Gastro-esophageal (GE) cancers are one of the major causes of cancer-related death in the world. There is a need for novel biomarkers in the management of GE cancers, to yield predictive response to the available therapies. Our study aims to identify leading genes that are differentially regulated in patients with these cancers. We explored the expression data for those genes whose protein products can be detected in the plasma using the Cancer Genome Atlas to identify leading genes that are differentially regulated in patients with GE cancers. Our work predicted several candidates as potential biomarkers for distinct stages of GE cancers, including previously identified CST1, INHBA, STMN1, whose expression correlated with cancer recurrence, or resistance to adjuvant therapies or surgery. To define the predictive accuracy of these genes as possible biomarkers, we constructed a co-expression network and performed complex network analysis to measure the importance of the genes in terms of a ratio of closeness centrality (RCC). Furthermore, to measure the significance of these differentially regulated genes, we constructed an SVM classifier using machine learning approach and verified these genes by using receiver operator characteristic (ROC) curve as an evaluation metric. The area under the curve measure was > 0.9 for both the overexpressed and downregulated genes suggesting the potential use and reliability of these candidates as biomarkers. In summary, we identified leading differentially expressed genes in GE cancers that can be detected in the plasma proteome. These genes have potential to become diagnostic and therapeutic biomarkers for early detection of cancer, recurrence following surgery and for development of targeted treatment.
Introduction: Venous access is a crucial element in chemotherapy delivery. It remains unclear whether cancer patients prefer a port to a peripherally inserted central catheter (PICC). Our study aimed to assess cancer patients’ satisfaction with their venous access device and to compare the quality of life (QoL) of subjects with a PICC to those with a port. Methods: In this prospective cohort study, EORTC QLQ-C30, and a locally developed quality of life survey (QLAVD), designed to assess satisfaction with venous access devices, were administered to breast or colorectal cancer patients over a one-year period following the device insertion. Mixed effects models were used to assess changes on mean scores at different time points. Results: A total of 101 patients were recruited over a three-year period, (PICC group, n = 50; port group, n = 51). Survey response rates for months one and three were 72% and 48%, respectively. Overall, no significant differences were noted between the two groups in relation to EORTC QOL. At three months, the mean pain scores were 3.5 ± 2.3 for the port and 1.3 ± 0.75 for PICC (<0.001). The mean score for a negative effect of the venous access device on psychosocial well-being was 6.0 ± 4.1 for PICC and 3.0 ± 2.7 for the port (p = 0.005). Complications related to PICCs occurred in 38% patients versus 41% with a port (p > 0.24). Conclusions: Although subjects with a port experienced more pain during the device insertion or access for chemotherapy, it had a smaller negative impact on psychosocial scores than the PICC. No significant differences in complications rates were observed between the two devices.
TPS445 Background: Pancreatic cancer is a major cause of cancer-related death. About 40% of patients with pancreatic cancer present with locally advanced disease and are not candidates for curative surgery. Most patients are treated with chemotherapy with a limited life expectancy. The role of local treatment such as radiation is not well defined. Other conventional ablative therapies, such as thermal or cryoablation have limited role due to the risk of collateral damage to the adjacent structures. Irreversible electroporation (IRE) is a novel non-thermal ablation technology that does not cause injury to nearby blood vessels, ducts, and bowel and has the potential to provide longer disease control and thereby better overall survival. We hypothesized that addition of IRE to combination chemotherapy in patients with locally advanced pancreatic cancer will improve their outcomes, and patients with undetectable 12-week post IRE circulating tumor cell DNA will have better prognoses. Methods: It is a prospective, multicenter, single-arm phase II study. The primary objective is to determine 12-month PFS rate of patients with locally advanced pancreatic cancer who are treated with combination chemotherapy and IRE. Secondary objectives include identification of prognostic and predictive biomarkers, 24-months survival rate, quality of life of subjects, as well as cost-effectiveness and complication rates of IRE. Based on the assumption that treatment with IRE and chemotherapy would result in doubling of PFS versus chemotherapy alone a sample of n = 27 of patients with locally advanced pancreatic adenocarcinoma is estimated. Eligible patients will be recruited at the two major cancer centers in Saskatchewan. All IRE-eligible patients will receive 12 weeks of induction combination chemotherapy and will undergo IRE if there is no disease progression. An additional 12 weeks of chemotherapy will be recommended. Patients who are not eligible for IRE will receive chemotherapy at the discretion of treating oncologist until disease progression or until they become eligible for IRE. Circulating tumor DNA and a panel of genes will be examined using next-generation sequencing for their correlation with prognosis. Quality of life will be assessed, and cost-effectiveness analysis of IRE will be performed.The results of this study will be used to develop a future multicenter, national phase III trial. Clinical trial information: NCT04276857.
Introduction: Venous access is a crucial element in systemic therapy delivery. PICCs are usually more easily and quickly inserted. It remains unclear whether cancer patients prefer a port to a PICC. Our study aimed to assess cancer patients’ satisfaction with their venous access device and to compare the QOL of subjects with a PICC to those with a port. Methods: In this prospective cohort study, EORTC QLQ-C30 and a locally developed QOL survey, designed to assess satisfaction with venous access devices, were administered to breast cancer (BC) or colorectal cancer patients up to four times over a 1-year period. Mixed effects models were used controlling for other covariates to assess changes on mean scores at different time points. Results: A total of 101 patients were recruited, 50 (BC, 29) in PICC and 51 (BC, 35) in port group. Survey response rates for months 1 and 3 were, 72% and 48%, respectively. Overall, no significant differences were noted between the two groups in relation to EORTC QOL constructs. Mixed effect model showed that patients with a PICC had significantly lower pain score estimate compared to patients with a port (β= -1.98, 95% CI: -0.92 - -3.05, p<0.001). Conversely, patients with a port had a psychosocial score estimate significantly higher than patients with a PICC (β= 2.18, 95% CI: 0.83 - 3.53, p=0.002). As survey time variable was not significant, there was no change in the mean pain or psychological scores for both devices at 3 months. Results for the QLC-30 survey did not reveal any statistically significant changes in mean scores for the different constructs between the surveys conducted at baseline and 3 months for the devices investigated. At 3 months 66.7% patients with a PICC vs. 33.3% with a port felt they had changed the way they dressed due to their device (OR=4.0, 95% CI:1.2-13.3, p=0.02). 88.2% patients with PICC vs.18.3% with port reported difficulties with showering, bathing or performing personal hygiene activities due to their device (OR=18.3, 95% CI: 3.5-97.1, p<0.0001). 41.7% patients with a PICC vs. 12.5% with a port experienced comments from people about their device (OR=5.0, 95% CI: 1.2-21.5, p=0.02). 45.8% patients with a PICC worried that their device may become infected vs. 8.3% with a port (OR= 9.3, 95% CI: 1.8-48.7, p=0.003). No significant differences were noted between the two group regarding sports, exercise, social activities, or the degree of discomfort in between treatments. The 3-month mean satisfaction score between two groups showed no difference (25.0 ±6.6 vs 25.2 ±5.9, p=0.87). Complications rates were 38% in PICC vs. 41% with a port (p>0.24). Overall, 8% patients with a PICC vs. 12% with a port developed DVT (p=NS). Conclusions: Although patients with a port experience more pain, it had a smaller negative impact on psychosocial scores than the PICC. No significant difference in device satisfaction or complications rates was observed between the two devices. Citation Format: Shahid Ahmed, Brent Burbridge, Lynn Dwernychuk, Ha Le, Tehmina Asif, Hyun Lim. Comparison of the quality of life (QOL) of patients with an arm vein port (TIVAD) versus a peripherally inserted central catheter (PICC) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-49.
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