The use of primary patient-derived organoids for drug sensitivity and resistance testing could play an important role in precision cancer medicine. We developed expandable ovarian cancer organoids in < 3 weeks; these organoids captured the characteristics of histological cancer subtypes and replicated the mutational landscape of the primary tumours. Seven pairs of organoids (3 high-grade serous, 1 clear cell, 3 endometrioid) and original tumours shared 59.5% (36.1-73.1%) of the variants identified. Copy number variations were also similar among organoids and primary tumours. The organoid that harboured the BRCA1 pathogenic variant (p.L63*) showed a higher sensitivity to PARP inhibitor, olaparib, as well as to platinum drugs compared to the other organoids, whereas an organoid derived from clear cell ovarian cancer was resistant to conventional drugs for ovarian cancer, namely platinum drugs, paclitaxel, and olaparib. The overall success rate of primary organoid culture, including those of various histological subtypes, was 80% (28/35). Our data show that patient-derived organoids are suitable physiological ex vivo cancer models that can be used to screen effective personalised ovarian cancer drugs. Patient-derived tumour organoids have become important preclinical model systems in both cancer research and clinical settings 1. In contrast to patient-derived xenograft (PDX) mouse models that need a large amount of surgical specimen and 4-8 months for development 2 , organoids can be cultured from patient materials and can be expanded with high efficiency in a relatively short period (typically < 1 month). Organoids from mouse intestine, as well as from various other mouse and human tissues, including the colon, stomach, liver, lung, prostate, and pancreas, have been established 3,4. Patient-derived tumour organoids have also been generated from the colon, pancreas, prostate, breast, gastric, lung, oesophageal, bladder, ovarian, kidney, and liver tumour tissues 1. Organoids maintain the key genetic and phenotypic features of primary tumours, thereby, enabling their use in a broad range of applications, such drug development and identification of the best therapeutic regimen for each patient. Ovarian cancer is a devastating disease, with 295,000 new patients and 185,000 deaths each year, worldwide 5. The relative 5-year survival rate is 47% and has not apparently increased in the last 40 years. Debulking surgery with platinum-combination chemotherapy is usually administered to patients, irrespective of the histological

AimTo examine the usefulness of the neutrophil : lymphocyte (N/L) ratio as a cost‐effective and simple diagnostic marker of mature cystic teratoma (MCT) with malignant transformation (MT).MethodsA retrospective chart review was performed between 1998 and 2013 of 12 MCT patients with MT and between 2009 and 2013 of 130 patients with benign MCT. Data were collected on age, tumor size, white blood cell count with differential counts, tumor marker levels, and presenting features.ResultsOlder age, greater tumor size, higher CA19‐9 or CA125, higher neutrophil count, and higher N/L ratio were associated with MT on univariate analysis. White blood cell count; lymphocyte count; and the tumor marker squamous cell carcinoma antigen were not associated with MT. Older age (≥median), larger tumor size (≥10 cm), and high N/L ratio (≥5.0) were predictors of MT (hazard ratio, 11.51, 5.87, and 11.11, respectively). Six of 12 patients were diagnosed with MT on preoperative magnetic resonance imaging and five of 12 had an N/L ratio ≥5.0.ConclusionsNeutrophil : lymphocyte ratio is a potential preoperative diagnostic marker of MT. The optimal cut‐off should be determined in future large‐scale studies.

Background Family history is one of the risk factors for pancreatic cancer. It is suggested that patients with pancreatic cancer who have a familial history harbor germline pathogenic variants of BRCA1 and/or BRCA2 (BRCA1/2), PALB2, or ATM. Recently, some germline variants of familial pancreatic cancers (FPCs), including PALB2, have been detected. Several countries, including Japan, perform screening workups and genetic analysis for pancreatic cancers. We have been carrying out active surveillance for FPC through epidemiological surveys, imaging analyses, and genetic analysis. Case presentation Here, we present the case of a female patient harboring pathogenic variants of PALB2 and NBN, with a family history of multiple pancreatic cancer in her younger brother, her aunt, and her father. Moreover, her father harbored a PALB2 pathogenic variant and her daughter harbored the same NBN pathogenic variant. Given the PALB2 and NBN variants, we designed surveillance strategies for the pancreas, breast, and ovary. Conclusions Further studies are required to develop strategies for managing FPCs to facilitate prompt diagnosis before their progression.

There has been a rapid advance in germline multigene panel testing by next-generation sequencing, and it is being widely used in clinical settings. A 56-year-old woman suspected of having Lynch syndrome was identified as a BRCA2 pathogenic variant carrier by multigene panel testing. The patient was diagnosed with endometrial cancer at the age of 39 years, and total laparoscopic hysterectomy and bilateral salpingectomy were performed at the age of 49 years; however, bilateral oophorectomy was not performed at that time. As she had a family history of colorectal cancer and a history of endometrial cancer, Lynch syndrome was suspected. However, germline multigene panel testing revealed a pathogenic BRCA2 variant rather than pathogenic variants in mismatch repair genes. In this case, with conventional genetic risk assessment, we were unable to determine whether the patient had a high risk of hereditary breast and ovarian cancer; thus, germline multigene panel testing may provide valuable information to improve disease management strategies for patients in clinical settings. Particularly, germline multigene panel testing may be useful for detecting hereditary tumor syndromes if a patient does not present with a typical family history of cancer.

This study showed that ddTC therapy was considerably effective and tolerable as NAC. The complete surgery rate was high with IDS, and perioperative complications were acceptable.

No abstract

No abstract

Endometrial cancer is one of the most common types of gynecologic cancer. The major prognostic factors of endometrial carcinoma include FIGO (International Federation of Gynecology & Obstetrics) staging, myometrial invasion, and histologic type and grade. 1Although total hysterectomy and bilateral salpingo-oophorectomy are the reference standard procedures for surgical staging, lymphadenectomy is required when the case is considered as high-risk for post-surgical recurrence.