Osteogenesis imperfecta (OI) is a heterogeneous group of genetic disorders that affect connective tissue integrity. The hallmark of OI is bone fragility, although other manifestations, which include osteoporosis, dentigenesis imperfecta, blue sclera, easy bruising, joint laxity and scoliosis, are also common among OI patients. The severity of OI ranges from prenatal death to mild osteopenia without limb deformity. Most forms of OI result from mutations in the genes that encode either the proa1or proa2 polypeptide chains that comprise type I collagen molecules, the major structural protein of bone. Treatment depends mainly on the severity of the disease with the primary goal to minimize fractures and maximize function. Current treatments include surgical intervention with intramedullarly stabilization and the use of prostheses. Pharmacological agents have also been attempted with limited success with the exception of recent use of bisphosphonates, which have been to shown to have some effect. Since OI is a genetic disease, these agents are not expected to alter the course of the collagen mutations. Cell and gene therapies as potential treatments for OI are therefore currently being actively investigated. The design of gene therapies for OI is however complicated by the genetic heterogeneity of the disease and by the factor that most of the OI mutations are dominant negative where the mutant allele product interferes with the function of the normal allele. The present review will discuss the molecular changes seen in OI, the current treatment options and the gene therapy approaches being investigated as potential future treatments for OI.

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BACKGROUND: Ovarian cancer (OC) is the deadliest gynecologic cancer. Despite randomized clinical trials showing improved survival for patients receiving intraperitoneal chemotherapy (IP), IP has not received a wide use outside of specialty hospitals. The aim of this study was to explore the impact of IP on OC patient survival and to evaluate whether treatment facility type impacted the outcomes. METHODS: Detailed demographic and clinical information on OC patients (N=2924) who underwent treatment in UPMC facilities between 2000-2016 was obtained from the UPMC Cancer Registry. Duplicate records, rare, grade 1, and non-epithelial tumors were excluded. Kaplan-Meier plots were constructed to compare 10-year survival rates based on the chemotherapy type (IP vs. no-IP), cancer grade, cancer stage, surgery type, neoadjuvant and treatment facility (specialized vs. community). Multivariable Gray's models and logistic regression model were fitted to evaluate the effect of different factors on survival and tumor recurrence respectively. Two tailed P-values <0.05 were considered significant. R software package was used to analyze the data. RESULTS: The final sample consisted from 1840 patients (250 IP and 1590 no-IP). IP chemotherapy was used only in 14% of OC patients and was associated with improved long-term survival. Similarly, cases reported by specialty treatment facilities (Magee and Passavant) had better survival compared to other hospitals. Multivariable Gray's model showed that IP and younger age were significantly associated with lower hazard of death, whereas higher cancer stage is significantly associated with higher hazard of death. Multivariable logistic regression showed that IP is not significantly associated with recurrence after adjusting for median income in the zip code of patient residence and cancer stage. CONCLUSIONS: These findings demonstrate enhanced long-term survival of patients treated with IP therapy at specialty centers. Increasing IP therapy use in clinical practice for OC patient treatment may be important strategy to improve OC outcomes. Citation Format: Adambekov S, Wang S, Taylor S, Buckanovich R, Coffman L, Edwards RP, Linkov F. INTRAPERITONEAL CHEMOTHERAPY USE AND OUTCOMES: EXPLORATION OF UPMC OVARIAN CANCER REGISTRY DATA [abstract]. In: Proceedings of the 12th Biennial Ovarian Cancer Research Symposium; Sep 13-15, 2018; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2019;25(22 Suppl):Abstract nr DP-010.