Day 1 :
Keynote Forum
Alvaro Macieira-Coelho
French National Institute of Health (INSERM),France
Keynote: The natural history of breast cancers
Biography:
Abstract:
Keynote Forum
Liane Deligdisch
Icahn School of Medicine at Mount Sinai, USA
Keynote: Hormonal pathology of the endometrium and endometrial neoplasia
Biography:
Liane Deligdisch has graduated from the Carol Davila University of Medicine and Pharmacy, Romania and is trained in Obstetrics-Gynecology and Pathology in Israel. She was a Resident in Pathology at the Boston Free Hospital for Women (Harvard Medical School), Visiting Professor at Magee Women's Hospital, Pittsburgh and was a Fellow in Perinatal Pathology at the Mount Sinai School of Medicine, New York. Currently, she is a Professor of Pathology and Obstetrics-Gynecology at the Mount Sinai School of Medicine, New York, USA. She founded the Division of Gynecologic Pathology and the Course of Gynecologic Pathology at the Mount Sinai School of Medicine. She is a Member of the French National Academy of Medicine, has authored 145 articles in peer-reviewed journals and has also edited 7 textbooks.
Abstract:
Keynote Forum
Tatiana Massarrah
Gregorio Maranon Hospital, Spain
Keynote: Development of an oncology clinical research nursing consulting: A matter of safety
Biography:
Abstract:
Keynote Forum
Sherry A Bradford
Keynote: Breast cancer and personalized medicine: Advances, conundrums and novel therapeutic interventions
Biography:
Sherry A Bradford has attended undergraduate school at SUNY at Buffalo and has done her PhD in Biochemistry from the University of Buffalo. During her clinical laboratory vocation, she was solicited by the Chief of Surgery at Millard Fillmore Hospital, Buffalo, NY, to direct the Surgical Research Laboratory. She was awarded for Excellence in Research by the American Federation for Clinical Research, and for the Excellence in Research – SUNY at Buffalo. Currently, she sits on the Editorial Board of many reputed national and international journals and has authored and co-authored a number of scientific peer-reviewed manuscripts. She is also a member of many professional organizations including: International Metabolic Cancer Group, AACR, ASCO and GLIFCA.
Abstract:
Biography:
Aleksandar Stefanovic has completed his PhD in Medical Faculty, University of Belgrade. He is the Director of Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia and President of Association of Gynecologist and Obstetricians of Serbia, Montenegro and Republic Srpska. He is also a Member of FIGO. He has published more than 46 papers in reputed journals and has been serving as an Editorial Board Member of repute. He was invited speaker in more than 60 international congresses.
Abstract:
Standard surgical approach to invasive cervical cancer carries risks of unfulfilled reproductive plans and morbidity, which could influence quality of life to a greater extent. Radical trachelectomy is a fertility sparing procedure with the aim to preserve reproductive potential of the patient with unchanged oncologic outcome. The procedure can be performed by vaginal or abdominal approach. Abdominal trachelectomy offers greater radicality concerning the parametrial resection with an easier learning curve, although studies demonstrate slightly lower reproductive success. Vaginal radical trachelectomy is combined with minimally invasive lymphadenectomy (laparoscopic or robotic). The procedure is applied to patients with early-stages of cervical cancer, FIGO staged as Ia1, Ia2 and smaller Ib1 tumours. Since the procedure is combined with an ex-tempore hystologic analysis, organization and experience of team is of crucial importance. Oncologic outcome is excellent and comparable to standard procedure. Fertility rates are between 40 and 70%, with an increased rate of pregnancies achieved by assisted reproductive procedures (about 1/3). The rate of pregnancy complication is higher, and include increased rates of abortions, preterm deliveries, chorioamnionitis and cesarean sections. In an attempt to further decrease morbidity and to optimize reproductive outcome, some institutions perform less radical approaches – conisation or amputation of cervix, precedeed by pelvic lympadenectomy. Novel approaches include sentinel node biopsies and neoadjuvant chemotherapy followed by fertility sparing procedures. Since the oncologic safety of these procedures is yet to be determined, for now these procedures have to be considered as experimental. More studies, concerning the safety of above mentioned procedures, are needed, before they can fully be utilized in routine practice.
- Organ Defined Cancers | Cancer Genetics | Cancer Biomarkers | Cancer Therapy & Treaments | Cancer Nursing
Chair
Nyla A Heerema
The Ohio State University Wexner Medical Center, USA
Co-Chair
Audrey Claing
Montreal University, Canada
Session Introduction
Nyla A Heerema
The Ohio State University Wexner Medical Center, USA
Title: CpG simulated karyotypic analysis of chronic lymphocytic leukemia (CLL) is a significant prognostic factor and should be performed on all patients
Biography:
Nyla A Heerema is a professor in the Department of Pathology at The Ohio State University Wexner Medical Center. She is the Director of the Cancer Cytogenetics Laboratory there, as well as conducts an active research program. Her areas of research are the cytogenetics of chronic lymphocytic leukemia (CLL) and of pediatric acute lymphoblastic leukemia. She is a member of the CLL Research Consortium, and is the Chairperson of the Cytogenetics Discipline for the Children’s Oncology Group. She has published over 300 articles.
Abstract:
CLL has a variable clinical course and prognostic factors are vital. Metaphase cytogenetics have been minimally informative as CLL cells do not respond to traditional mitogens. CpG stimulates CLL cells to divide in <80% cases. Investigation of karyotypic abnormalities within one year of diagnosis in untreated CLL patients using CpG-stimulation identified complex karyotype (CK) (>3 unrelated abnormalities) that predicted a shorter time to first treatment (TFT) compared to non-CK (NCK, 12 months estimates 45% and 15%, respectively, p=0.0005). Despite a strong correlation of del(17p) with CK, CK predicted TFT independent of del(17p), a known poor prognosticator. Additionally, in patients with either balanced or unbalanced translocation, the good prognosis of mutated IGHV was negated (mutated IGHV translocation present vs absent, HR 3.59, p<0.001; unmutated IGHV translocation present vs absent, HR 1.03, p=0.92, interaction p=0.002). Independent of IGHV and translocation, CK (HR 1.70, p=0.037) remained statistically significant. Patients with Richter’s transformation (RT), an aggressive lymphoma in some CLL patients, exhibited higher risk for death with CK (HR 2.72, p=0.025) than in patients with NCK after R-EPOCH treatment. CK was independently associated with ibrutinib discontinuation due to progression. Although a low percentage of patients treated with ibrutinib experience RT, 6/9 patients with near-tetraploidy detected prior to ibrutinib treatment developed RT. In a multivariable model, both near-tetraploidy (HR 8.66, p<0.0001) and CK (HR 4.78, p=0.01) were independent risk factors for discontinuing ibrutinib due to transformation. In conclusion, CpG-stimulated karyotypes should be performed in CLL patients to identify karyotypic abnormalities that are significant for prognostication.
Charles L Hitchcock
The Ohio State University, USA
Title: Evolution of a system for surgical treatment of adenocarcinomas
Biography:
Charles L Hitchcock is an Emeritus Faculty member of the Department of Pathology at The Ohio State University in Columbus, Ohio USA. For the last 35 years, he has been a member of a multidisciplinary team of physicians, engineers, chemists, and biomedical scientists whose goal is to provide physicians with the resources to optimize the treatment of patients with solid tumors. Their efforts have resulted in over 500 publications and abstracts, multiple research grants, patents, and several biotech companies.
Abstract:
Alice Dragomir
McGill University, Canada
Title: Creating the best clinical and economic evidence to assist decision-making in urological cancers
Biography:
Alice Dragomir is an Assistant Professor at the McGill University, Faculty of Medicine, and Scientist in Health Economics and Outcomes Research at the Research Institute of the McGill University Health Center. She is an Economist and Biostatistician with Master’s degree in Statistics and Doctoral degree in Pharmacoepidemiology and Pharmacoeconomics, from University of Montreal, Canada. She has 14 years of experience in academic research. She was involved in research projects focused on evaluation of health outcomes and health economics related to different treatment strategies, adherence to treatments, health services utilization and disease modeling. Her current research is focused on clinical and economic evaluation of different treatments strategies offered to patients with prostate cancer or other urologic cancers. She has an extended experience in analyzing administrative healthcare databases and disease modeling. Her research represents a valuable tool for decision-makers and clinician leaders while evaluating the clinical and economic impacts of innovative treatments.
Abstract:
M Helena Vasconcelos
University of Porto, Portugal
Title: Unraveling the full role of P-glycoprotein in multidrug resistant cancers
Time : 15:25-15:50
Biography:
M Helena Vasconcelos is an Assistant Professor at FFUP (Faculty of Pharmacy, University of Porto) and Group Leader of the Cancer Drug Resistance Group at i3S/ IPATIMUP. She has done her First degree in Pharmaceutical Sciences (1991) from FFUP in Portugal, MSc (1992) and PhD (1996) from the University of Aberdeen in Scotland. Her current research focuses on the identification and validation of biomarkers and therapeutic targets to overcome drug resistance in cancer and on the activity of small molecules to counteract drug resistance. She has published more than 85 papers published in international journals and with an h-index of 23.
Abstract:
Multidrug resistance (MDR) is often responsible for treatment failure in cancer patients. One of the main reasons for the MDR phenotype of cancer cells is an overexpression of drug-efflux pumps such as P-glycoprotein (P-gp). Recently, my research group, together with international collaborators, compared MDR cells with their drug-sensitive counterparts and verified that MDR cells present metabolic alterations which may be further explored as molecular targets to counteract the MDR phenotype. In addition, my group observed that P-gp may be horizontally transferred by extracellular vesicles (EVs), between MDR and drug-sensitive cells, confirming results from other researchers and indicating that this protein has a stronger influence in the MDR phenotype of tumor cells than had been initially realized. Interestingly, we and collaborators had recently found that the EVs released by MDR cells are enriched in microvesicle-like EVs. However, the work indicates that drug-resistant cells without overexpression of P-gp do not present this enrichment. Thus, we are currently verifying if P-gp could be involved in the release of microvesicles by MDR cells.
Audrey Claing
Montreal University, Canada
Title: ARF proteins as new molecular targets for the treatment of invasive breast cancer
Biography:
Audrey Claing has completed her PhD from the University of Sherbrooke (Canada) in 1997. She has worked at the Laboratory of Dr. Robert J Lefkowitz, 2012 Nobel Laureate, for her Post-doctoral studies at Duke University (USA). She is now the Professor of Pharmacology and Physiology at the Montreal University (Canada). She has published more than 60 papers in reputed journals and has greatly advanced research in the field of G Protein Signaling.
Abstract:
Triple-negative breast cancers (TNBC) are a highly invasive type of breast cancer and associated with poor prognostics. Although, these tumors do not express the typical hormone receptors (ER-, PR-), nor the HER2 receptor, their proliferation and invasive capacities can be enhanced by growth factors such as the epidermal growth factor (EGF). Drugs inhibiting EGF receptor activity have however shown limited effects mainly due to the development of resistance. There is therefore an urgent need to identify new therapeutic targets for the design of therapies that would complement current approaches (surgery, chemo and radiotherapy). We and others have shown that the Ras-related ADP-ribosylation factors (ARF) are another class of small GTPases regulating key features of cancer cells. ARF1 and ARF6, two isoforms best characterized, are highly expressed in cells and tumor tissue of the most aggressive and advanced subtypes of breast cancers. Knock down of ARF1 expression, for example, impairs the ability of breast cancer cells to proliferate, migrate and degrade the extracellular matrix. Furthermore, growth of primary tumors as well as lung metastasis is reduced in a murine xenograft model when expression of the GTPase is inhibited. Our findings have demonstrated that increased levels of ARF1, in non-invasive cells lead to the epithelial-mesenchymal transition (EMT). Overall, our work has identified ARF1 as a molecular switch of cancer progression and thus suggests that limiting the expression/activation of this GTPase could help improve outcome for breast cancer patients.
Hirendra Banerjee
University of North Carolina, USA
Title: An investigation in the role of noncoding RNA’s in epithelial mesenchymal transition (EMT) in prostate cancer
Biography:
Hirendra Nath Banerjee completed his undergraduate degree in Biology & Chemistry and Bachelor of Medicine and Surgery degree from Calcutta University, India. His M.S. in Molecular Biology is from LIU at NY, USA and Ph.D. from Howard University Cancer Center in Washington, D.C. Dr. Banerjee did his post-doctoral training at Yale University and Medical University of South Carolina, USA. As a tenured Professor at Elizabeth City State University under the University of North Carolina system, Dr. Banerjee is involved in cancer research for more than two decades training many talented under graduate and graduate students in the process.
Abstract:
Katarina Jeremić
Clinical Center of Serbia, Serbia
Title: Challenges of therapeutic options in treatment of early stages of endometrial cancer
Biography:
Katarina Jeremić attended Medical School, University of Belgrade in 1996, MD in 2000, PhD in 2006 and Academic Special Studies in Gynecology and Obstetrics.She has 19 years of Clinical Experience, working as Gynecologist at Clinic for Gynecology & Obstetrics Clinical Centre of Serbia, which is the biggest one in whole region. She is currently the Head of Gynecologic Oncology Department and also member of many scientific projects on Cancer and Pregnancy. She worked at the Medical Faculty, University Belgrade as Lecturer and Associate Professor of Gynecology and Obstetrics. She has 50 publications in CC/SCI expanded and JCRindexed, and participated in more than 50 international congresses, with a total number of 150 publications. She is a member of FIGO, ESGO, and other societies.
Abstract:
Conservative approaches of early-stage endometrial carcinoma includes hormonal therapy, in selected group of young patients with endometrial carcinoma with age less than 45 years and wishes to preserve fertility, that shows low grade 1 endometrioid adenocarcinomas limited to the endometrium with MRI excluded myomaterial invasion, without evidence of limphovascular space involvement or extrauterine disease (cervical, ovarian, lymphnodal or any other extra-uterine disease). The diagnosis is proven by two experienced gynoncology pathologists review of analyzed endometrial samples. It could be collected by biopsy, hysteroscopy or dilatation & curatage and if it possible PgR analysis should be done. Invasive procedures for collecting endometrial samples are hysteroscopy that permits evaluation of endometrial cavity and biopsy of suspicious lesion. The accuracy of hysteroscopy is high with sensitivity rate of 86.4% and specific rate of 99.2%, even higher in the diagnosis, than in excluding it. The possible dissemination of malignant cells through fallopian tubes during hysteroscopy, has not been proven in meta analysis in early stage of the disease. Obligate pretreatment assessments include biopsy, hysteroscopy or dilatation & curatage, radiologic imaging, contrast MRI (to exclude myometrial invasion, exclude extrauterine spread of disease, ovarian, lymphonodal, cervical involvement) even laparoscopy and assessment of ovaries, peritoneum and PW + SLN, as also CA 125, X ray for chests examination. The results according to many studies are that almost a two third of patients (50-75% of patients) that are treated with gestagen therapy have complete response, but 20-45% patients will have recurrence even after initial response and 25% would not answer on the therapy. Follow up is repeating of endometrial biopsies by hysteroscopy every 3 months which is recommended, until there is a complete response or achieving pregnancy. Surgery is recommended if there is no response after 6 months of medication treatment. Hormonal therapy that could be applied is progestins that inhibits the estrogenic effect and suppresses cell proliferation (medroxy progesterone acetate, megestrl acetate), GnRh analogues, but also local gestagens ( IUD), oral natural progesterons, aromatase inhibitors - antiestrogens as also three step endoscopic (hysteroscopic) resection - remove tumour, surrounding endometrium, myometrium.
Vasco Fonseca
Centro Hospitalar Lisboa Ocidental, Portugal
Title: Do breast cancer units treat patients based on their own neoadjuvant protocols?
Biography:
Vasco Fonseca has a degree in Medicine from the University of Lisbon in 2000. He is trained as a Medical Oncologist at the IPO of Lisbon and is currently working at the CHLO, in “Maria José Nogueira Pinto” Centre, as well as for the Portuguese National Military Forces. He is currently developing clinical trials in the area of breast cancer. He is the author of clinical protocol for Breast Cancer of the CHLO and has publications in reputed journals.
Abstract:
In the CHLO Breast Unit, which incorporates 4 hospitals, we treat almost 300 new breast cancer patients per year. In most cases, the international guidelines are very clear regarding locally advanced breast cancer, allowing a vast number of options in the grey area that concerns the Unit’s experience. We consider that the Unit’s experience and tumor staging, but also tumor biology, patient’s preference, individual risk factors and relative contraindications should be the principal considerations for the neoadjuvant treatment decision (according to international data). For this reason, we have formulated an internal protocol which allows us, not only to include all the indicated patients, but also to compile a database for their follow-up. In our protocol, triple negative, Her2 positive tumors and luminal B-like with high proliferative index, equal or above 2 cm (cT2N0), are proposed for neoadjuvant treatment. Patients with hormone dependent tumors that refuse surgical treatment, older patients, or patients with severe comorbidities, as well as selected luminal-A-like patients, are included in neoadjuvant hormonal treatment, which in some cases is extended over 8 months.