Cancer Patients In Clinical Practice Research Articles

The Influence of Exercise on Cancer Risk, the Tumor Microenvironment and the Treatment of Cancer.

There are several modifiable factors that can be targeted to prevent and manage the occurrence and progression of cancer, and maintaining adequate exercise is a crucial one. Regular physical exercise has been shown to be a beneficial strategy in preventing cancer, potentially amplifying the effectiveness of established cancer therapies, alleviating certain cancer-related symptoms, and possibly mitigating side effects resulting from treatment. Nevertheless, the exact mechanisms by which exercise affects tumors, especially its impact on the tumor microenvironment (TME), remain uncertain. This review aims to present an overview of the beneficial effects of exercise in the context of cancer management, followed by a summary of the exercise parameters, especially exercise intensity, that need to be considered when prescribing exercise for cancer patients. Finally, we discuss the influence of exercise on the TME, including its effects on crucial immune cells (e.g., T cells, macrophages, neutrophils, natural killer cells, myeloid-derived suppressor cells, B cells), intratumor angiogenesis, and cancer metabolism. This comprehensive review provides up-to-date scientific evidence on the effects of exercise training on cancer and offers guidance to clinicians for the development of safe and feasible exercise training programs for cancer patients in clinical practice.

Improving the identification of high-risk non-metastatic castration-resistant prostate cancer patients in clinical practice.

Non-metastatic castration-resistant prostate cancer (nmCRPC) represents a challenging disease state in prostate cancer care. nmCRPC patients with a high risk of progression to metastatic disease who are identified by a prostate-specific antigen doubling time (PSADT) ≤10 months are eligible for treatment with the novel androgen receptor inhibitors (ARIs), shown to delay disease progression and extend survival. However, nmCRPC is often unexploited in clinical practice due to a lack of standardization in the methodology and in the tools used for its identification. In this article, a group of Urology and Oncology specialists with acknowledged expertise in prostate cancer reviews the state of the art in the management of high-risk nmCRPC patients, identifies gaps and unmet needs, and proposes strategies to optimize the identification of this patient subgroup in the clinical practice and improve their health outcomes.

Exploration of radionuclide labeling of a novel scFv-Fc fusion protein targeting CLDN18.2 for tumor diagnosis and treatment

PurposeClaudin 18.2 (CLDN18.2), due to its highly selective expression in tumor cells, has made breakthrough progress in clinical research and is expected to be integrated into routine tumor diagnosis and treatment. MethodsIn this research, we obtained an scFv-Fc fusion protein (SF106) targeting CLDN18.2 through hybridoma technology. The scFv-Fc fusion protein was labeled with radioactive isotopes (124I and 177Lu) to generate the radio-probes. The targeting and specificity of the radio-probes were tested in cellular models, and its diagnostic and therapeutic potential was further evaluated in tumor-bearing models. ResultsThe molecular probes [124I]I-SF106 and [177Lu]Lu-DOTA-SF106 possess high radiochemical purity (RCP, 98.18 ± 0.93 % and 97.05 ± 1.1 %) and exhibit good stability in phosphate buffer saline and 5 % human serum albumin (92.44 ± 4.68 % and 91.03 ± 2.42 % at 120 h). [124I]I-SF106 uptake in cells expressing CLDN18.2 was well targeted and specific, and the dissociation constant was 17.74 nM [124I]I-SF106 micro-PET imaging showed that the maximum standardized uptake value (SUVmax) was significantly higher than CLDN18.2-negative tumors (1.83 ± 0.02 vs. 1.23 ± 0.04, p < 0.001). The maximum uptake was attained in tumors expressing CLDN18.2 at 48 h after injection. [124I]I-SF106 and [177Lu]Lu-DOTA-SF106 dosimetric study showed that the effective dose in humans complies with the medical safety standards required for their clinical application. The results of treatment experiments showed that 3 MBq of [177Lu]Lu-DOTA-SF106 in CLDN18.2-expressing tumor-bearing mice could significantly inhibit tumor growth. ConclusionThese results indicate that radionuclide-labeled scFv-Fc molecular probes ([124I]I-SF106 and [177Lu]Lu-DOTA-SF106) provide a new possibility for the diagnosis and treatment of CLDN18.2-positive cancer patients in clinical practice.

The Clinical Potential of FBPA-PET/CT Imaging for Colorectal Cancer and its Liver Metastases Expressing LAT1.

18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG PET) has become indispensable for staging colorectal cancer but has limitations. Thus, PET with a focus on metabolism other than glucose, mainly amino acid metabolism, has been developed. L-type amino acid transporter 1 (LAT1) is known to be a cancer-specific amino acid transporter and, although 4-Borono-2-(18)F-fluoro-phenylalanine (FBPA) has been reported to be useful as a probe for LAT1, the significance of LAT1 expression in colorectal cancer is ambiguous and implementation of 18F-FBPA-PET in colorectal cancer has not yet been reported. The aims of this study were to investigate the expression of LAT1 in primary lesions and metastatic lesions of colorectal cancer by immunohistochemical analysis and report the initial experience of performing 18F-FBPA-PET on colorectal cancer patients in clinical practice. There was a significant correlation between LAT1 protein expression in primary tumors and liver metastases. Furthermore LAT-1 expression was positively correlated with recurrence (p=0.033). We performed 18F-FBPA-PET on three rectal cancer patients and detected cancer. LAT1 protein is expressed not only in the primary colorectal tumor, but also in liver metastases. 18F-FBPA-PET can be safely performed in patients with colorectal cancer.

102 - Implementation of an antihypertensive deprescribing protocol in frail, stage IV lung cancer patients in clinical practice

102 - Implementation of an antihypertensive deprescribing protocol in frail, stage IV lung cancer patients in clinical practice

Impact of enteral administration of sodium hypochlorite on the mechanisms of inflammation and hemostasis in cancer patients with enteral insufficiency syndrome after multi-organ surgeries

Background. Enteral insufficiency syndrome is a complicated and multifactorial symptom complex that is accompanied with impaired functions of the gastrointestinal tract and is also one of the main causes of the development of endotoxicosis, systemic inflammatory response syndrome, abdominal sepsis, septic shock, and multi-organ failure. Thrombosis, which is associated with oncological diseases, is another common cause of death among patients with cancer after the progression of the disease. Development and implementation of new methods of detoxification in cancer patients in clinical practice after multi-organ surgeries is a major problem in intensive care. Purpose – to study the effectiveness of the enteral administration of sodium hypochlorite in cancer patients after multi-organ surgeries with systemic inflammatory response syndrome and to monitor the dynamics of certain markers of inflammation. Materials and methods. 53 patients with cancer were observed after having undergone multi-organ surgeries on the abdominal organs. The patients were divided into two groups: the main group (n=27), in which indirect electrochemical detoxification with sodium hypochlorite at a concentration of 0,06% was carried out by the drip infusion method through a gastrointestinal tube, and the comparison group (n=26), in which the treatment was performed according to standard treatment regimens. The examination was carried out at 3 stages – before NaClO infusion, on the 1st and the 7th day after the indirect electrochemical detoxification. Groups were compared according to age and anatomical and functional zones of the surgery (the surgery was performed on the abdominal organs). Results. Patients with stage 2/3 enteral insufficiency syndrome were treated with the method of electrochemical detoxification with sodium hypochlorite, which led to the inflammation reduction and normalization of the hemostatic system parameters. In patients, who were receiving sodium hypochlorite (the main group), the reduction in inflammatory mediators was observed: C-reactive protein (CRP) – from 22.1 to 5.6 mg/l, interleukin-6 (IL-6) – from 14,36 to 1.55 pg/ml, and also hemostatic parameters were improved. A decrease in the international normalized ratio (INR), fibrin, activated partial thromboplastin time (APTT), D-dimer level, blood clotting time, and an increase in prothrombin index were observed. Analyzing the effectiveness, it should be noted that the correction of the hemostatic system and the development of inflammation are significantly faster (on the 1st day after the NaClO infusion) compared with standard treatment methods while also ensuring plasma preservation. Conclusions. The use of the method of electrochemical detoxification with 0,06% NaClO in postoperative intensive therapy in enteral insufficiency syndrome prevents the development of systemic inflammation and hypocoagulation. The inclusion of sodium hypochlorite in the complex postoperative therapy during the day allowed the development of inflammation (a decrease in the expression of IL-6 and CRP) to be halted and procoagulative changes (a decrease in INR, fibrin, APTT, D-dimer level, blood clotting time, and an increase in prothrombin index) to be achieved.

P080 Fertility Preservation and Pregnancy in Breast Cancer Patients in Clinical Practice, Slovak Republic Survey

P080 Fertility Preservation and Pregnancy in Breast Cancer Patients in Clinical Practice, Slovak Republic Survey

Feasibility and preliminary effectiveness of a psychosocial support program for adolescent and young adult cancer patients in clinical practice: a retrospective observational study

PurposeAdolescent and young adult cancer patients (AYAs) often experience profound psychological distress, with various unmet supportive care needs that can be alleviated with appropriate screening and attention by healthcare workers. The Distress Thermometer and Problem List-Japanese version (DTPL-J) is our previously developed screening tool to facilitate individual support of AYAs. This study evaluated the feasibility and preliminary effectiveness of a psychosocial support program based on the DTPL-J for AYAs in clinical practice.MethodsThis multicenter, retrospective, observational study included 19 of 126 wards and 9 of 75 outpatient clinics at 8 institutions in Japan. Over 200 patients were expected to participate during the eligibility period. Patients participated in a support program at least once, and approximately once a month based on the DTPL-J results. The program was evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) implementation framework.ResultsThe screening rate of the 361 participants was 90.3%, suggesting high feasibility. Distress Thermometer scores, the number of supportive care needs, and the rates of AYAs with high distress were significantly reduced 1 month after screening (p < 0.05), suggesting the preliminary effectiveness of the program. The program was continued at the 8 institutions as part of routine care after the study.ConclusionAnalysis using the RE-AIM suggested the sufficient feasibility and preliminary effectiveness of a psychosocial support program based on the DTPL-J for AYAs.Trial registrationUniversity Hospital Medical Information Network (UMIN CTR) UMIN000042857. Registered 25 December 2020—Retrospectively registered.

HSD111 Evaluation of the Implementation of Value-Based Healthcare With a Weekly Digital Follow-up of Lung Cancer Patients in Clinical Practice

The aim of this study was to evaluate the implementation of Value-Based Healthcare principles for lung cancer patients in a large Belgian hospital. This hospital implemented a digital platform for the collection of patient-reported outcomes and the standardization of care pathways. Also, a follow-up by the multidisciplinary care team was put in place.

Serum albumin to globulin ratio prior to treatment as a potential non-invasive prognostic indicator for urological cancers

Numerous clinical studies have reported an association between the pretreatment albumin to globulin ratio (AGR) and survival outcomes of urological cancers. However, these conclusions remain controversial. Therefore, we performed a meta-analysis to explore the prognostic value of the AGR in urinary system tumors. We retrieved eligible studies published up to June 2022 through a comprehensive search of multiple databases. Pooled hazard ratios (HRs) with 95% confidence intervals (CI) for overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), progression-free survival (PFS), and biochemical recurrence-free survival (BRFS) were used to evaluated the predictive effect of the AGR before treatment in urinary system tumors. Heterogeneity test, random-effects models, fixed-effects models and sensitivity tests were used for analyses. A total of 21 studies with 18,269 patients were enrolled in our meta-analysis. We found that patients with urinary system cancer with low AGR prior to treatment had poor OS [HR = 1.93, 95% CI (1.56-2.39), p < 0.001], CSS [HR = 2.22, 95% CI (1.67-2.96), p < 0.001], RFS [HR = 1.69, 95% CI (1.29-2.22), p < 0.001], and PFS [HR = 1.29, 95% CI (0.54-3.07), p < 0.001]. For prostate cancer (PCa), a low pretreatment AGR was associated with poor BRFS [HR = 1.46, 95% CI (1.28-1.67), p < 0.001]. Also, a subgroup analysis, stratified by ethnicity, cancer type, cutoff value, sample size and publication year, was conducted. The results showed that worse OS and CSS were significantly associated with these factors. Our meta-analysis revealed that the AGR before treatment could be used as a non-invasive predictive biomarker to evaluate the prognosis of urological cancer patients in clinical practice.

Systemic immune-inflammation index: A new indicator of predicting 1-, 2-and 3-year disease-free survival of patients with colon cancer.

The systemic immune-inflammation index (SII) is a useful prognostic indicator for some types of cancer, but it remains to be elucidated if it is similarly useful for colon cancer. This study aims to investigate the prognostic value of preoperative SII in patients with colon cancer undergoing radical surgery. The clinical materials of 188 patients with colon cancer who underwent radical surgery from September 1, 2013, to August 31, 2018, in Zhongda Hospital at Southeast University (Nanjing, China) were collected retrospectively. The SII was calculated as platelet count × neutrophil count / lymphocyte count. All patients enrolled in the study were then assigned into 2 different groups according to the median value of SII for comparison of clinical features between the 2 groups. The survival curve was drawn using the Kaplan-Meier method. Univariate and multivariate analysis were performed using the Cox regression model, analyzing the independent risk factors. The independent factors were analyzed with the R software to construct a nomogram of 1-, 2- and 3-year disease-free survival (DFS) after operation. Lastly, a web-based probability calculator was constructed to dynamically predict the possibility of DFS of patients. The SII could significantly predict DFS of patients with colon cancer with the median value of 514.13xs. For DFS, multivariate Cox analysis indicated that age, tumor location, pathological N stage, and preoperative SII level were independent risk factors for patients with colon cancer after radical resection (p < 0.05). A nomogram and a web-based probability calculator were constructed based on these factors. The preoperative SII level can predict DFS in patients who received radical surgery with colon cancer. The nomogram constructed based on independent risk factors is helpful in predicting DFS of colon cancer patients in clinical practice.

The heterogeneous immune landscape between lung adenocarcinoma and squamous carcinoma revealed by single-cell RNA sequencing

A thorough interrogation of the immune landscape is crucial for immunotherapy strategy selection and prediction of clinical responses in non-small-cell lung cancer (NSCLC) patients. Single-cell RNA sequencing (scRNA-seq) techniques have prompted the opportunity to dissect the distinct immune signatures between lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), the two major subtypes of NSCLC. Here, we performed scRNA-seq on 72,475 immune cells from 40 samples of tumor and matched adjacent normal tissues spanning 19 NSCLC patients, and drew a systematic immune cell transcriptome atlas. Joint analyses of the distinct cellular compositions, differentially expressed genes (DEGs), cell–cell interactions, pseudotime trajectory, transcriptomic factors and prognostic factors based on The Cancer Genome Atlas (TCGA), revealed the central roles of cytotoxic and effector T and NK cells and the distinct functional macrophages (Mφ) subtypes in the immune microenvironment heterogeneity between LUAD and LUSC. The dominant subtype of Mφ was FABP4-Mφ in LUAD and SPP1-Mφ in LUSC. Importantly, we identified a novel lymphocyte-related Mφ cluster, which we named SELENOP-Mφ, and further established its antitumor role in both types, especially in LUAD. Our comprehensive depiction of the immune heterogeneity and definition of Mφ clusters could help design personalized treatment for lung cancer patients in clinical practice.

Evaluation of the implementation of Value-Based Healthcare with a weekly digital follow-up of lung cancer patients in clinical practice.

The aim of this study was to evaluate the implementation of Value-Based Healthcare principles for lung cancer patients in a large Belgian hospital. This hospital implemented a digital platform for the collection of patient-reported outcomes and the standardisation of care pathways. Also, a follow-up by the multidisciplinary care team was put in place. Evaluation was done by employing a mixed method approach with data analysis of all included patients (n= 201), a pilot study (n= 30) and semi-structured interviews with the care team (n= 5). Overall, 95% of all lung cancer patients of two thoracic oncologists agreed to participate in the digital follow-up during the period January 2018 to September 2020 (201 participating patients). The response rates of those patients were high: 92% of the weekly questionnaires and 90% of the 6-weekly ICHOM questionnaires were responded. Based on the pilot study, we conclude that questions are clear and the platform is user-friendly for 90% of patients in the pilot. The interviews revealed that the weekly follow-up has a positive impact on the patient-provider communication and makes it easier to discuss psychological and palliative care needs. This study shows a successful implementation of Value Based Healthcare with weekly digital follow-up. Clinical trial registration is as follows: www. gov, NCT04712149.

A retrospective study of the efficacy and safety of naldemedine for opioid-induced constipation in thoracic cancer patients.

BackgroundWe conducted a multicenter, retrospective study on the efficacy and safety of naldemedine in thoracic cancer patients using opioids in clinical practice.MethodsWe retrospectively evaluated thoracic cancer patients treated with naldemedine at 10 institutions in Japan. Clinical data of patients administered naldemedine between June 2017 and August 2019 were extracted from electronic medical records. Inclusion criteria were as follows: (i) patients hospitalized for at least seven days before and after naldemedine administration, and (ii) those whose frequency of defecation was entered in the medical records.ResultsForty patients were analyzed, and defecation frequency was observed for at least seven days before and after naldemedine administration. The response rate was 65.0% (95% CI: 50.2%–79.7%). The number of defecations increased significantly after naldemedine administration in the overall population, as well as among only those who defecated <3 times/week before naldemedine administration, and those that were administered ≥30 mg/day of morphine equivalent. Diarrhea was the most common adverse event in all grades, occurring in 11 patients (27.5%), of which 9 (81.8%) were grade 1 or 2. None of the patients experienced grade 4 or higher adverse events.ConclusionThe efficacy and safety of naldemedine for thoracic cancer patients in clinical practice were comparable with those of prospective studies, which suggest that naldemedine may be effective and feasible for most thoracic cancer patients.

Quality of life of caregivers of breast cancer patients: a cross-sectional evaluation

BackgroundThe aim of this study was to evaluate the care-related quality of life in caregivers of breast cancer patients, to assess its association with breast cancer patients’ health-related quality of life (HRQoL), and to identify its potential predictors.MethodsCaregivers of breast cancer patients at six and twelve months follow up were identified through the institutes electronic patient reported outcome measurement collection tool. The Care-related Quality of Life Instrument (CarerQoL) was used to obtain CarerQoL utility scores by applying a pre-existent set of Dutch tariffs and the CarerQoL VAS score, which represented the overall happiness of caregivers. The associations between breast cancer patients’ EQ-5D-5L and EORTC QLQ-C30 scores and caregivers’ CarerQoL scores was determined with Spearman’s correlation coefficients. Associations between log transformed CarerQol scores and patient and caregiver characteristics were analyzed with multivariable linear regression analyses.ResultsA total of 116 completed CarerQoL questionnaires were analyzed. Most caregivers were male spouses or partners (81.4%) with a mean age of 55.7 ± 16.4. The median CarerQoL utility score was 92.4/100 and median CarerQoL VAS was 8.0/10. We found weak correlations between CarerQoL VAS scores and patients’ EQ-5D-5L utility score (0.301, p = 0.002) and EQ VAS score (0.251, p = 0.009), and between EORTC QLQ-C30 scores and CarerQol VAS (0.339, p < 0.001) and utility score (0.236, p = 0.015). There was a negative association between chemotherapy and log-transformed CarerQoL utility score (B = − 0.063, p = 0.001) and VAS score (B = − 0.044, p = 0.038) at six months follow-up.ConclusionsThis study provides the first evaluation of the CarerQoL in caregivers of Dutch breast cancer patients. Caregivers’ happiness was associated with breast cancer patients’ HRQoL. Our results can be used as reference values for future care-related quality of life evaluations.Plain English SummaryBreast cancer patients face many difficulties during their cancer journey and often need the support of their caregivers. Despite the fact that successfully providing informal care can have positive effects on caregivers’ wellbeing, it may also have a negative impact on their quality of life. Monitoring the quality of life using a standardized questionnaire, such as the CarerQoL questionnaire, may result in early detection of possible quality of life issues. In this study, we evaluated 116 caregivers and found overall high CarerQoL scores. The scores showed a positive relation to the patients’ quality of life. Lower CarerQoL scores at six months after surgery were found in caregivers of patients who received chemotherapy. Our research underlines the importance to include caregivers of breast cancer patients in clinical practice, provides reference values for future research, and the results can be used to manage the caregivers’ expectations prior to treatment.

Clinical implementation of value based healthcare: Impact on outcomes for lung cancer patients

Value based Healthcare (VBHC) focuses on patient centered outcomes, by incorporating Patient Reported Outcome Measures (PROMS). Expectations on the benefits of VBHC are high, but few data are available that validate its routine use. We wanted to investigate if VBHC is feasible and beneficial for lung cancer patients in clinical practice. MethodWe developed a digital transmural care pathway for lung cancer patients. During systemic therapy, patients digitally reported side effects weekly. Every six weeks, quality of life was reported trough EORTC questionnaires. Case-mix variables, treatment approaches and outcome indicators were systematically collected.We evaluated the compliance of the patients with the digitally reporting system and the impact of the care pathway on patient centered outcomes such as emergency department (ED) visits, time spent on the oncology day clinic, survival and quality of death. Results221 lung cancer patients were included in the care pathway. 3091 weekly questionnaires were digitally collected. Compliance with the weekly digital follow-up was 92%: 2835 of 3091 questionnaires were completed. Patients in the care pathway had significantly less ED visits (3.5% vs 4.8%, p 0.04) and a shorter length of stay at the day clinic (2.5 h vs 4.1 h, p < 0,05) compared to routine clinical care. In stage IV lung cancer patients, overall survival was significantly higher in the care pathway (447 days (95% CI 379–663)) compared to routine care (286 days (95% CI 191–400)) (p = 0,025). ConclusionImplementation of value based healthcare is feasible and beneficial in daily clinical care for lung cancer patients.

Assessment of diarrhea as side effect of oral targeted antineoplastic agents in clinical practice.

Diarrhea is one of the most frequent class adverse events associated with targeted oral antineoplastic agents (OAAs). Our objective was to analyze the incidence, characteristics, and severity of diarrhea in cancer patients in clinical practice. An observational, longitudinal, and prospective study of cancer outpatients treated with targeted OAAs was carried out in a tertiary hospital. Targed OAAs analyzed were anaplastic lymphoma kinase inhibitors, BCR-ABL inhibitors, cyclin-dependent kinase inhibitors, epidermal growth factor receptor inhibitors, mTOR inhibitors, poly (ADP-ribose) polymerase inhibitors, and vascular endothelial growth factor receptor inhibitors. Patients were given a data collection form to record daily the number, severity (CTCAE version 5.0), and characteristics of stools during the first 30days of treatment with OAAs. Multivariate analysis was performed to identify risk factors associated with the incidence of diarrhea. We analyzed 240 patients, of whom 28.7% experienced diarrhea (25.4% grades 1-2 and 3.3% grades 3-4). Patients treated with EGFR and VEGFR inhibitors had a higher incidence of diarrhea. The multivariate analysis revealed that taking the OAA with food was associated with a lower risk of diarrhea (OR = 0.404 [0.205-0.956], p = 0.038). More than a third of patients in treatment with OAAs presented diarrhea (any grade), and 22.1% of stools were semi-liquid/liquid. In multivariate analysis, taking the OAA on an empty stomach was associated with a statistically significant increase in the incidence of diarrhea.

A Radiomics Approach for Prediction of PD-L1 Expression in Cervical Cancer Patients: An Initial Result

Programmed death ligand 1 (PD-L1) expression level plays an important role in guiding immune therapy for cervical cancer patients according to the latest version of NCCN (Version 3. 2019). We aimed to assess if quantitative radiomic features can predict PD-L1 expression in cervical cancer (CC). This retrospective study included 378 stage I-IV CC patients with pretreatment Magnetic Resonance Imaging (MRI) images and PD-L1 expression (SP142) test results. Clinical variables data were collected from electronic medical records. Features were extracted from pretreatment MRI, then filtered with automatic relevance determination and minimized with LASSO model based on its relevance of PD-L1 expression status. We constructed two models for multivariate logistic regression analysis (one based on clinical variables, and the other based on a combination of clinical variables and radiomic features), and the receiver operating characteristic as well as the corresponding area under the curve (AUC) was reckoned for each model to identify the model with the higher predictability. Among 378 patients, 238 patients were classified as PD-L1 positive and 140 patients as PD-L1 negative. There was no significant difference in clinical characteristics including age, FIGO stage, and histologic diagnosis between the two PD-L1 expression groups (P > 0.05 for all). With the total of 25 selected MRI-based radiomics features which were significantly associated with PD-L1 expression levels, we established two prediction models for predicting PD-L1 positivity. Models that comprised clinical variables and clinical combined with MRI-based radiomic features resulted in an AUC of 0.56 and 0.96, respectively. Model composed of clinical variables and MRI radiomic features can predict PD-L1 expression in cervical cancer. This model may facilitate noninvasive assessment of PD-L1 expression, and may be helpful in guiding immunotherapy for cervical cancer patients in clinical practice.

A Preliminary Study on the Establishment of the PDTX Model.

ObjectiveThe current study aims to explore the establishment of the patient-derived tumor xenograft (PDTX) model.Materials and MethodsTwenty patients with gastric cancer, 10 males and 10 females, were enrolled in the current study. Firstly, the volume, invasion and metastasis of the xenografts were observed. Subsequently, the correlation between tumor tissues of the PDTX mouse model and the patients’ primary tumor tissues was evaluated by pathological H&E staining and immunohistochemistry.ResultsThe results showed that the PDTX models corresponding to 15 of the 20 patients were successfully established, and the success rate of PDTX model establishment was 75%. Furthermore, the PDTX models maintained the differentiation degree, morphological characteristics and structural characteristics of tumor cells.ConclusionA PDTX model can be used as a substitute for cancer patients in clinical practice and may be suitable for clinical pharmacodynamic screening and new drug development.

Abstract P6-10-30: Developing 3D subtyping model for breast cancer patients based on absolute quantitation or ER, PR and Her2 at protein level

Abstract The concept of intrinsic subtypes of breast cancer have been well accepted with several predictor applications based on this concept achieved success in clinical practice. However, all these predictor applications are based on gene expression profiling, and the surrogate assay at protein level is based on immunohistochemistry (IHC), which is known to be associated with inherent problems of subjectivity and inconsistency. Consequently, subtyping of breast cancer patients in clinical practice is limited either by the cost or the inaccuracy (surrogate assay). In this study, we proposed the first predictor model at protein level based on the three-dimensional (3D) distribution of samples using ER, PR and Her2 protein levels as coordinates. Method: Quantitative dot blot (QDB) method was used as a universal platform to achieve absolute quantitative of ER, PR, Her2 and Ki67 protein levels using total tissue lysates prepared from 2 × 15 um Formalin Fixed Paraffin Embedded (FFPE) slices. Total of 1248 FFPE slices were provided from local hospitals sequentially and non-selectively. The measured tissue biomarker levels were plotted in 3D scatterplot for analysis, in combination with provided clinicopathological parameters and overall survival data. Results: We observed natural segregation of these samples into three distinct groups to mimic “balls falling from ceiling corner” distribution pattern. This distribution pattern disappeared when the scatterplot was narrowed in a small box of ER&amp;lt;0.2 nmole/g, PR &amp;lt;0.8 nmole/g and Her2&amp;lt;0.3 nmole/g. When the observed Her2 level at 0.3 nmole/g was used as cutoff to convert samples dichotomously, we achieved overall concordance with IHC at 94.8%. In addition, 260 out 271 Her2 positive samples were either with ER&amp;lt;0.2 nmole/g or PR&amp;lt;0.8 nmole/g or both, with 8 more samples at the vicinity of corner group. The model was further evaluated with both the overall recurrence and survival of the patients. Conclusion: We developed the first 3D predictor model for subtyping of breast cancer patients based on the absolute and quantitative levels of ER, PR and Her2 at protein level. We propose this model the projection of intrinsic types at protein level. The adoption of this predictor model in clinical practice should significantly lower the barrier to allow practicing subtyping of breast cancer patients in daily clinical practice worldwide. Citation Format: Jiandi Zhang. Developing 3D subtyping model for breast cancer patients based on absolute quantitation or ER, PR and Her2 at protein level [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-10-30.