Improvement of the quality of propagation material for organic farming system

The use of organic propagation material is obligatory according to the current EU regulations for organic production. However, frequently difficulties are en-countered regarding the availability, the costs or the quality. In the Netherlands a national research program aims at developing solutions, needed for improving the production of high quality organic propagation material. The main emphasis in the pro-gram is on the model crops cabbage, onion, wheat and potato. Individual projects within the program include epidemiological studies of seed borne dis-eases to develop disease prevention strategies, meth-ods to improve resistance of seeds and seedlings towards pathogens and methods to control silver scurf in seed potatoes, development of multi-spectral analysis and sorting techniques and methods for analysis and improvement of seed vigour. Active involvement of producers and users of the seeds or seed potatoes ensures that the results will be imple-mented in practice. The program also aims at strengthening the international collaboration, amongst others through involvement in international research projects

Non-state nations: Structure, rescaling, and the role of territorial policy communities, illustrated by the cases of Wales and Sardinia

This paper explores the role of non-state nations’ identity and agency with regard to relations with their host nation states. The particular focus here is on the means by which such regions might express their individuality. To this end, we employ a comparative case study analysis of two non-state nations with a range of differing yet in other ways similar qualities – namely Wales (UK) and Sardinia (Italy). We suggest that this is a valuable exercise, allowing as it does for the exploring of evidence ‘on the ground’ of the processes involved. The conceptual rationale for the paper is provided by new regionalism – regions as actors beyond the nation state. Following this, the idea of the ‘territorial policy community’ is presented as a point of departure, with the scope of the paper being to develop a diachronic framework for regional change. Given the focus on identity and interest articulation, the role of regional political parties is a particular subject of the empirical investigation, with non-state nations and nation states linked by opportunistic relationships based on political and electoral support. We then consider what this might mean with regard to the capacity of non-state nations to build on the past to successfully negotiate future policy-making agendas. Finally, we reflect on the limitations of the study, and consider the implications of its findings for further research agendas

Application of PET Tracers in Molecular Imaging for Breast Cancer

Purpose of Review: Molecular imaging with positron emission tomography (PET) is a powerful tool to visualize breast cancer characteristics. Nonetheless, implementation of PET imaging into cancer care is challenging, and essential steps have been outlined in the international “imaging biomarker roadmap.” In this review, we identify hurdles and provide recommendations for implementation of PET biomarkers in breast cancer care, focusing on the PET tracers 2-[18F]-fluoro-2-deoxyglucose ([18F]-FDG), sodium [18F]-fluoride ([18F]-NaF), 16α-[18F]-fluoroestradiol ([18F]-FES), and [89Zr]-trastuzumab. Recent Findings: Technical validity of [18F]-FDG, [18F]-NaF, and [18F]-FES is established and supported by international guidelines. However, support for clinical validity and utility is still pending for these PET tracers in breast cancer, due to variable endpoints and procedures in clinical studies. Summary: Assessment of clinical validity and utility is essential towards implementation; however, these steps are still lacking for PET biomarkers in breast cancer. This could be solved by adding PET biomarkers to randomized trials, development of imaging data warehouses, and harmonization of endpoints and procedures

Detection of Dural Metastases Before the Onset of Clinical Symptoms by 16 alpha-[F-18]Fluoro-17 beta-Estradiol PET in a Patient With Estrogen Receptor-Positive Breast Cancer

We offer an illustrative case about estrogen receptor (ER) imaging (also known as 16 alpha-[F-18]fluoro-17 beta-estradiol ([F-18]-FES) PET) and the detection of metastatic lesions in the dural region. We present a case of a woman with ER-positive metastatic breast cancer and high [F-18]-FES uptake in the dural region on PET imaging, without associated clinical symptoms. These lesions were missed on [F-18]-FDG PET because of physiological [F-18]-FDG uptake in the brain. This case highlighted some difficulties in the interpretation of imaging of brain metastases and demonstrated the added value of [F-18]-FES PET imaging. [F-18]-FES PET could be used to prove the presence of ER-positive metastases in the brain

Image Quality and Interpretation of [18F]-FES-PET:Is There any Effect of Food Intake?

BACKGROUND: High physiological 16α-[18F]-fluoro-17β-estradiol ([18F]-FES) uptake in the abdomen is a limitation of this positron emission tomography (PET) tracer. Therefore, we investigated the effect of food intake prior to PET acquisition on abdominal background activity in [18F]-FES-PET scans. METHODS: Breast cancer patients referred for [18F]-FES-PET were included. Three groups were designed: (1) patients who consumed a chocolate bar (fatty meal) between tracer injection and imaging (n = 20), (2) patients who fasted before imaging (n = 20), and (3) patients without diet restrictions (control group, n = 20). We compared the physiological [18F]-FES uptake, expressed as mean standardized uptake value (SUVmean), in the abdomen between groups. RESULTS: A significant difference in [18F]-FES uptake in the gall bladder and stomach lumen was observed between groups, with the lowest values for the chocolate group and highest for the fasting group (p = 0.015 and p = 0.011, respectively). Post hoc analysis showed significant differences in the SUVmean of these organs between the chocolate and fasting groups, but not between the chocolate and control groups. CONCLUSION: This exploratory study showed that, compared to fasting, eating chocolate decreases physiological gall bladder and stomach [18F]-FES uptake; further reduction through a normal diet was not seen. A prospective study is warranted to confirm this finding

Effect of Extending the Original Eligibility Criteria for the CROSS Neoadjuvant Chemoradiotherapy on Toxicity and Survival in Esophageal Cancer

Patients with curable esophageal cancer (EC) who proceed beyond the original Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study (CROSS) eligibility criteria are also treated with neoadjuvant chemoradiotherapy (nCRT). This study assessed the effect that extending the CROSS eligibility criteria for nCRT has on treatment-related toxicity and overall survival (OS) in EC. The study enrolled 161 patients with locally advanced EC (T1N1-3/T2-4aN0-3/M0) treated with the CROSS schedule followed by esophagectomy. Group 1 consisted of 89 patients who met the CROSS criteria, and group 2 consisted of 72 patients who met the extended eligibility criteria, i.e. a tumor length greater than 8 cm (n = 24), more than 10% weight loss (n = 35), more than 2-4 cm extension in the stomach (n = 21), celiac lymph node metastasis (n = 13), and/or age over 75 years (n = 2). The study assessed the differences in nCRT-associated toxicity [National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) grade3] and 90-day postoperative mortality. Moreover, the prognostic value for OS was assessed with multivariate Cox regression analysis. No difference was found in nCRT-associated toxicity (P = 0.117), postoperative complications (P = 0.783), and 90-day mortality (P = 0.492). The OS differed significantly (P = 0.004), with a median of 37.3 months [95% confidence interval (CI), 10.4-64.2 months] for group 1 and 17.2 months (95% CI 13.8-20.7 months) for group 2. Pathologic N stage (P = 0.023), pathologic T stage (P = 0.043), and group 2 (P = 0.008) were independent prognostic factors for OS. Extension of the CROSS study eligibility criteria for nCRT did not affect nCRT-associated toxicity, postoperative complications, and postoperative mortality, but was prognostic for OS

Monitoring the Crosstalk Between the Estrogen Receptor and Human Epidermal Growth Factor Receptor 2 with PET

Purpose: Ovarian cancer (OC) leads to poor survival rates mainly due to late stage detection and innate or acquired resistance to chemotherapy. Thus, efforts have been made to exploit the estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) to treat OC. However, patients eventually become resistant to these treatments as well. HER2 overexpression contributes to the acquired resistance to ER-targeted treatment. Trastuzumab treatment, on the other hand, can result in increased expression of ER, which, in turn, increases the sensitivity of the tumors towards anti-estrogen therapy. More insight into the crosstalk between ER and HER2 signaling could improve our knowledge about acquired resistance in ovarian cancer. The aim of this study was to evaluate whether PET could be used to detect changes in ER expression induced by HER2-targeted treatment in vivo. Procedures: Male athymic nude mice were subcutaneously (sc) inoculated with 106 SKOV3 human ovarian cancer cells (HER2+/ER+). Two weeks after inoculation, tumor-bearing mice were treated intraperitoneally with either vehicle, the HER2 antibody trastuzumab (20 mg/kg, 2×/week), or the HER2-tyrosine kinase inhibitor lapatinib (40 mg/kg, 5 days/week) for 2 weeks. Thereafter, ER expression in the tumor was assessed by PET imaging with 16α-[18F]-fluoro-17β-estradiol ([18F]FES). Tumors were excised for ex vivo ER and HER2 measurement with Western blotting and immunohistochemistry. Results: All treatments led to smaller tumors than vehicle-treated tumors. Higher [18F]FES maximum standardize tumor uptake (SUVmax) was observed in animals treated with trastuzumab (+ 29 %, P = 0.002) or lapatinib (+ 20 %, P = 0.096) than in vehicle-treated controls. PET results were in agreement with ex vivo analyses. Conclusion: FES-PET imaging can detect changes in ER expression induced by HER2-targeted treatment and therefore can be used to investigate the crosstalk between ER and HER2 in a noninvasive manner

Re-Irradiation in Patients with Recurrent Rectal Cancer is Safe and Feasible

BACKGROUND: There is no consensus yet for the best treatment regimen in patients with recurrent rectal cancer (RRC). This study aims to evaluate toxicity and oncological outcomes after re-irradiation in patients with RRC in our center. Clinical (cCR) and pathological complete response (pCR) rates and radicality were also studied. METHODS: Between January 2010 and December 2018, 61 locally advanced RRC patients were treated and analyzed retrospectively. Patients received radiotherapy at a dose of 30.0-30.6 Gy (reCRT) or 50.0-50.4 Gy chemoradiotherapy (CRT) in cases of no prior irradiation because of low-risk primary rectal cancer. In both groups, patients received capecitabine concomitantly. RESULTS: In total, 60 patients received the prescribed neoadjuvant (chemo)radiotherapy followed by surgery, 35 patients (58.3%) in the reRCT group and 25 patients (41.7%) in the long-course CRT group. There were no significant differences in overall survival (p = 0.82), disease-free survival (p = 0.63), and local recurrence-free survival (p = 0.17) between the groups. Patients in the long-course CRT group reported more skin toxicity after radiotherapy (p = 0.040). No differences were observed in late toxicity. In the long-course CRT group, a significantly higher cCR rate was observed (p = 0.029); however, there was no difference in the pCR rate (p = 0.66). CONCLUSIONS: The treatment of RRC patients with re-irradiation is comparable to treatment with long-course CRT regarding toxicity and oncological outcomes. In the reCRT group, less cCR was observed, although there was no difference in pCR. The findings in this study suggest that it is safe and feasible to re-irradiate RRC patients