Shared Vulnerability Research Articles

The Co-occurrence of Pediatric Chronic Pain and Anxiety: A Theoretical Review of a Developmentally Informed Shared Vulnerability Model.

The development and maintenance of pediatric chronic pain and anxiety are complex, underscoring the need to better understand the interactive forces contributing to their co-occurrence. The shared vulnerability model (SVM) was developed to explain the co-occurrence of chronic pain and posttraumatic stress disorder in adults. Although many core tenets have been well supported by pediatric research, the SVM has yet to be extended to pediatric pain populations. We propose a developmentally informed pediatric SVM for advancing our understanding of the co-occurrence of pediatric chronic pain and anxiety disorders. The proposed SVM postulates that youth at increased risk for the development of chronic pain and/or anxiety share predisposing vulnerabilities, including anxiety sensitivity, and that these shared vulnerabilities give rise to negative emotional responses (child and parent) in the context of stressful events. Consequences of fear and anxiety, including avoidance behavior, further contribute to the development of chronic pain, anxiety, and their co-occurrence. The parental, school, and peer contexts in which these problems develop and are maintained in youth are pertinent to integrate into a SVM, as pediatric chronic pain and anxiety disorders share several social-contextual risk and maintenance factors. We also highlight new areas of inquiry.

Shared vulnerability for connectome alterations across psychiatric and neurological brain disorders.

Macroscale white matter pathways are the infrastructure for large-scale communication in the human brain and a prerequisite for healthy brain function. Disruptions in the brain's connectivity architecture play an important role in many psychiatric and neurological brain disorders. Here we show that connections important for global communication and network integration are particularly vulnerable to brain alterations across multiple brain disorders. We report on a cross-disorder connectome study comprising in total 1,033 patients and 1,154 matched controls across 8 psychiatric and 4 neurological disorders. We extracted disorder connectome fingerprints for each of these 12 disorders and combined them into a 'cross-disorder disconnectivity involvement map' describing the level of cross-disorder involvement of each white matter pathway of the human brain network. Network analysis revealed connections central to global network communication and integration to display high disturbance across disorders, suggesting a general cross-disorder involvement and the importance of these pathways in normal function.

SCNC phenotypic convergence reveals shared vulnerabilities.

Balanis, Sheu and colleagues show that small-cell neuroendocrine cancers converge on a common molecular phenotype across epithelial tissues and share therapeutic vulnerabilities with haematological cancers, revealing unique opportunities to guide the development of new treatments based on existing blood cancer therapies.

Tobacco smoking and schizophrenia: re-examining the evidence

SUMMARYTobacco smoking among people with mental illnesses can be explained by biological, psychological and social factors. The prevalence of smoking in people diagnosed with schizophrenia is higher than in people with other mental disorders and in the general population. This article explores three current hypotheses that explain this higher prevalence of smoking in schizophrenia. The first, the self-medication hypothesis, is increasingly countered by a growing body of evidence indicating that smokers experience more severe symptoms of schizophrenia. Numerous researchers have already identified smoking as a possible risk factor for the development of schizophrenia, which is the second hypothesis. The third hypothesis (shared genetic vulnerability) identifies certain genes that confer vulnerability for both schizophrenia and nicotine dependence. Understanding the reasons behind the higher prevalence of smoking among people with schizophrenia is vital in planning effective primary, secondary and tertiary smoking prevention for these individuals.LEARNING OBJECTIVESAt the end of this article, readers will be able to: •understand the self-medication hypothesis in relation to tobacco smoking by people with schizophrenia•understand the role of tobacco smoking as a possible risk factor for causation of schizophrenia•understand the role of shared genetic vulnerability in the causation of both schizophrenia and nicotine dependence.

Esposito’s affirmative biopolitics in multispecies homes

Drawing on Roberto Esposito’s conceptualization of ‘affirmative biopolitics’, this article examines the relationship between bedbugs and humans in the Glasgow neighbourhood of Govanhill. Through an analysis of ethnographic field notes and interviews with people who live in the area, this article traces their experiences from first encounters. The trajectory of this experience shows a shift from a desire to immunize their homes through total annihilation of the creatures to the more pragmatic position of learning how to live with them through an orientation toward ‘shared vulnerability’. This case study raises interesting questions for biopolitical theory: how can we conceive of affirmative biopolitics when the limitations of species being are evident, and is it possible to conceive of a multi or even interspecies munus or obligation?

“Do You Feel Safe at the Border?” An Intermedial Pedagogy for Sensing Communities of Shared Fate

This article considers the limitations of 1990s humanitarian and diaspora frames to mediate a sense of the border that moves beyond securitization and yet remains accountable to refugee claimant advocacy. As an alternative, this article explores an intermedial pedagogy for bringing critical border studies into the realm of embodiment and feeling. Drawing on teaching and research interviews, I consider how asking “do you feel safe at the border?” produces an effective challenge to persistent public emotions conflating national “borders” with the need for “security.” In complex ways, this kind of storytelling can bring into view, what Melissa Williams calls, “communities of shared fate” that exist across the spectrum of legal statuses, tapping in to extant feelings rooted in real, shared vulnerability at the border.

Enlivening a Community of Authentic Scholarship

Background: Critical and engaged qualitative scholarship depends on high-quality graduate training. The need to reexamine graduate student mentorship has become particularly pressing, given the high level of mental health distress experienced by students. It is unclear whether mentorship emerging within the student–advisor relationship is sufficient to ensure comprehensive mentorship. Innovative, experiential pedagogical approaches that integrate emotional and intellectual aspects are limited but may play a vital role in mentorship. There is a critical need to develop and study creative mentorship initiatives for emerging qualitative scholars. Methods: This study used interpretive description methodology and a community of practice theoretical framework to describe a faculty-mentored experience for graduate nursing students at the 2016 Qualitative Health Research Conference (FM-QHR) hosted by the International Institute for Qualitative Methodology. Participants completed written journals elucidating their experiences throughout FM-QHR. The textual data were analyzed using a constant comparative group analysis process, leading to the development of salient and interconnected themes. Results: Six graduate students and four faculty mentors submitted journals. Three interrelated themes articulate how this FM-QHR initiative enlivened a community of authentic scholarship: Questioning the Academic Self: Unvoiced Experiences of Angst, Uncertainty, and Fear; Cocreating Authentic Community through Shared Vulnerability; and Generative and Emergent Empowerment. Conclusion: These findings provide compelling insights into the importance of assisting students to navigate the emotional experiences that are a part of qualitative graduate training. Relational, mentorship initiatives hold potential to not only alleviate emotional distress but also support student empowerment, socialization, and entrance into a community of international qualitative researchers.

Solidarity in dark times: Arendt and Gadamer on the politics of appearance

AbstractThis essay surveys the theme of solidarity in the respective works of Hans‐Georg Gadamer and Hannah Arendt. Recent discourses in continental political philosophy have arrived at an impasse regarding solidarity. On the one hand, solidarities are important for galvanizing historically oppressed peoples against dominant discourses. On the other hand, solidarities that impose similarities in advance run the risk of absorbing difference and becoming exclusionary. Gadamer and Arendt, each in different manners, promise a distinctive approach to discourses on solidarity through their emphasis on the existential concern for human finitude. Both suggest that insofar as we are finite, we are bound together not by familiarity and sameness but rather by shared vulnerability, finding help with this vulnerability by remaining open to the difference and otherness that is always at stake in communal life. In this, Gadamer and Arendt open new paths to theorizing collectives in ways that embrace and defend difference rather than rejecting it. Moreover, both remind us of the urgency of such a notion of solidarity for responding to what, in allusion to Arendt, we may be inclined to call the dark times in which we live.

Community Study of Outcome Monitoring for Emotional Disorders in Teens (COMET): A comparative effectiveness trial of a transdiagnostic treatment and a measurement feedback system

Emotional disorders, encompassing a range of anxiety and depressive disorders, are the most prevalent and comorbid psychiatric disorders in adolescence. Unfortunately, evidence-based psychosocial therapies typically focus on single disorders, are rarely adopted by community mental health center clinicians, and effect sizes are modest. This article describes the protocol for a comparative effectiveness study of two novel interventions designed to address these challenges. The first intervention is a transdiagnostic treatment (the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents, UP-A), a promising new approach that uses a small number of common strategies to treat a broad range of emotional disorders, and their underlying shared emotional vulnerabilities. The second intervention is a standardized measurement feedback system, the Youth Outcomes Questionnaire (YOQ), designed to improve clinical decision making using weekly symptom and relational data. The three study arms are treatment as usual (TAU), TAU plus the YOQ (TAU+), and UP-A (used in combination with the YOQ). The primary aims of the study are to [1] compare the effects of the UP-A and TAU+ to TAU in community mental health clinics, [2] to isolate the effects of measurement and feedback by comparing the UP-A and TAU+ condition, and [3] to examine the mechanisms of action of both interventions. Design considerations and study methods are provided to inform future effectiveness research.

Preconception and prenatal cannabis use and the risk of behavioural and emotional problems in the offspring; a multi-informant prospective longitudinal study.

Studies of the long-term consequences of maternal cannabis use on child development beyond the neonatal period are sparse. In the current study, we use a multi-information approach to assess the association of prenatal cannabis exposure and child behavioural and emotional functioning. To explore the possible causal nature of the association, we investigated whether maternal tobacco and paternal cannabis use during pregnancy were also associated with child problems. The study population included children of a population-based birth cohort in The Netherlands (n = 5903). Information on parental cannabis use was collected using questionnaires; urine of mothers was analysed for the presence of cannabis metabolites. Child behavioural and emotional problems at approximately 7-10 years were measured using validated teacher-, child- and mother-reports. Our findings show associations of maternal cannabis use during pregnancy with offspring externalising problems (B = 0.53; 95% CI: 0.29-0.77), but not with internalising problems (B = -0.10; 95% CI: -0.31-0.11). However, maternal cannabis use before pregnancy was also associated with offspring externalising problems (B = 0.27; 95% CI: 0.02-0.52). Further, cannabis use by the father was associated with child externalising problems (B = 0.36; 95% CI: 0.22-0.49) but not internalising problems. Prenatal exposure to maternal cannabis use is specifically associated with offspring behavioural problems, but not emotional problems. This association is probably not due to an effect of intrauterine cannabis exposure on fetal development, because both maternal and paternal cannabis exposure during pregnancy were related to offspring externalising problems. Our findings suggest that the association can be explained through residual confounding, most likely through shared genetic vulnerabilities for parental cannabis use and offspring behavioural problems.

Feeding the flock: Wild cockatoos and their Facebook friends

Wildlife is persisting in urban areas of Australia even though white settler colonialism has resulted in the large-scale destruction of forested landscapes. While many bird species are in decline, the Sulphur-crested Cockatoo has found emergent opportunities for flourishing within the built environment. Cockatoos are actively generating relationally constituted spaces, drawing humans into urban ecosystems that are ‘more-than-human’ places, abundant and lively multispecies communities. Beginning in 2011, yellow tags attached to the wings of cockatoos, along with a smart-phone app and a Facebook page, have enabled scientists to collect data about these birds’ movements. These tracking technologies were quickly co-opted by an emergent public for their own purposes, including speculating about the personalities, relationships, intentions, and desires of individual birds. Interspecies friendships formed between humans and birds – involving shared understandings, emotional resonances, ongoing social exchanges, and utilitarian arrangements. We used the wingtags and the associated digital infrastructure as an opportunity to experiment with new modes of collaborative research and teaching in multispecies ethnography. Bringing together a flock of academics and students, we explored emergent social spaces involving people and birds. While many participants who fed the birds worried that they would become tame, we found multispecies flocks were fleeting associations where wild and unruly behaviours redoubled as people offered up food. We found that wildness emerged in intimate encounters with other species, encounters that were often characterised by shared but unequal vulnerabilities. Some cockatoos have been killed, after conflicts over property damage led authorities to identify them as nuisance animals. Against the backdrop of asymmetrical risks, we studied flocks of birds as models of, and models for, fleeting forms of association and collaboration. In these spaces, feelings of interspecies attraction quickly alternated with agitated and uncomfortable experiences. Amid animated encounters, people explored the ethics of inclusivity and conviviality.

Dissecting genetic cross-talk between ADHD and other neurodevelopmental disorders: Evidence from behavioural, pharmacological and brain imaging investigations

Several epidemiological and genetic studies have provided evidence of an overlap between neurodevelopmental disorders. However, the details of the etiological pathways remain to be elucidated. In this study, we garnered the findings of previous GWAS, conducted with schizophrenia and bipolar disorder. We conducted an exploratory study to examine the association between these SNPs and quantitative clinical/ behavioural/ cognitive/ structural brain parameters, as well as response to treatment with a fixed dose of methylphenidate, in a relatively large sample of children with ADHD. Family-based association tests were conducted with nine tag SNPs with 602 nuclear families. In addition, structural magnetic resonance imaging (sMRI) was conducted in a subset of children with ADHD (n = 76). Of the 9 tag SNPs examined, rs1602565 showed a significant association with ADHD, several dimensional measures and response to treatment. An association was also observed between rs1006737 (CACNA1C) and performance IQ. In addition, significant reductions in cortical thickness measurements were observed with the risk allele in rs1006737. These results provide preliminary evidence for putative shared genetic vulnerability between childhood ADHD and other neurodevelopmental disorders.

Genetic basis of psychopathological dimensions shared between schizophrenia and bipolar disorder

Shared genetic vulnerability between schizophrenia (SCZ) and bipolar disorder (BP) was demonstrated, but the genetic underpinnings of specific symptom domains are unclear. This study investigated which genes and gene sets may modulate specific psychopathological domains and if genome-wide significant loci previously associated with SCZ or BP may play a role.Genome-wide data were available in patients with SCZ (n = 226) or BP (n = 228). Phenotypes under investigation were depressive and positive symptoms severity, suicidal ideation, onset age and substance use disorder comorbidity. Genome-wide analyses were performed at gene and gene set level, while 148 genome-wide significant loci previously associated with SCZ and/or BP were investigated. Each sample was analyzed separately then a meta-analysis was performed.SH3GL2 and CLVS1 genes were associated with suicidal ideation in SCZ (p = 5.62e-08 and 0.01, respectively), the former also in the meta-analysis (p = .01). SHC4 gene was associated with depressive symptoms severity in BP (p = .003). A gene set involved in cellular differentiation (GO:0048661) was associated with substance disorder comorbidity in the meta-analysis (p = .03). Individual loci previously associated with SCZ or BP did not modulate the phenotypes of interest.This study provided confirmatory and new findings. SH3GL2 (endophilin A1) showed a role in suicidal ideation that may be due to its relevance to the glutamate system. SHC4 regulates BDNF-induced MAPK activation and was previously associated with depression. CLVS1 is involved in lysosome maturation and was for the first time associated with a psychiatric trait. GO:0048661 may mediate the risk of substance disorder through an effect on neurodevelopment/neuroplasticity.

Shared Vulnerability, Collaborative Composition, and the Interrogation and Reification of Oppressive Values in a High School LGBTQ-Themed Literature Course

With recent decades showing an increase in educational literacy scholarship attending to Lesbian, Gay, Bisexual, Trans, and Queer (LGBTQ) people and texts with LGBTQ themes, we sought to extend this scholarship through examining collaborative composition for public audiences beyond a classroom and school. We explored these composing practices through our ethnographically informed qualitative study of a semester-long LGBTQ-themed literature course for high school juniors and seniors, which we cotaught and coresearched. Ultimately, we found, through collaborative composing for public audiences, students and teachers in the LGBTQ-themed literature course had opportunities for interrogating oppressive values. When students and teachers shared vulnerability in that they shared responsibility for oppressive values, they embraced these opportunities. However, when students and teachers failed to share vulnerability but, instead, imposed it on a single individual, they squandered these opportunities. These findings underscore the importance of sharing vulnerability when working to interrogate oppressive values through collaborative composition for public audiences.

Integrative Bayesian Analysis Identifies Rhabdomyosarcoma Disease Genes

Identifying oncogenic drivers and tumor suppressors remains a challenge in many forms of cancer, including rhabdomyosarcoma. Anticipating gene expression alterations resulting from DNA copy-number variants to be particularly important, we developed a computational and experimental strategy incorporating a Bayesian algorithm and CRISPR/Cas9 "mini-pool" screen that enables both genome-scale assessment of disease genes and functional validation. The algorithm, called iExCN, identified 29 rhabdomyosarcoma drivers and suppressors enriched for cell-cycle and nucleic-acid-binding activities. Functional studies showed that many iExCN genes represent rhabdomyosarcoma line-specific or shared vulnerabilities. Complementary experiments addressed modes of action and demonstrated coordinated repression of multiple iExCN genes during skeletal muscle differentiation. Analysis of two separate cohorts revealed that the number of iExCN genes harboring copy-number alterations correlates with survival. Our findings highlight rhabdomyosarcoma as a cancer in which multiple drivers influence disease biology and demonstrate a generalizable capacity for iExCN to unmask disease genes in cancer.

La vaca que nos mira: vida precaria y ficción

Draw from two recent texts, Cuaderno de campo, a story of the Argentinian Carlos Rios published in 2014 and De gados e homens, a short novel of the Brazilian writer Ana Paula Maia published in 2013, we propose to explore the figure of the cow and in particular the animal face within the simbolic universe of the slaughterhouse. In these texts, the slaughterhouse and the bovine face shows a politics of corporeal vulnerability that inquire Judith Butler’s analysis of Emmanuel Levinas, the face and precarious life, which sustain and implicit hierarchy for the living human. Therefore, these re-writings of slaughterhouses work as a knowledge of precarity, that is to say, they point to a share vulnerability or living precarity that proves the affective and sensitive dimmension that emerges in the between human and bovine bodies.

Temperament in child and adolescent offspring of patients with schizophrenia and bipolar disorder.

Shared vulnerability in offspring of individuals with schizophrenia (SzO) and bipolar disorder (BpO) might manifest early during development through common temperament traits. Temperament dimensions in child and adolescent BpO (N = 80), SzO (N = 34) and the offspring of community controls (CcO) (N = 101) were assessed using the Revised Dimensions of Temperament Survey. The association between temperament dimensions and lifetime psychopathology (including threshold and subthreshold DSM-IV-TR diagnoses) and current socio-academic adjustment was assessed using logistic regression. Fully adjusted models showed that both BpO and SzO scored significantly lower in the positive mood dimension and in the adaptability factor than CcO, with small-medium effect sizes (Cohen's d ~ 0.3-0.5). BpO also scored lower in the activity factor and the activity dimensions than CcO (Cohen's d ~ 0.3). Lower scores in the positive mood dimension were associated with increased risk of impaired adjustment both in BpO [OR 2.30, 95% CI (1.18-4.46)] and in SzO [OR 2.87, 95% CI (1.07-7.66)]. In BpO, lower scores in positive mood were also associated with increased likelihood of internalizing [OR 1.84, 95% CI (1.28-2.64)] and externalizing disorders [OR 1.48, 95% CI (1.01-2.18)]; in SzO, higher scores in activity and flexibility were associated with increased likelihood of internalizing [OR 2.31, 95% CI (1.22-4.38)] and externalizing disorders [OR 3.28, 95% CI (1.2-9)], respectively. Early difficulties in emotion regulation might represent a shared vulnerability phenotype in BpO and SzO. The identification of extreme temperament traits could help to characterize subgroups at greater risk of psychopathology and impaired adjustment, in which targeted interventions are warranted.

Sydney as an Indigenous place: “Goanna walking” brings people together

Sydney, Australia, is rarely seen as an Indigenous place, yet over 52,000 Indigenous people live here. “Indigeneity” persists in educational discourse as a remote phenomenon, but the research reveals otherwise for many Indigenous people who continue to live in Sydney. This is reflected in the contemporary lives of seven Dharug women who constitute the basis of a doctoral project. The seven women disclose how caring and connectivity to place and people continue to be important markers of belonging to Country in the city. This article also draws on Judith Butler’s work to investigate the conditions of possibility for sustained collaboration between Indigenous and non-Indigenous people in Sydney. Through a collaborative project between local Dharug artists and teacher education students, we find that cross-cultural understandings are built through vulnerabilities, as much as they are through reason. Shared vulnerability provides the conditions for meeting on Country, and “goanna walking” takes us there.

Thinking with Crocodiles, Thinking Through Humans: Vulnerable, Entangled Selves in Lauren Beukes's Zoo City

ABSTRACTZoo City's (2010) author, Lauren Beukes, claims to have written her novel in response to widespread xenophobic attitudes towards refugees in South Africa. The frequent attacks made by crocodiles on these people as they attempt to enter the country by crossing the Limpopo River are a fitting, if gruesome, metaphor for such prejudice. Against this background, I read Zoo City's own crocodile as a central figure in Beukes's engagement with discourses of prejudice. The animal familiar of a murderous human, this crocodile is blatantly politicised. Anthropomorphising nonhuman animals, as Beukes does here, is generally criticised for perpetuating anthropocentric ways of looking at the world. However, I read Zoo City's crocodile in light of work carried out by scholars such as Neel Ahuja, Nandini Thiyagarajan, and Kari Weil, who suggest that this contested practice might yet be of value to wider efforts to combat prejudiced and hierarchical ways of thinking about others. Straddling the boundaries between human and nonhuman, predator and prey, Beukes's crocodile dramatises the extent to which humans and nonhumans are entangled with and connected to one another, not only through prejudiced language and imagery, but also through their shared vulnerability. Acknowledging such shared vulnerability is, I suggest, a good way for humans to begin to rethink themselves and their place in the world. Through her nonhuman animals, and in particular her crocodile, Beukes explores, then, the potential for human prejudice that has infiltrated the rest of the animal kingdom to be reappropriated as a tool for ethical progress. Indeed, if nonhumans are already present in the biopolitical fold on account of the human prejudice they bear, then they might just be able to help challenge, from the inside, the very human hierarchies of being on which prejudice is founded. This, I argue, is precisely the work performed by the complex figure of the crocodile in Beukes's Zoo City.

Abstract B123: A mesenchymal subset of cancers with elevated ZEB1 expression is sensitive to low doses of silver nanoparticles

Abstract The epithelial-to-mesenchymal transition (EMT) is an evolutionarily conserved process that is required for normal development. However, EMT is often dysregulated and hijacked by cancers during tumor progression. Cancer cells that have undergone EMT and acquired a mesenchymal phenotype harbor several distinct traits, including increased tumor initiating properties, augmented motility, increased metastatic properties, and a higher incidence of resistance to therapy. Therefore, treatment regimens specific to mesenchymal cancer cells would be advantageous. In this study, we discovered that a mesenchymal subpopulation of breast, ovarian, lung, colorectal, and prostate cancer cell lines with high expression of the transcription factor ZEB1 (zinc finger E-box binding homeobox 1) and low expression of epithelial genes repressed by ZEB1 including ESRP1 (epithelial splicing regulatory protein 1) and CDH1 (E-cadherin) are an order of magnitude (>10-fold) more sensitive to exposure to silver nanoparticles (AgNPs) than cells expressing only low levels of ZEB1. This finding is significant because: (i) This is the first time a biomarker has been identified that is predictive of a positive response to any form of engineered nanomaterial; (ii) ZEB1 expression is a marker of poor clinical prognosis, and therefore identification of improved therapeutics for this poor outcome patient population is desirable; (iii) this work establishes that there is a shared and exploitable vulnerability across multiple cancer types that is independent of tissue origin and identifiable based upon mRNA or protein quantification of ZEB1. We establish that the ZEB1high selective cytotoxic properties of biocompatible AgNPs are not achieved using ionic silver, and therefore is one of the first examples of a “new to nano” cytotoxic property. Mechanistically, we find that AgNPs are rapidly ionized in ZEB1high cells, leading to endoplasmic reticulum stress, DNA damage, and apoptotic cell death. Furthermore, we show that AgNPs do not disrupt the normal architecture of breast acini in 3D cell culture, nor do they cause DNA damage. In contrast, the same doses of AgNPs cause extensive DNA damage and apoptosis in ZEB1high breast tumor nodules produced in 3D culture. Induction of EMT using TGF-β increases sensitivity to AgNPs and, conversely, knockdown of ZEB1 desensitizes cells to AgNP therapy. Finally, we demonstrate that systemic administration of AgNPs is safe and effective for treatment of ZEB1high breast cancer orthotopic xenografts in mice. In conclusion, our work provides evidence that a therapeutic window exists for the safe use of AgNPs as a precision medicine for patients with ZEB1-expressing tumors regardless of tissue origin. Citation Format: Cale D. Fahrenholtz, Jessica Swanner, James Sears, Katherine Cook, Pierre-Alexandre Vidi, Ravi Singh. A mesenchymal subset of cancers with elevated ZEB1 expression is sensitive to low doses of silver nanoparticles [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr B123.