclusion: Chemo port insertion without image guidance by surgeons gives low periprocedural complication rates in comparison to chemo port insertion done by image guidance.  Using right IJV as the entry site, the image guidance gives good success rate with least complication.

The advantage of doing it without  image guidance is that it saves a lot of time. Also it can be done under local anaesthetia. It doesn’t require any radiological assistance during the procedure. And it requires lesser number of skilled personals in terms of manpower.

To our best knowledge, this is the first publication of chemo port insertion without image guidance. 

Biography:

Dina Abdallah is working at Alexandria Faculty of Medicine, Egypt

Abstract:

Background: Colorectal cancer is the third most common cancer in men and the second most common cancer in women worldwide. Recently, cancer stem cells (CSCs) have received attention due to their role in cancer initiation, progression, and metastases. Their ability of self-renewal, unlimited proliferation, and multipotency are considered cancer stem-cell phenotypes, and they seem to be responsible for local relapse and metastasis by inducing resistance against traditional drug therapy.

Methods: In this study, we evaluated the immunohistochemical expression of OCT-4 and CD133 in 30 cases of rectosigmoid adenocarcinoma which received neoadjuvant chemoradiotherapy in relation to other clinicopathological features of the tumor.

Results: Negative OCT-4 expression was noted in 17 cases with the scores less than 4 positive OCT-4 expression was observed in 13 cases with the scores equal to or more than 4. A significant relationship was found between OCT-4 and tumor stage (P = 0.029). And significant relationship was found between OCT-4 and clinical response (P = 0.010).

10 cases out of 30 were negatively stained by CD133, while the other 20 cases were positively stained. Positive stained samples further classified into high expression (12 specimens) and low expression (8 specimens). No statistically significant relationship was found between CD133 and different clinicopathological parameters as patient's age, sex, tumor stage, grade, LN status, clinical response and pathological response to chemoradiotherapy.

Conclusions:We concluded that the expression of OCT-4 is significantly positive correlated with tumor stage which might indicate that OCT-4 expression is a poor prognostic factor in CRC. The expression of OCT-4 is significantly correlated with good clinical response to chemoradiotherapy. The mean age for development of CRC is lower in the Egyptian population than the western countries.

Biography:

Manar Atoum is working at Hashemite University, Jordan

Abstract:

Lung cancer is the leading cause of cancer-related deaths worldwide. Malondialdehyde (MDA) is one of reactive species that plays a role in increasing DNA damage. Superoxide dismutase (SOD) is an important antioxidant enzyme that protect against ROS injury in lung. X-ray cross complement gene (XRCC1) is a DNA repairing gene that has an important role in repairing DNA alterations. Arg399Gln polymorphism in XRCC1 may affects the risk of lung cancer. So, the aim of this study is to determine the association between MDA, Cu-Zn Superoxide dismutase serum level and Arg399Gln polymorphism among Jordanian lung cancer patients.

This study conducted in Al-Basheer hospital between (2015 and 2016) and enrolled thirty five lung cancer patients and forty healthy subjects. MDA serum level was measured using colorimetric assay and the serum level of (Cu-Zn SOD) was determined using ELISA assay. DNA samples were amplified by PCR, genotyped using MspI restriction enzyme digestion and electrophoresed on agarose gel.

MDA serum level was significantly higher among lung cancer patients (3.34 ±0.6 nmol/mL) compared to control (2.72 ±0.49 nmol/mL) and associated with around ten folds increased risk for lung cancer (OR 2.54). (Cu-Zn SOD) serum level was significantly lower in lung cancer patients (50.03 ±9.6 ng/mL) compared to control (67.26 ±13.2 ng/mL) and associated with more than three folds increased risk for lung cancer (OR 3.85).

Significant differences were found in genotypic and allelic distribution of XRCC1 gene Arg399Gln polymorphism between lung cancer patients and control. GA, AA genotypes and A allele were more frequent in lung cancer patients (52.8%, 15.1%, 41.5%) compared to control (38.8%, 2%, 21.4%) and significantly associated with increase lung cancer risk (GA; OR 2.51), (AA; OR 13.65),(A; OR 2.60). No significant association was found between serum levels of MDA, (Cu-Zn SOD) and XRCC1 Arg399Gln polymorphism among lung cancer patients and control group.

Conclusion: high serum levels of MDA and low serum levels of (Cu-Zn SOD) are associated with increased lung cancer risk among Jordanian lung cancer patients. AA, GA genotypes and A allele of the XRCC1 Arg399Gln are also associated with increased lung cancer risk.

Biography:

Wen Li Lin is working at Chi Mei Medical Center, Taiwan

Abstract:

Background:  Colorectal cancer  is the cancer with the highest prevalence in Taiwan. Care coordination has received increased attention because it critically affects patient safety and care quality across services.

Objectives:  This paper is a report of a study conducted to examine the effects of a the psychoeducational intervention (PEI) on anxiety, depression, and self-efficacy in patients with colorectal cancer undergoing chemotherapy.

Methods: After baseline screening, patients with colorectal cancer who agreed to participate (n = 100) were randomized to either experimental or control group. The experimental group participated in a PEI. The PEI was constructed with two separate parts: educational information and materials relating to depression, anxiety, EORTC QLQ-C30, and self-efficacy. The intervention group participated in the PEI for at least 1 hour per section for 6 sections, in addition to using an educational manual designed and presented by the researchers. Participants in the control group were exposed only to the traditional pamphlet education approach in OPD. Data were collected just before the chemotherapy (T1), the 3rd (T2) and 5th weeks of chemotherapy (T3), and 2 weeks after the final session of chemotherapy (T4). The study was carried out from 2015 to 2016.

Results:  Values for anxiety, depression, and quality of life two weeks (T4) after chemotherapy treatment ended showed significant differences for colorectal cancer patients who received PEI. Significant differences in self-efficacy were shown between the two groups after the fifth chemotherapy treatment (T3).  The effects of anxiety, depression, and quality of life remained significant when group and time interactions were included in the model, showing a positive relationship between PEI and the variables of anxiety, depression, and quality of life.

Conclusion: Face-to-face PEI can be used effectively for colorectal cancer patients before chemotherapy in clinical oncology settings to reduce the degree of emotional disturbance and accelerate adaptation. PEI significantly improved disease care techniques, reduced chemotherapy-related discomfort, and improved quality of life for participants in the experimental group.

Biography:

Qingcai Meng is a PhD student in Fudan University Shanghai Cancer Center. He is mainly committed to molecular typing and clinical transformation research of pancreatic cancer. He has published more than 5 papers in reputed journals.

Abstract:

Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest cancers worldwide, partly due to tumor chemoresistance. Numerous studies have shown that glutathione peroxidase-1 (GPx1) plays various roles in development and progression of multiple tumors. However, its role in pancreatic cancer remains unclear. In this study, we sought to elucidate the function of GPx1 in pancreatic cancer malignancy and gemcitabine (GEM) resistance. Experimental Design: PDAC tissue microarrays was used to evaluate the correlation between GPx1 expression and clinicopathological features. Cytobiology, molecular biology assays and mouse models were performed to investigate the detailed mechanisms. Finally, RNA-sequencing was performed in the scramble-shRNA and GPx1-shRNA MiaPaCa-2 cells to identify core signaling pathways. Results: The level of GPx1 expression was negatively associated with overall survival (OS) in patients with PDAC. Silencing of GPx1 resulted in an epithelial–mesenchymal transition (EMT) phenotype and increased chemoresistance to GEM in vitro and in vivo. Additionally, activation of Akt/GSK3β/Snail signaling was demonstrated to be involved in this process. Conclusions: Our results reveal that GPx1 could inhibit EMT and chemoresistance by regulating Akt/GSK3β/Snail axis in PDAC. 

Biography:

Pei-Hua Wu is working at Chi Mei Medical Center, Taiwan

Abstract:

Background:  Lymphoma has the highest prevalence among all cancer types in Taiwan. Care coordination has received increased attention because it critically affects patient safety and care quality across services.

Objectives:  This study examines and evaluates the effect that adopting a nurse navigator interventions for newly diagnosed lymphoma patients.

Methods: In this retrospective study, 212 lymphoma patients were recruited between January 2009 and December 2013. The experimental group comprised 115 patients who had received nurse navigator interventions. The nurse navigator coordinated the recruitment, liaison, care plan implementation, conducted disease education, telephone consultations, follow-ups, and evaluations. The control group comprised 97 lymphoma patients. The patients in the control group had similar characteristics to those in the experimental group, and received routine care.

Results:  Adopting a nurse navigator interventions in lymphoma care increased patient follow-up appointment compliance rates at 3 months (p =0.007). The model also effectively reduced the patients’ 14-day readmission rate (p =0.05). Furthermore, these improvements were statistically significant. The results also indicated that the survival rate for patients receiving care from lymphoma. A nurse navigator interventions was superior to that of the control group receiving traditional care.

Conclusion: Adopting a anurse navigator interventions in lymphoma care effectively enhanced clinical treatment adherence, increased survival rates, and reduced the 14-day readmission rate. This study provides evidence that standardized nurse navigator programs can improve patient outcomes in cancer care.