Citations

Abstract Background: The Breast Cancer Surveillance Consortium (BCSC) model predicts invasive breast cancer risk in women with Benign Breast Disease (BBD), and recently incorporated BBD histology into the model. The BCSC has been validated in the Mayo Mammography Health Study, but has yet to be examined in Mayo Clinic’s BBD cohort. The Benign Breast Disease to Breast Cancer (BBD-BC) model predicts risk of both invasive and in situ breast cancer. Here we compare the performance of the BCSC and BBD-BC in Mayo Clinic’s BBD cohort. Methods: Eligible women underwent a breast biopsy with benign findings at the Mayo Clinic between years 1997-2001 and had a 4-view screening mammogram within six months of biopsy. Clinical BI-RADS density assessments using the 4th edition American College of Radiology were available on all mammograms, and were coded as almost entirely fat, scattered fibroglandular densities, heterogeneously dense, and extremely dense. Risk at 5 and 10 years of invasive cancer only (BCSC model) or both invasive and in situ cancer (BBD-BC model) were estimated. In situ cancers were censored at time of diagnosis for both models. Concordance statistics, i.e. model discrimination (higher is better), for each model were calculated using a Cox proportional hazards model with predicted risk as the sole predictor, and were compared using permutation tests. The ratio of total predicted (sum of predicted risk) to observed number of invasive breast cancers was used to assess model calibration. Calibration was not formally compared across models due to differences in how DCIS was treated in the development of each (BCSC censored; BBD-BC event). Results: 999 women met inclusion criteria. BI-RADS density was categorized as fatty in 46 (4.6%), scattered densities in 372 (37.2%), heterogeneously dense in 423 (42.3%), and extremely dense in 158 (15.8%). 62 invasive cancers occurred over a median 13.3yrs of follow-up, with 16 (25.8%) and 48 (77.4%) of the cancers occurring with-in 5 and 10 years. The concordance of the BCSC at 5 years was 0.550 (95% CI 0.409—0.691), compared to 0.719 (95% CI 0.578—0.860) for the BBD-BC (p-value=0.005). At 10 years the BCSC concordance was not significantly different from the BBD-BC, at 0.624 (95% CI 0.542—0.706) and 0.662 (95% CI 0.580—0.744), respectively (p-value=0.306). The BCSC over predicted the number invasive cancers in the BBD cohort at 5 years (predicted-to-observed=1.54; 95% CI 1.01—2.70), but was well calibrated at 10 years (1.06; 95% CI 0.83, 1.47). Conclusions: The BCSC model performed reasonably well in the BBD Cohort 10 years post-biopsy, but overestimated risk at 5 years. Additional study is needed to improve models for prediction of breast cancer risk among women with BBD. Citation Format: Ryan D. Frank, Celine M. Vachon, Stacey J. Winham, Robert A. Vierkant, Marlene H. Frost, Derek C. Radisky, Daniel W. Visscher, Amy C. Degnim. Validation of the BCSC model within the Mayo Benign Breast Disease Cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5299. doi:10.1158/1538-7445.AM2017-5299

Abstract BRAFV600E mutation occurs in ~10% of human colorectal cancers (CRC) where it is associated with treatment resistance and poor prognosis. Data from TCGA and a clinical trial cohort identified a distinct subset of BRAF mutant colon cancers with deregulation of the cell cycle and overexpression of CDK1 (Barras D, et al, Clin Cancer Res. 2016). We tested the hypothesis that CDK1 inhibition can enhance apoptosis in BRAFV600E CRC cells. Since BRAF mutant cells show p-ERK activation, combined inhibition of CDK1 and MEK/ERK was evaluated. Using isogenic colon cancer cells, BRAF mutant alleles were shown to confer resistance to the CDK1 inhibitor, R0-3306, in a gene dose-dependent manner that was associated with reduced cleavage of caspase-3 and downstream PARP, and decreased pH2AX (DNA fragmentation marker). Ectopic BRAFV600E or constitutively active MEK mutant also conferred resistance to R0-3306. CDK1 siRNA was shown to increase cobimetinib-induced apoptosis, including annexin V labeling, and increased pH2AX. Furthermore, ERK siRNA or cobimetinib treatment attenuated CDK1 protein expression and increased R0-3306-induced pH2Ax. Moreover, treatment with R0-3306 plus cobimetinib significantly enhanced a caspase-dependent apoptosis and markedly reduced colony formation vs either drug alone in two CRC cell lines. Caspase-3 cleavage by R0-3306 + cobimetinib was dependent upon caspase-8. Mechanistically, CDK1 inhibition by R0-3306 suppressed the phosphorylation of procaspase-8 at Ser-387 shown by R0-3306 withdrawal which restored p-C8-S387 coincident with expression of the mitotic marker, pH3S10. In conclusion, inhibition of CDK1 can significantly augment apoptosis induction by MEK/ERK inhibition in BRAFV600E CRC cells, suggesting a novel therapeutic strategy to overcome mutant BRAF-mediated resistance. Apoptosis induction by CDK1 inhibitor (R0-3306) ± MEK/ERK inhibitor cobimetinibTreatmentTreatmentTreatementTreatmentCRC cell linesDMSOR0-3306 (5 µM)cobimetinib (5 µM)combinationAnnexin V+ (%)RKO13.43 ± 1.4132.55 ± 2.9315.04 ± 0.2652.72 ± 3.16Annexin V+ (%)HT-2911.22 ± 1.8442.44 ± 2.7025.29 ± 0.1665.62 ± 4.11 Citation Format: Hisato Kawakami, Shengbing Huang, Frank A. Sinicrope. Targeting CDK1 and MEK/ERK overcome mutant BRAF-mediated apoptosis resistance in human colorectal cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2173. doi:10.1158/1538-7445.AM2017-2173

In pigs, the deep location of the common carotid artery and overlying sternomastoideus muscle in the neck has led to the recommendation for a surgical cutdown for common carotid access, as opposed to minimally invasive techniques for vascular access. We sought to determine if direct percutaneous common carotid artery access in piglets is attainable. Seventeen piglets were anesthetized and intubated. Under two-dimensional and color flow Doppler ultrasound guidance, a 21 gauge needle was utilized to access the right common carotid artery. Following arterial puncture, the Seldinger technique was applied to place a 4 or 5 French introducer. Upon completion of cardiac catheterization with intracoronary stem cell infusion the introducer was removed and manual pressure was applied to prevent hematoma development. Successful access with an introducer was achieved in all 17 piglets. The average weight was 8.5 ± 1.7 kg. One piglet developed a hematoma with hemorrhaging from the catheterization site and was euthanized. This piglet was given bivalirudin for the procedure. After this incident, subsequent piglets were not given anticoagulation and no other complications occurred. Ultrasound guided percutaneous common carotid artery access in piglets is attainable in a safe, reliable, and reproducible manner when performed by microvascular experts.

ObjectiveTo confirm prior findings that the larger the maximum monthly increase in solar insolation in springtime, the younger the age of onset of bipolar disorder.MethodData were collected from 5536 patients at 50 sites in 32 countries on six continents. Onset occurred at 456 locations in 57 countries. Variables included solar insolation, birth‐cohort, family history, polarity of first episode and country physician density.ResultsThere was a significant, inverse association between the maximum monthly increase in solar insolation at the onset location, and the age of onset. This effect was reduced in those without a family history of mood disorders and with a first episode of mania rather than depression. The maximum monthly increase occurred in springtime. The youngest birth‐cohort had the youngest age of onset. All prior relationships were confirmed using both the entire sample, and only the youngest birth‐cohort (all estimated coefficientsP< 0.001).ConclusionA large increase in springtime solar insolation may impact the onset of bipolar disorder, especially with a family history of mood disorders. Recent societal changes that affect light exposure (LEDlighting, mobile devices backlit withLEDs) may influence adaptability to a springtime circadian challenge.