Preoperative breast radiation therapy: Indications and perspectives.

Preoperative breast radiation therapy (RT) is not a new concept, but older studies failed to change practice. More recently, there has been interest in revisiting preoperative RT using modern techniques. This current perspective discusses the indications, summarises the published literature and then highlights current clinical trials, with particular attention to combining with novel drugs and optimising associated translational research

Prospective multi-center trial utilizing electronic brachytherapy for the treatment of endometrial cancer

<p>Abstract</p> <p>Background</p> <p>A modified form of high dose rate (HDR) brachytherapy has been developed called Axxent Electronic Brachytherapy (EBT). EBT uses a kilovolt X-ray source and does not require treatment in a shielded vault or a HDR afterloader unit. A multi-center clinical study was carried out to evaluate the success of treatment delivery, safety and toxicity of EBT in patients with endometrial cancer.</p> <p>Methods</p> <p>A total of 15 patients with stage I or II endometrial cancer were enrolled at 5 sites. Patients were treated with vaginal EBT alone or in combination with external beam radiation.</p> <p>Results</p> <p>The prescribed doses of EBT were successfully delivered in all 15 patients. From the first fraction through 3 months follow-up, there were 4 CTC Grade 1 adverse events and 2 CTC Grade II adverse events reported that were EBT related. The mild events reported were dysuria, vaginal dryness, mucosal atrophy, and rectal bleeding. The moderate treatment related adverse events included dysuria, and vaginal pain. No Grade III or IV adverse events were reported. The EBT system performed well and was associated with limited acute toxicities.</p> <p>Conclusions</p> <p>EBT shows acute results similar to HDR brachytherapy. Additional research is needed to further assess the clinical efficacy and safety of EBT in the treatment of endometrial cancer.</p

Genes of Both Parental Origins Are Differentially Involved in Early Embryogenesis of a Tobacco Interspecies Hybrid

BACKGROUND: In animals, early embryonic development is largely dependent on maternal transcripts synthesized during gametogenesis. However, in higher plants, the extent of maternal control over zygote development and early embryogenesis is not fully understood yet. Nothing is known about the activity of the parental genomes during seed formation of interspecies hybrids. METHODOLOGY/PRINCIPAL FINDINGS: Here, we report that an interspecies hybridization system between SR1 (Nicotiana tabacum) and Hamayan (N. rustica) has been successfully established. Based on the system we selected 58 genes that have polymorphic sites between SR1 and Hamayan, and analyzed the allele-specific expression of 28 genes in their hybrid zygotes (Hamayan x SR1). Finally the allele-specific expressions of 8 genes in hybrid zygotes were repeatedly confirmed. Among them, 4 genes were of paternal origin, 1 gene was of maternal origin and 3 genes were of biparental origin. These results revealed obvious biparental involvement and differentially contribution of parental-origin genes to zygote development in the interspecies hybrid. We further detected the expression pattern of the genes at 8-celled embryo stage found that the involvement of the parental-origin genes may change at different stages of embryogenesis. CONCLUSIONS/SIGNIFICANCE: We reveal that genes of both parental origins are differentially involved in early embryogenesis of a tobacco interspecies hybrid and functions in a developmental stage-dependent manner. This finding may open a window to seek for the possible molecular mechanism of hybrid vigor

Applicability and reproducibility of acute myeloid leukaemia stem cell assessment in a multi-centre setting

Leukaemic stem cells (LSC) have been experimentally defined as the leukaemia-propagating population and are thought to be the cellular reservoir of relapse in acute myeloid leukaemia (AML). Therefore, LSC measurements are warranted to facilitate accurate risk stratification. Previously, we published the composition of a one-tube flow cytometric assay, characterised by the presence of 13 important membrane markers for LSC detection. Here we present the validation experiments of the assay in several large AML research centres, both in Europe and the United States. Variability within instruments and sample processing showed high correlations between different instruments (Rpearson &nbsp;&gt;&nbsp;0·91, P&nbsp;&lt;&nbsp;0·001). Multi-centre testing introduced variation in reported LSC percentages but was found to be below the clinical relevant threshold. Clear gating protocols resulted in all laboratories being able to perform LSC assessment of the validation set. Participating centres were nearly unanimously able to distinguish LSChigh (&gt;0·03% LSC) from LSClow (&lt;0·03% LSC) despite inter-laboratory variation in reported LSC percentages. This study proves that the LSC assay is highly reproducible. These results together with the high prognostic impact of LSC load at diagnosis in AML patients render the one-tube LSC assessment a good marker for future risk classification

Neuroendocrine carcinoma arising in soft tissue: three case reports and literature review

<p>Abstract</p> <p>Background</p> <p>Neuroendocrine tumours (NET) are tumours arising from neuroendocrine cells of neural crest origin. They are characterised by the presence of neurosecretory granules which react positively to silver stains and to specific markers including neuron specific enolase, synaptophysin and chromogranin. Metastasis to the skin occurs infrequently but primary soft tissue NET is excessively rare.</p> <p>Case presentation</p> <p>We report our experience with 3 such cases. In the first case, the NET originated in muscle and was treated with wide surgical excision and adjuvant radiotherapy. The second case presented as a subcutaneous mass in the foot and the tumour was positive on ¹²³I mIBG scan. She has had prolonged recurrence-free survival following primary hypo-fractionated radiotherapy. In the third case, a cutaneous nodule proved to be a NET and at surgery, lymph node disease was present. He has remained disease-free after surgical excision without the need for external beam radiotherapy.</p> <p>Conclusion</p> <p>These tumours appear to have a good prognosis. Complete excision offers potentially curative treatment. Adjuvant radiotherapy may be helpful when the tumour margin is narrow. For patients with unresectable disease or where surgery would not be appropriate, radiotherapy appears to be an effective therapeutic option.</p

Salt tolerance of halophytes, research questions reviewed in the perspective of saline agriculture

Halophytes of the lower coastal salt marsh show increased salt tolerance, and under high salinity they grow faster than upper marsh species. We could not show reduced growth rate of halophytes compared with glycophytes when grown under non-saline conditions. This indicates limited energy costs associated with high-salt tolerance in plants of genera such as Salicornia, providing a good perspective of saline agriculture cultivating Salicornia as a vegetable crop.We show that halophytes do not occur on non-saline or inland sites because of a reduced growth rate at low soil salinity, but probably due to other ecological traits of glycophytic upper marsh species. These traits provide competitive advantage over lower salt marsh halophytes, such as earlier germination and increased growing season length.Some halophytic Amaranthaceae (Salicornioideae, Chenopodioideae and Suaedoideae) are not just highly salt tolerant, their growth rate is stimulated at a salinity range of 150–300 mM NaCl. Alternatively this may be described as depressed growth at low salinity.Selective pressure for such high-salt tolerance and salt stimulated growth likely occurred with prevailing arid climate and saline soil conditions. Under such conditions highly-salt tolerant succulent Salicornioideae, Chenopodioidea and Suaedoideae may have evolved about 65 Mya. In the context of evolution and diversication of land plants this origin of highly-salt tolerant succulent plants is relatively recent.Such high-salt tolerance might be characterized as constitutive in comparison with inducible (lower) salt tolerance of other dicotyledonae and monocotyledonae (Poaceae) species. Levels of salt tolerance of the latter type span a large range of low, intermediate to high-salt tolerance, but do not include salt stimulated growth. Salt tolerant traits of the latter inducible type appear to have evolved repeatedly and independently.Early highly-salt tolerant succulent Salicornioideae, Chenopodioidea and Suaedoideae were perennial and frost sensitive and occurred in warm temperate and Mediterranean regions. A shift from the perennial Sarcocornia to an annual life form has been phylogenetically dated circa 9.4–4.2 Mya and enabled evolution of annual hygrohalophytes in more northern coastal locations up to boreal and subarctic coastal sites avoiding damage of winter frost. Diversification of such hygrohalophytes was facilitated by polyploidization (e.g. occurrence of tetraploid and diploid Salicornia species), and a high degree of inbreeding allowing sympatric occurrence of Salicornia species in coastal salt marshes.High-level salt tolerance is probably a very complex polygenic trait. It is unlikely that glycophytes would accommodate the appropriate allelic variants at all the loci involved in halophyte salt tolerance. This might explain why attempts to improve crop salt tolerance through conventional breeding and selection have been unsuccessful to date.Genetic engineering provides a viable alternative, but the choice for the appropriate transgenes is hampered by a fundamental lack of knowledge of the mechanisms of salt tolerance in halophytes. The chances to identify the determinant genes through QTL analyses, or comparisons among near isogenic lines (NILS) are limited. Salt-tolerance is usually a species-wide trait in halophytes, and intra-specific divergence in salt tolerance in facultative halophytes seems to be often associated with chromosomal incompatibility.A variety of candidate salt tolerance genes been identified in Arabidopsis thaliana, among which genes encoding Na+ and K+ transporters, and genes involved in the general stress or anti-oxidant response, or in compatible solute metabolism. Many of these genes have been over-expressed in different glycophytic hosts, which usually appeared to alleviate, to some degree, the response to high salinity levels. However, with few exceptions, there are no indications that the same genes would be responsible for the superior salt tolerance in (eu)halophytes. Comparisons of gene expression and gene promoter activity patterns between halophytes and glycophytes are, with few exceptions, virtually lacking, which is a major omission in current day salt tolerance research.Full-genome transcriptomic comparisons between halophytes and related glycophytes through deep sequencing seem to be the most promising strategy to identify candidate genetic determinants of the difference in salt tolerance between halophytes and glycophytes.The most reliable validation of any candidate gene is through silencing the gene in the halophytic genetic background, preferably down to the level at which it is expressed in the glycophyte reference species. This requires genetically accessible halophyte models, which are not available to date, with the exception of Thellungiella halophila. However, more models are required, particularly because T. halophila is not a typical halophyte. Eventually, the pyramiding of validated salt tolerance genes under suitable promoters may be expected to be a viable strategy for crop salt tolerance improvement

The impact of disease progression on perceived health status and quality of life of long-term cancer survivors

Introduction The number of cancer survivors experiencing disease progression (DP) is increasing with the number of cancer survivors. However, little is known whether DP affects health-related quality of life (HRQL) of long-term cancer survivors. We aimed therefore to compare the health status (HS) and HRQL of DP and disease-free (DF) survivors up to 15 years after initial diagnosis. Methods 232 cancer survivors with DP identified through the Eindhoven Cancer Registry were matched with 232 DF survivors of similar demographic and clinical characteristics. Patients completed generic HS (SF-36) and cancer-specific HRQL (QOL-CS) questionnaires 5-15 years after diagnosis. Results Compared with DF survivors, DP survivors exhibited significantly lower scores on all SF-36 and QOL-CS (except spiritual well-being) dimensions. DF survivors had better scores than the normative population on all SF-36 dimensions. Among survivors with DP, those with short survival (<5 years) had significantly poorer HS scores on all dimensions except bodily pain compared with the normative population. Comparatively, the long survival (≥5 years) DP group had better HRQL than the short DP group but poorer HRQL than the normative population. In multivariate analyses, DP and DF survival time were independently associated with aspects of HS and HRQL in cancer survivors. Discussions/Conclusions DP cancer survivors have poorer long-term HS and HRQL compared with DF survivors. However, there is suggestion that HS and HRQL does improve over time following DP. Implication for Cancer Survivors Although DP survivors report poorer long-term HRQL compared with DF cancer survivors, results suggest that time can attenuate the distress of DP on HRQL. Psycho-educational programs could help to increase patients' sense of empowerment and personal control should DP occur

Necrosis related HIF-1α expression predicts prognosis in patients with endometrioid endometrial carcinoma

<p>Abstract</p> <p>Background</p> <p>Hypoxia inducible factor 1α (HIF-1α) plays an essential role in the adaptive response of cells to hypoxia and is associated with aggressive tumour behaviour. We have shown p27^kip1, which is generally reduced in endometrial cancer, to be re-expressed in hypoxic regions. This possibly contributes to survival of cancer cells. The aim of this study was to evaluate the prognostic value of HIF-1α and p27^kipexpression in patients with endometrioid endometrial cancer.</p> <p>Methods</p> <p>Expression levels of HIF-1α, CAIX, Glut-1, and p27^kip1were analyzed by immunohistochemistry. Percentage of positive cells, staining pattern (perinecrotic, diffuse, or mixed) and presence of necrosis were noted.</p> <p>Results</p> <p>Necrosis was correlated with shortened disease free survival (DFS) (p <it>= </it>0.008) and overall survival (OS) (p <it>= </it>0.045). For DFS, perinecrotic HIF-1α expression was also prognostic (p <it>= </it>0.044). Moreover, high p27^kip1expression was an additional prognostic factor for these patients with perinecrotic HIF-1α expression. In multivariate Cox regression, perinecrotic HIF-expression emerged as an independent prognostic factor. Perinecrotic HIF-1α expression was significantly associated with CAIX and Glut-1 expression, pointing towards functional HIF-1.</p> <p>Conclusions</p> <p>In patients with endometrioid endometrial cancer, necrosis and necrosis-related expression of HIF-1α are important prognostic factors. More aggressive adjuvant treatment might be necessary to improve the outcome of patients with these characteristics.</p

Target 2035-update on the quest for a probe for every protein

Twenty years after the publication of the first draft of the human genome, our knowledge of the human proteome is still fragmented. The challenge of translating the wealth of new knowledge from genomics into new medicines is that proteins, and not genes, are the primary executers of biological function. Therefore, much of how biology works in health and disease must be understood through the lens of protein function. Accordingly, a subset of human proteins has been at the heart of research interests of scientists over the centuries, and we have accumulated varying degrees of knowledge about approximately 65% of the human proteome. Nevertheless, a large proportion of proteins in the human proteome (∼35%) remains uncharacterized, and less than 5% of the human proteome has been successfully targeted for drug discovery. This highlights the profound disconnect between our abilities to obtain genetic information and subsequent development of effective medicines. Target 2035 is an international federation of biomedical scientists from the public and private sectors, which aims to address this gap by developing and applying new technologies to create by year 2035 chemogenomic libraries, chemical probes, and/or biological probes for the entire human proteome