Oxidative stress, a condition characterized by an imbalance between pro-oxidant molecules and antioxidant defense systems, is increasingly recognized as a key contributor to cancer development. This is because the reactive oxygen species (ROS) generated during oxidative stress can damage DNA, proteins, and lipids to facilitate mutations and other cellular changes that promote cancer growth. Antioxidant supplementation is a potential strategy for decreasing cancer incidence; by reducing oxidative stress, DNA damage and other deleterious cellular changes may be attenuated. Several clinical trials have been conducted to investigate the role of antioxidant supplements in cancer prevention. Some studies have found that antioxidant supplements, such as vitamin A, vitamin C, and vitamin E, can reduce the risk of certain types of cancer. On the other hand, some studies posit an increased risk of cancer with antioxidant supplement use. In this review, we will provide an overview of the current understanding of the role of oxidative stress in cancer formation, as well as the potential benefits of antioxidant supplementation in cancer prevention. Additionally, we will discuss both preclinical and clinical studies highlighting the potentials and limitations of preventive antioxidant strategies.

Introduction: Immunotherapy has revolutionized how cancer is treated. Many of these immunotherapies rely on ex vivo expansion of immune cells, classically T cells. Still, several immunological obstacles remain, including tumor impermeability by immune cells and the immunosuppressive nature of the tumor microenvironment (TME). Logistically, high costs of treatment and variable clinical responses have also plagued traditional T cell-based immunotherapies. Methods: To review the existing literature on cellular immunotherapy, the PubMed database was searched for publications using variations of the phrases "cancer immunotherapy", "ex vivo expansion", and "adoptive cell therapy". The Clinicaltrials.gov database was searched for clinical trials related to ex vivo cellular therapies using the same phrases. The National Comprehensive Cancer Network guidelines for cancer treatment were also referenced. Results: To circumvent the challenges of traditional T cell-based immunotherapies, researchers have developed newer therapies including tumor infiltrating lymphocyte (TIL), chimeric antigen receptor (CAR), T cell receptor (TCR) modified T cell, and antibody-armed T cell therapies. Additionally, newer immunotherapeutic strategies have used other immune cells, including natural killer (NK) and dendritic cells (DC), to modulate the T cell immune response to cancers. From a prognostic perspective, circulating tumor cells (CTC) have been used to predict cancer morbidity and mortality. Conclusion: This review highlights the mechanism and clinical utility of various types of ex vivo cellular therapies in the treatment of cancer. Comparing these therapies or using them in combination may lead to more individualized and less toxic chemotherapeutics.

756 Background: The incidence of pancreatic cancer among young adults has sharply risen over the past decade. Young adults often utilize online educational media, such as YouTube videos, for information about their disease. These may be subject to a high degree of bias and misinformation; previous analyses have demonstrated low quality of other cancer-related YouTube videos. Thus, we sought to determine if patients can rely on YouTube videos for accurate information about pancreatic cancer, and we compared relevant YouTube videos with those published by NCI-designated cancer centers (CCs). Methods: We designed a novel search query and inclusion/exclusion criteria based on published studies evaluating YouTube user tendencies. These criteria were used to identify videos most likely watched by patients, which composed our “Patient-Focused” (PF) group. We compared PF videos with those uploaded by CCs by manually searching each CC’s affiliated YouTube and applying the same inclusion/exclusion criteria. Data were summarized by descriptive statistics. Videos were evaluated based on two well-known criteria, the DISCERN and JAMA tools, as well as a tool published by Sahin et al to analyze the contents of colorectal cancer videos. A score of ≥ 6 on the Sahin scale correlated with high quality information. We used t-test and Chi-squared test to analyze differences between groups. Results: 39 videos met inclusion criteria within the PF sample and 19 videos within the CC sample, total sample of 58 videos. The PF sample had mean Sahin scores of 4.24 ± 2.21, DISCERN scores of 2.15 ± 0.47, and JAMA scores of 1.77 ± 0.60. CC videos had mean Sahin scores of 3.84 ± 2.70, DISCERN scores of 2.25 ± 0.63, and JAMA scores of 2.00 ± 0.0. Perceived speakers’ ethnicity was 75% White (n=77), 21% Asian (n=21), and 4% Hispanic (n=4). There were no Black speakers. Most videos uploaded were fair or poor quality. 16.4% (n=27) were of average or high quality by the Sahin criteria, with 1 video receiving a perfect score. 9.6% (n=5) and 90.4% (n=47) were average or high quality by DISCERN and JAMA criteria, respectively. 8.6% (n=5) of videos discussed palliative care and 10.3% (n=6) discussed staging. Independent samples t-test revealed no significant differences between PF and CC videos for the Sahin criteria (p=0.429) and DISCERN criteria (p=0.387). The mean JAMA score was higher for CCs (2.0 ± 0.0) than the PF group (1.8 ± 0.6) (p=0.001). Chi-squared test revealed that CC and PF videos had similar speaker ethnic diversity (p=0.381). Conclusions: Educational pancreatic cancer YouTube videos demonstrate low to moderate quality information with limited speaker ethnic diversity. Given ongoing trends in the spread of misinformation through social media, CCs and other patient educators should be mindful of their role in producing high quality, comprehensive information for patients and their caregivers.

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