While much progress has been made in the treatment of breast cancer, cardiac complications resulting from therapy remain a significant concern. Both anthracyclines and novel targeted agents can inflict cardiac damage. The present study aimed to evaluate the difference between what it is currently done and what standards of care should be used to minimizing and managing cardiac toxicity in breast cancer survivors.
A two-round multicenter Delphi study was carried out. The panel consisted of 100 oncologists who were asked to define the elected therapies for breast cancer patients, the clinical definition and patterns of cancer drug-derived cardiac toxicity, and those protocols focused on early detection and monitoring of cardiovascular outcomes.
Experts agreed a more recent definition of cardiotoxicity. Around 38 % of patients with early-stage disease, and 51.3 % cases with advanced metastatic breast cancer had preexisting risk factors for cardiotoxicity. Among risk factors, cumulative dose of anthracycline ≥450 mg/m(2) and its combination with other anticancer drugs, and a preexisting cardiovascular disease were considered the best predictors of cardiotoxicity. Echocardiography and radionuclide ventriculography have been the proposed methods for monitoring changes in cardiac structure and function. Breast cancer is generally treated with anthracyclines (80 %), so that the panel strongly stated about the need to plan a strategy to managing cardiotoxicity. A decline of left ventricular ejection fraction (LVEF) >10 %, to an LVEF value <53 % was suggested as a criterion for changing the dose schedule of anthracyclines, or suspending the treatment of chemotherapy plus trastuzumab until the normalization of the left ventricular function. The use of liposomal anthracyclines was strongly suggested as a treatment option for breast cancer patients.
The present report is the first to produce a set of statements on the prevention, evaluation and monitoring of chemotherapy-induced cardiac toxicity in breast cancer patients.

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On April 22, 2016 CRT and The University of Copenhagen reported to have signed a deal with Switzerland-based ADC Therapeutics SA (ADCT) to license antibodies against a cancer-specific cell surface protein (Press release, Cancer Research Technology, 22 22, 2016, View Source [SID1234523187]). The antibodies will be used by ADCT to develop a novel Antibody Drug Conjugate (ADC) that could potentially treat a range of cancers.

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The antibodies – jointly developed by Cancer Research UK and the University of Copenhagen scientists – target a protein overexpressed on the surface of some cancer cells, which is not expressed on healthy cells.

ADCT intends to incorporate the antibodies into a novel ADC therapeutic using its proprietary linker and pyrrolobenzodiazepine (PBD) cytotoxic warhead technology*. The antibodies are expected to selectively target the PBD cytotoxic to cancer cells, sparing normal tissue.

Thomas Bjørnholm, Pro-Vice-chancellor for Research and Innovation, the University of Copenhagen, said: "We are very pleased and proud that research from the University’s Faculty of Health and Medical Sciences has been licensed to ADCT for the development of new cancer therapeutics. Our mission as a public university is precisely to make sure that our leading-edge research is disseminated and is taken to the market together with commercial partners for the benefit of society at large."

Dr Keith Blundy, Cancer Research Technology’s chief executive, said: "This important license deal brings together CRT’s access to world class research and ADCT’s cutting edge technology to develop exciting new therapeutics for cancer.

"We hope this agreement will pave the way for promising new ways to treat a range of cancers in a targeted way without damaging healthy tissue."

In recent years, various outcome adaptive randomization (AR) methods have been used to conduct comparative clinical trials. Rather than randomizing patients equally between treatments, outcome AR uses the accumulating data to unbalance the randomization probabilities in favor of the treatment arm that currently is superior empirically. This is motivated by the idea that, on average, more patients in the trial will be given the treatment that is truly superior, so AR is ethically more desirable than equal randomization. AR remains controversial, however, and some of its properties are not well understood by the clinical trials community.
Computer simulation was used to evaluate properties of a 200-patient clinical trial conducted using one of four Bayesian AR methods and compare them to an equally randomized group sequential design.
Outcome AR has several undesirable properties. These include a high probability of a sample size imbalance in the wrong direction, which might be surprising to nonstatisticians, wherein many more patients are assigned to the inferior treatment arm, the opposite of the intended effect. Compared with an equally randomized design, outcome AR produces less reliable final inferences, including a greatly overestimated actual treatment effect difference and smaller power to detect a treatment difference. This estimation bias becomes much larger if the prognosis of the accrued patients either improves or worsens systematically during the trial.
AR produces inferential problems that decrease potential benefit to future patients, and may decrease benefit to patients enrolled in the trial. These problems should be weighed against its putative ethical benefit. For randomized comparative trials to obtain confirmatory comparisons, designs with fixed randomization probabilities and group sequential decision rules appear to be preferable to AR, scientifically, and ethically.
© The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].

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The high rate of failure of new agents in oncology clinical trials indicates a weak understanding of the complexity of human cancer. Recent understanding of the mechanisms underlying castration resistance in prostate cancer led to the development of new agents targeting the androgen receptor pathway; however, their effectiveness is limited. Hence, there is a need for experimental systems that are able to better reproduce the biological diversity of prostate cancer in preclinical settings. In this study, we established a unique patient-derived xenograft (PDX) model to identify biomarkers for treatment efficacy and resistance and better understand prostate cancer biology.
A prostate cancer tissue sample from a Japanese patient was transplanted subcutaneously into male, severe combined immune-deficient (SCID) mice and this PDX mouse model was named KUCaP3. Sequential tumor volume changes were observed before and after castration. Androgen receptor (AR), prostate-specific antigen (PSA), and other molecular markers were examined immunohistochemically. Sequence analysis of AR was also performed to detect mutations. Proteomic analysis of cyst fluid and sera samples of KUCaP3 mice were analyzed by mass spectrometry (MS).
KUCaP3 cell line, derived from human tissue, was successfully and serially passaged in vivo with approximately 60% take rate. KUCaP3 exhibited cyst formation, showed androgen-dependent growth initially, and developed castration-resistant growth several months after castration of the mice. Immunohistochemical analysis showed that KUCaP3 was positive for AR, PSA, CK18, and α-methyl acyl-coenzyme A racemase, but negative for CK5/6 and ERG. The AR gene in KUCaP3 cells contained a substitution from CAT (histidine) to TAT (tyrosine) at the nucleotide positions corresponding to codon 875 (H875Y) in the ligand-binding domain. Chemiluminescent immunoassay revealed higher levels of PSA in cystic fluid and the serum of KUCaP3-bearing mice. MS analysis detected 23 proteins of human origin in cystic fluids of KUCaP3.
We developed KUCaP3, an androgen-dependent PDX model with cyst formation. Several proteins including PSA were detected in the cystic fluid and sera of tumor-bearing mice. This original PDX model has the potential to be used as a clinically relevant model to evaluate molecular markers for prostate cancer diagnosis and treatment. Prostate © 2016 Wiley Periodicals, Inc.
© 2016 Wiley Periodicals, Inc.

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This quadrivalent human papillomavirus (qHPV) (HPV6, -11, -16, and -18) vaccine long-term follow-up (LTFU) study is an ongoing extension of a pivotal clinical study (FUTURE II) taking place in the Nordic region. The LTFU study was designed to evaluate the effectiveness, immunogenicity, and safety of the qHPV vaccine (Gardasil) for at least 10 years following completion of the base study. The current report presents immunogenicity data from testing samples of the year 5 LTFU visit (approximately 9 years after vaccination). FUTURE II vaccination arm subjects, who consented to being followed in the LTFU, donated serum at regular intervals and in 2012. Anti-HPV6, -11, -16, and -18 antibodies were detected by the competitive Luminex immunoassay (cLIA), and in addition, serum samples from 2012 were analyzed by the total IgG Luminex immunoassay (LIA) (n = 1,598). cLIA geometric mean titers (GMTs) remained between 70% and 93% of their month 48 value depending on HPV type. For all HPV types, the lower bound of the 95% confidence interval (CI) for the year 9 GMTs remained above the serostatus cutoff value. The proportion of subjects who remained seropositive based on the IgG LIA was higher than the proportion based on cLIA, especially for anti-HPV18. As expected, the anti-HPV serum IgG and cLIA responses were strongly correlated for all HPV types. Anti-HPV GMTs and the proportion of vaccinated individuals who are seropositive remain high for up to 9 years of follow-up after vaccination.
Copyright © 2015, American Society for Microbiology. All Rights Reserved.

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