The Association Between Braf V600E Mutation and Circulating Melanoma Cells in Stage I-IV Melanoma Patients

Introduction. Melanoma is the deadliest type of skin cancer, and its incidence is projected to increase at a rate of 1.4% per year. Circulating melanoma cells (CMCs) are cells shed from the primary tumor into the bloodstream, and are believed to seed distant tumors. The BRAF V600E mutation is a significant genetic variant in melanoma, and is associated with greater risk of melanoma. Both CMCs and the BRAF V600E mutation are associated with poor outcomes in melanoma patients. Although CMCs are prognostically significant, the precise mechanism of their release is not well understood. Therefore, we hypothesize that BRAF V600E is associated with greater likelihood of CMC release. Aims and Methods. The purpose of this research was to determine whether the presence of the BRAF V600E mutation is associated with higher odds of CMCs among a cohort of 280 melanoma patients treated at M.D. Anderson Cancer Center between 2012 and 2016. The association between BRAF V600E mutation and CMCs was tested using simple and multiple logistic regression models which included potential confounding variables known to be relevant to disease prognosis. Results. The analysis indicates that BRAF V600E is not positively associated with presence of CMCs in melanoma patients. In fact, individuals with the BRAF V600E variant were slightly less likely to have CMCs than individuals without the variant, although the association was not statistically significant. Additionally, tumor size is positively associated with greater odds of CMCs. Conclusions. The results of this study indicate that the BRAF V600E mutation may be protective against the release of CMCs, and therefore, metastasis. It also suggests that tumor size may be important in CMC release. Future studies should examine prevalence of CMCs in BRAF+ individuals, comparing individuals who received targeted therapy versus those who did not, as well as research into the basic science of CMC dissemination

<i>Social Support, Depression, Self-Esteem, and Coping Among LGBTQ Adolescents Participating in</i> Hatch Youth

Evidence-based interventions that increase social support have the potential to improve the health of lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. Hatch Youth is a group-level intervention that provides services four nights a week to LGBTQ youth between 13 and 20 years of age. Each Hatch Youth meeting is organized into three 1-hour sections: unstructured social time, consciousness-raising (education), and a youth-led peer support group. Youth attending a Hatch Youth meeting between March and June 2014 (N = 108) completed a cross-sectional survey. Covariate adjusted regression models were used to examine the association between attendance, perceived social support, depressive symptomology, self-esteem, and coping ability. Compared to those who attended Hatch Youth for less than 1 month, participants who attended 1 to 6 months or more than 6 months reported higher social support (beta(1-6mo.) = 0.57 [0.07, 1.07]; beta(6+mo.) = 0.44, 95% confidence interval [CI; 0.14, 0.75], respectively). Increased social support was associated with decreased depressive symptomology (beta = -4.84, 95% CI [-6.56, -3.12]), increased self-esteem (beta = 0.72, 95% CI [0.38, 1.06]), and improved coping ability (beta = 1.00, 95% CI [0.66, 1.35]). Hatch Youth is a promising intervention that has the potential to improve the mental health and reduce risk behavior of LGBTQ youth.</p

Exploratory Analyses of Risk Behaviors Among GLBT Youth Attending a Drop-In Center

This exploratory study examines measures of one drop-in center's efforts to improve health outcomes of gay, lesbian, bisexual, and transgender (GLBT) youth by facilitating out-group secondary social ties. Hatch Youth, located in Houston, Texas, aims to increase self-esteem and decrease negative health outcomes by encouraging GLBT youth to be part of Houston's greater GLBT community. Survey data (N = 614) collected between October 2003 and April 2013 were entered into logistic regression models. Attending Hatch Youth for 6 or more months was associated with having a social group outside of school (adjusted odds ratio [aOR] = 2.07; 95% confidence interval [CI] = [1.33, 3.20]), being out to that social group (aOR = 2.34; 95% CI = [1.35, 4.03]), and interacting with the GLBT community outside of Hatch Youth (aOR = 2.33; 95% CI = [1.50, 3.54]), when referenced against youth attending less than 1 month. Having a good family relationship in the last 90 days (aOR = 2.48; 95% CI = [1.67, 3.70]) and having a social group outside of school (aOR = 2.57; 95% CI = [1.67, 3.97]) were associated with higher self-esteem. Higher self-esteem was associated with practicing safe sex (aOR = 1.86; 95% CI = [1.25, 2.75]) and not using street drugs (aOR = 0.45; 95% CI = [0.24, 0.83]). Interacting with the GLBT community outside of Hatch Youth was associated with practicing safe sex (aOR = 1.64; 95% CI = [1.12, 2.42]). Drop-in centers can strengthen secondary social ties among youth. Because questions remain about how drop-in centers can assist youth aging out of their programs to find other supportive secondary social ties, additional studies examining similar drop-in centers are needed

Circulating tumor cells in breast cancer patients treated by neoadjuvant chemotherapy: A Meta-analysis

BACKGROUND: We conducted a meta-analysis in nonmetastatic breast cancer patients treated by neoadjuvant chemotherapy (NCT) to assess the clinical validity of circulating tumor cell (CTC) detection as a prognostic marker. METHODS: We collected individual patient data from 21 studies in which CTC detection by CellSearch was performed in early breast cancer patients treated with NCT. The primary end point was overall survival, analyzed according to CTC detection, using Cox regression models stratified by study. Secondary end points included distant disease-free survival, locoregional relapse-free interval, and pathological complete response. All statistical tests were two-sided. RESULTS: Data from patients were collected before NCT (n = 1574) and before surgery (n = 1200). CTC detection revealed one or more CTCs in 25.2% of patients before NCT; this was associated with tumor size (P < .001). The number of CTCs detected had a detrimental and decremental impact on overall survival (P < .001), distant disease-free survival (P < .001), and locoregional relapse-free interval (P < .001), but not on pathological complete response. Patients with one, two, three to four, and five or more CTCs before NCT displayed hazard ratios of death of 1.09 (95% confidence interval [CI] = 0.65 to 1.69), 2.63 (95% CI = 1.42 to 4.54), 3.83 (95% CI = 2.08 to 6.66), and 6.25 (95% CI = 4.34 to 9.09), respectively. In 861 patients with full data available, adding CTC detection before NCT increased the prognostic ability of multivariable prognostic models for overall survival (P < .001), distant disease-free survival (P < .001), and locoregional relapse-free interval (P = .008). CONCLUSIONS: CTC count is an independent and quantitative prognostic factor in early breast cancer patients treated by NCT. It complements current prognostic models based on tumor characteristics and response to therapy