a b s t r a c tObjective. There is a need to develop and validate biomarkers for treatment response and survival in tuboovarian high-grade serous carcinoma (HGSC). The chemotherapy response score (CRS) stratifies patients into Gynecologic Oncology 154 (2019) 441-448 complete/near-complete (CRS3), partial (CRS2), and no/minimal (CRS1) response after neoadjuvant chemotherapy (NACT). Our aim was to review current evidence to determine whether the CRS is prognostic in women with tubo-ovarian HGSC treated with NACT.Methods. We established an international collaboration to conduct a systematic review and meta-analysis, pooling individual patient data from 16 sites in 11 countries. Patients had stage IIIC/IV HGSC, 3-4 NACT cycles and N6-months follow-up. Random effects models were used to derive combined odds ratios in the pooled population to investigate associations between CRS and progression free and overall survival (PFS and OS).Results. 877 patients were included from published and unpublished studies. Median PFS and OS were 15 months (IQR 5-65) and 28 months (IQR 7-92) respectively. CRS3 was seen in 249 patients (28%). The pooled hazard ratios (HR) for PFS and OS for CRS3 versus CRS1/CRS2 were 0·55 (95% CI, 0·45-0·66; P b 0·001) and 0·65 (95% CI 0·50-0·85, P = 0·002) respectively; no heterogeneity was identified (PFS: Q = 6·42, P = 0·698, I2 = 0·0%; OS: Q = 6·89, P = 0·648, I2 = 0·0%). CRS was significantly associated with PFS and OS in multivariate models adjusting for age and stage. Of 306 patients with known germline BRCA1/2 status, those with BRCA1/2 mutations (n = 80) were more likely to achieve CRS3 (P = 0·027).Conclusions. CRS3 was significantly associated with improved PFS and OS compared to CRS1/2. This validation of CRS in a real-world setting demonstrates it to be a robust and reproducible biomarker with potential to be incorporated into therapeutic decision-making and clinical trial design.• The Chemotherapy response score (CRS) assesses histological effect in ovarian cancer after neoadjuvant chemotherapy (NACT). • The CRS is associated with progression-free and overall survival.• CRS could provide useful information to estimate a patient's probability of early vs. late relapse.• The CRS is an appealing primary endpoint in clinical trials as a surrogate for survival as it can be measured earlier. • We recommend the CRS be incorporated as an endpoint in clinical trials of novel therapeutic agents that have a NACT arm.

Corrigendum to "Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data" Gynecol. Oncol. 154 (2019) 441-448

Cellular plasticity and transitional phenotypes add to complexities of cancer metastasis initiated by single cell epithelial to mesenchymal transition or cooperative cell migration (CCM).We identified novel regulatory cross-talks between Tcf21 and Slug in mediating phenotypic and migration plasticity in high-grade serous ovarian adenocarcinoma. Live imaging discerned CCM as being achieved either through rapid cell proliferation or sheet migration. Transitional states were enriched over the rigid epithelial or mesenchymal phenotypes under conditions of environmental stresses. The Tcf21-Slug interplay identified in HGSC tumors through effective stratification of subtypes also contributed to class-switching in response to disease progression or therapy. Our study effectively provides a framework for understanding the relevance of cellular plasticity in situ as a function of two transcription factors.

Objective:The primary objective of the study was to evaluate the effect of California tri-pull taping (CTPT) method on post stroke shoulder subluxation, pain, active range of motion and upper limb functional recovery. Design: Pretest post test design. Setting: Study was conducted ininpatient and outpatient department of MM hospital Mullana-Ambala. Participants: 10 subjects with post stroke shoulder subluxation were included into the study. (7 male , 3 female). Intervention: For taping, two types of tape was used, cotton pre-tape and rigid post-tape. Tape was applied to subjects for thrice a week, for six weeks and conventional neuro rehabilitation programmewas also given to the subjects, five days a week for six weeks. Main outcome measures: Pre, and post assessment scores were taken from each subject by using, Digital Vernier caliper, visual analogue scale (VAS), Goniometer, and Fuglmeyer scale (FUG). Results: The CTPT method produced significant reduction on inferior subluxation from pre intervention to post intervention, pain. There was also significant improvement of AROM, and FUG. Conclusion: This intervention is a promising adjunct to the management of the hemiplegic subluxed shoulder. The main limitation of the study was, small sample size and no control group was used.

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