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Breast cancer in young women has been shown to have an aggressive behavior and worse prognosis. Studies evaluating young women enrolled in clinical trials of neoadjuvant chemotherapy have shown that age is a determinant factor in the achievement of a pathological complete response (pCR). In this study, we sought to analyze the outcomes of young patients treated with neoadjuvant chemotherapy at a single institution. 1639 patients treated with neoadjuvant chemotherapy were included. 316 patients ≤40 years were compared with 1323 patients aged >40 years regarding the achievement of a pCR (defined as no invasive residual tumor in the breast or lymph nodes). Disease-free survival (DFS) and overall survival were compared between groups according to pCR status and subtype, defined by hormone receptor (HR) and HER2 status. Young women were more likely to have a pCR than their older counterparts (37.4 vs. 26.3 %, P < 0.001). This difference was significant both for HR+/HER2- and triple-negative (TN) tumors. Young age and achieving less than pCR were associated with a greater chance of recurrence for the entire population. Age was not an independent factor for recurrence in TN and HER2+ disease. However, being younger than 40 increased recurrence risk in HR+/HER2- tumors. The achievement of a pCR was not associated with improved DFS in young women with HR+/HER2- tumors. Although young women have a high rate of pCR, they also have a worse prognosis. In a real-world clinical setting, the achievement of a pCR was an independently significant protective factor for recurrence across all subtypes and ages, except for HR+, HER2- disease in young women.

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The invasive multicoloured Asian lady beetle, Harmonia axyridis (Pallas), and the indigenous twelve spotted lady beetle, Coleomegilla maculata DeGeer (Col., Coccinellidae), are two important generalist predators commonly found in apple orchards in Quebec, Canada. Both species are exposed to two reduced-risk insecticides, recently adopted to control codling moth, Cydia pomonella (L.) (Lep., Tortricidae) in south-eastern Canada. Chlorantraniliprole (Altacor â 35 WG), an anthranilic diamide insecticide, causes paralyses of the muscle cells by interfering with the insect ryanodine receptors, whereas novaluron (Rimon â EC 10), a benzoylphenyl urea, inhibits the chitin synthesis. The aim of this study was to compare the sensitivity of both the invasive ladybeetle H. axyridis and the indigenous C. maculata to reduced-risk insecticides through the assessment of lethal effect on eggs and larvae following topical contact, ingestion of treated prey and exposure to fresh residues, at field rates (50.75 g a.i./ha chlorantraniliprole and 100 g a.i./ha novaluron) in laboratory conditions. Eggs of both species were not affected. Following 6 days of residual contact, chlorantraniliprole and novaluron caused more than 98% mortality to larvae of both ladybeetle species. In topical contact and ingestion trials, chlorantraniliprole caused less than 18% mortality to larvae of the two species after 6 days following exposure. Novaluron had a drastically different impact on the two predators. It did not affect the indigenous C. maculata, whereas it killed 91% and 96% of H. axyridis individuals after 6 days, respectively, following topical contact and ingestion. These results illustrate a differential sensitivity to novaluron between two relatively close species (subfamily Coccinellinae), a potential impact on the invasion process by H. axyridis, and consequently on the ladybeetle assemblage in the field.

To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.

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The aim of this study was to determine the benefits of supplementation with eicosapentaenoic (EPA) and docosahexaenoic (DHA) polyunsaturated fatty acids (PUFA) in terms of chemotoxicity and inflammatory status, to Mexican women with locally advanced breast cancer (LABC), receiving a standard neoadjuvant chemotherapy (NeoCT AC-taxol regimen). We performed a randomized double-blind, placebo-controlled, clinical trial, in which we studied 44 LABC patients (stages IIA to IIIA) who took 2.4g/d (1.6 g EPA and 0.8 g DHA, ratio 2:1) (N=22) or placebo (N=22) during NeoCT with doxorubicin/ cyclophosphamide followed paclitaxel weekly. Edmonton Scale and Common Terminology Criteria for Adverse Events (CTCAE) v4. assessment were performed before each CT, and also blood total leukocytes, and percentage lymphocytes and monocytes by standard lab methods. Serum inflammatory proteins and adipokines, were quantified by multiplexed analysis using a luminometer (MAGPIX) at basal time (0) and after cessation (+6 months) of AC and paclitaxel regimen. RESULTS: There were no differences in age between the supplemented and the placebo groups (51.6y vs. 49.1y, p=0.4), neither in body mass index (BMI, 28.7 kg/m2 and 28.9 kg/m2, p=0.8). After 6 months of supplementation, patients who were supplemented with PUFAs had significant changes (time 0 vs 6, respectively) in total leukocytes (from 6.3 to 5.1 x103/mL, p =0.002) lymphocytes (from 33.5 to 25.2%, p =0.002), leptin (from 60.2 to 36.1 pg/mL, p=0.04) and adiponectin (from 36.8 to 43.3 mg/mL, p=0.05 ). On the other hand, placebo group had significant changes in the number of leukocytes (from 6.8 to 10.0 x103/mL, p =0.04), monocytes (from 6.7 to 10.1%, p=0.03) and an increase in leptin (from 22.7 to 46.3 pg/mL, p=0.04). CONCLUSIONS: Supplementation with 2.4g/d of EPA and DHA (ratio 2:1) during 6 months in Mexican LABC patients receiving NeoCT resulted in a less inflammatory status when compared to patients who received none. Our results clearly suggest that this type of supplementation may be beneficial to these type of patients. Currently, we are analyzing if treatment with omega-3 PUFAs are associated with lower incidence of side effects due to chemotherapy. Citation Format: DelaRosa-Oliva F, Ruiz-Garcia E, Gomez E, Arce-Salinas C, Lara-Medina F, Alvarado-Miranda A, Matus-Santos J, Flores-Díaz D, Deneken-Hernandez Z, Bargalló- Rocha J, Cabrera P, Guadarrama-Orozco J, Ruiz-Calzada H, Meneses-García A, Astudillo-de la Vega H. Effect of supplementation with eicosapentaenoic and docosahexaenoic omega-3 polyunsaturated fatty acid on the chemotoxicity in Mexican patients with locally advanced breast cancer (LABC) treated with neoadjuvant chemotherapy (NeoCT) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-11-10.

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