Medicine and Health Sciences Commons^™

Proceedings Of 2016 Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 42nd annual Aurora Scientific Day research symposium, held May 25, 2016, in Milwaukee, Wisconsin. Aurora Scientific Day provides a forum for original research conducted by faculty, fellows, residents, students and other allied health professionals affiliated with Aurora Health Care, a not-for-profit health system comprised of integrated hospitals and clinics across eastern Wisconsin and northeastern Illinois.

Identifying Disparities In Colorectal Cancer Screening Rates In Milwaukee-Based Academic And Nonacademic Clinics, Jasmine Wiley, Jonathan J. Blaza, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns, Shelby L. Pischke, Tracy L. Greiten

Journal of Patient-Centered Research and Reviews

Background: The Institute for Healthcare Improvement’s Triple Aim focuses on improving the patient’s experience of care, improving population health and reducing the per capita cost of health care. Health care systems and providers continuously seek to improve quality of care through understanding what percentage of their patients are achieving quality-of-care standards for various indicators, including immunizations, tobacco cessation, asthma and cancer screening. As health care moves toward reimbursing for value-based care, deepening our understanding of patient population characteristics within each of these conditions is vital to continuous quality improvement.

Purpose: To determine if there are race/ethnicity/age/preferred language (REAL) disparities in …

Determining The Incidence And Factors Of Cardiotoxicity In Breast Cancer Patients Treated With Anthracycline And/Or Trastuzumab-Containing Regimen At Aurora Health Care, Stephanie Ghojallu, Matthew Rappelt, Han-Yang Chen, Ruth Perez, Lydia Garlie, Geoffrey Riddell, Yingying Gu, Jun Zhang, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi

Journal of Patient-Centered Research and Reviews

Background: Anthracycline and trastuzumab are common breast cancer treatments. While improving survival, they elevate risk of congestive heart failure. The incidence of cardiotoxicity (CTx) with these therapies varies in the literature from 10% to 59%, higher than those reported in clinical trials (4%–10%) that excluded patients with preexisting cardiovascular comorbidities. Studies have failed to establish consensus on the risk factors for CTx associated with these therapies.

Purpose: We aim to determine the incidence and risk factors of CTx in breast cancer patients treated with anthracycline and/or trastuzumab at Aurora Health Care.

Methods: A retrospective review of patients with breast cancer …

Download Entire Bodine Journal Volume 1, Issue 1, 2008

Bodine Journal

No abstract provided.

Factors Associated With Severe Late Toxicity After Concurrent Chemoradiation For Locally Advanced Head And Neck Cancer: An Rtog Analysis, Mitchell Machtay, Md, Jennifer Moughan, Ms, Andrew Trotti, Md, Adam S. Garden, Md, Randal S. Weber, Md, Jay S. Cooper, Md, Arlene Forastiere, Md, K. Kian Ang, Md

Bodine Journal

Purpose

Concurrent chemoradiotherapy (CCRT) for squamous cell carcinoma of the head and neck (SCCHN) increases both local tumor control and toxicity. This study evaluates clinical factors that are associated with and might predict severe late toxicity after CCRT.

Methods

Patients were analyzed from a subset of three previously reported RTOG trials of concurrent chemoradiotherapy for locally advanced SCCHN (RTOG 91-11; 97-03; and 99-14). Severe late toxicity was defined in this secondary analysis as chronic Grade 3-4 pharyngeal/laryngeal toxicity (RTOG/EORTC late toxicity scoring system) and/or requirement for a feeding tube ≥2 years after registration and/or potential treatment-related death (e.g. pneumonia) within …

Increasing Tumor Volume Is Predictive Of Poor Overall And Progression-Free Survival: Secondary Analysis Of The Radiation Therapy Oncology Group 93-11 Phase I-Ii Radiation Dose-Escalation Study In Patients With Inoperable Non-Small-Cell Lung Cancer, Maria Werner-Wasik, R. Suzanne Swann, Phd, Jeffrey Bradley, Md, Mary Graham, Md, Bahman Emani, Md, James Purdy, Phd, William Sause, Md

Bodine Journal

Purpose

Patients with non–small-cell lung cancer (NSCLC) in the Radiation Therapy Oncology Group (RTOG) 93-11 trial received radiation doses of 70.9, 77.4, 83.8, or 90.3 Gy. The locoregional control and survival rates were similar among the various dose levels.We investigated the effect of the gross tumor volume (GTV) on the outcome.

Methods and Materials

The GTV was defined as the sum of the volumes of the primary tumor and involved lymph nodes. The tumor response, median survival time (MST), and progression-free survival (PFS) were analyzed separately for smaller (≤45 cm3) vs. larger (>45 cm3) tumors.

Results

The distribution of …

Inhibition Of P73 Function By Pifithrin-Α As Revealed By Studies In Zebrafish Embryos, William R Davidson, Qing Ren, Gabor Kari, Ori Kashi, Adam Dicker Md, Phd, Ulrich Rodeck

Bodine Journal

The p53 family of proteins contains two members that have been implicated in sensitization of cells and organisms to genotoxic stress, i.e., p53 itself and p73. In vitro, lack of either p53 or p73 can protect certain cell types in the adult organism against death upon exposure to DNA damaging agents. The present study was designed to assess the relative contribution of p53 to radiation resistance of an emerging vertebrate model organism, i.e., zebrafish embryos. Consistent with previous reports, suppressing p53 protein expression using antisense morpholino oligonucleotides (MOs) increased survival and reduced gross morphological alterations in zebrafish embryos exposed to …

Vegf Trap In Combination With Radiotherapy Improves Tumor Control In U87 Glioblastoma, Phyllis Wachsberger, Phd, Randy Burd, Phd, Chris Cardi, Ms, Mathew L. Thakur, Constantine Daskalakis, Jocelyn Holash, Phd, George D. Yancopoulos, Phd, Adam Dicker Md, Phd

Bodine Journal

Purpose

To determine the effect of vascular endothelial growth factor VEGF Trap (Regeneron Pharmaceuticals, Tarrytown, NY), a humanized soluble vascular endothelial growth factor (VEGF) receptor protein, and radiation (RT) on tumor growth in U87 glioblastoma xenografts in nude mice.

Methods and Materials

U87 cell suspensions were implanted subcutaneously into hind limbs of nude mice. VEGF Trap (2.5–25 mg/kg) was administered every 3 days for 3 weeks alone or in combination with a single dose of 10 Gy or fractionated RT (3 x 5 Gy). In addition, three scheduling protocols for VEGF Trap plus fractionated RT were examined.

Results

Improved tumor …

A Cone Beam Ct-Based Study For Clinical Target Definition Using Pelvic Anatomy During Post-Prostatectomy Radiotherapy, Timothy Showalter Md, A. Omer Nawaz, Ma, Ying Xiao, James Galvin Phd, Richard K. Valicenti, Md

Bodine Journal

Introduction:

Radiation therapy (RT) is delivered after radical prostatectomy (RP) either as salvage treatment for an elevated prostate-specific antigen (PSA) level1-6 or as adjuvant therapy for patients with highrisk pathologic features7-8. Recent prospective data demonstrated a disease-free survival benefit of adjuvant RT for pathologic T3N0 prostate cancer9-10. Despite literature supporting the delivery of post-RP RT to the prostatic fossa (PF), no clear target definition guidelines exist for intensity modulated radiation therapy (IMRT) or image-guided RT (IGRT)11.

Visualization of the PF is limited on standard CT images, with significant interobserver variability and uncertainty in CTV definition12. Efforts to incorporate complementary imaging …

Toxicity Of Radiotherapy In Patients With Collagen Vascular Disease, Alexander Lin, Md, Eyad Abu-Isa, Md, Kent A. Griffith, Mph, Ms, Edgar Ben-Josef, Md

Bodine Journal

Background

A diagnosis of collagen vascular disease (CVD) may predispose to radiotherapy (RT) toxicity. The objective of the current study was to identify factors that influence RT toxicity in the setting of CVD.

Methods

A total of 86 RT courses for 73 patients with CVD were delivered between 1985 and 2005. CVD subtypes include rheumatoid arthritis (RA; 33 patients), systemic lupus erythematosus (SLE; 13 patients), scleroderma (9 patients), dermatomyositis/polymyositis (5 patients), ankylosing spondylitis (4 patients), polymyalgia rheumatica/temporal arteritis (4 patients), Wegener granulomatosis (3 patients), and mixed connective tissue disorders (MCTD)/other (2 patients). Each patient with CVD was matched to 1 …

Table Of Contents: Bodine Journal Volume 1, Issue 1, Fall 2008

Bodine Journal

No abstract provided.

Download Entire Bodine Journal Volume 2, Issue 1, 2009

Bodine Journal

No abstract provided.

Flexible Needle-Tissue Interaction Modeling With Depth-Varying Mean Parameter: Preliminary Study, Kai Guo Yan, Tarun Podder, Yan Yu, Tien-I Liu, Christopher W.S. Cheng, Wan Sing Ng

Bodine Journal

Flexible needle steering has aroused a lot of research interest in recent years. It has the potential to correct targeting errors, which may be caused by needle bending, tissue deformation, or error in insertion angle. In addition, control and planning based on a steering model can guide the needle to some areas that are currently not amenable to needles because of obstacles, such as bone or sensitive tissues. Thus, there is a clear motivation for needle steering. In this paper, a spring–beam– damper model is proposed to describe the dynamics during the needle–tissue contact procedure. Considering tissue inhomogeneity, depth-varying mean …

Does Intraoperative Radiation Therapy Improve Local Tumor Control In Patients Undergoing Pancreaticoduodenectomy For Pancreatic Adenocarcinoma? A Propensity Score Analysis, Timothy Showalter Md, Atul Rao, Rani Anne Md, Francis E. Rosato, Ernest L Rosato, Jocelyn Andrel, Terry Hyslop, Xia Xu, Adam C. Berger

Bodine Journal

Background:

Locoregional recurrence (LRR) is an important factor after pancreaticoduodenectomy (PD) for pancreatic cancer. IORT administered to the resection bed may improve local tumor control.

Methods:

We performed a retrospective analysis of patients who underwent PD at Thomas Jefferson University Hospital (TJUH) between 1995 and 2005 to identify patients who underwent resection with and without intraoperative radiation therapy (IORT). Data collected included age, gender, complications, margin status, stage, survival, and recurrence. Unadjusted analyses of the IORT and non-IORT groups were performed using Fisher’s chi-square method for discrete variables and Wilcoxon Rank Sum test for continuous variables. To account for biases …

Combination Of Vandetanib, Radiotherapy, And Irinotecan In The Lovo Human Colorectal Cancer Xenograft Model, Phyllis Wachsberger, Phd, Randy Burd, Phd, Anderson Ryan, Phd, Constantine Daskalakis, Phd, Adam Dicker Md, Phd

Bodine Journal

Purpose:

The tumor growth kinetics of the human LoVo colorectal xenograft model was assessed in response to vandetanib, an orally available receptor tyrosine kinase inhibitor, radiotherapy (RT), or irinotecan (CPT-11), as single therapies and in combination.

Methods and Materials:

LoVo cells were injected subcutaneously into the right hind limb (5x106 cells in 100μL phosphate-buffered saline) of athymic NCR NUM mice and tumors were grown to a volume of 200–300mm3 before treatment. Vandetanib was administered at 50 mg/kg daily orally for 14 days starting on Day 1. RT was given as three fractions (3x3 Gy) on Days 1, 2, and 3. …

Nuclear Factor Κb Inhibitors Alleviate And The Proteasome Inhibitor Ps-341 Exacerbates Radiation Toxicity In Zebrafish Embryos, Borbala Daroczi, Gabor Kari, Qing Ren, Adam Dicker Md, Phd, Ulrich Rodeck

Bodine Journal

Inflammatory changes are a major component of the normal tissue response to ionizing radiation, and increased nuclear factor κB (NF-κB) activity is an important mediator of inflammatory responses. Here, we used zebrafish embryos to assess the capacity of two different classes of pharmacologic agents known to target NF-κB to modify radiation toxicity in the vertebrate organism. These were proteasome inhibitors, including lactacystin, MG132, and PS-341 (Bortezomib/VELCADE), and direct inhibitors of NF-κB activity, including ethyl pyruvate (EP) and the synthetic triterpenoid CDDO-TFEA (RTA401), among others. The proteasome inhibitors either did not significantly affect radiation sensitivity of zebrafish embryos (MG132, lactacystin) or …

Bodine Journal, Table Of Contents, Volume 2, Issue 1, Fall 2009

Bodine Journal

No abstract provided.

Numerical Investigation Of Novel Microwave Applicators Based On Zero-Order Mode Resonance For Hyperthermia Treatment Of Cancer, David Vrba, Jan Vrba, Dario B. Rodrigues, Paul R. Stauffer

Department of Radiation Oncology Faculty Papers

This paper characterizes three novel microwave applicators based on zero-order mode resonators for use in hyperthermia treatment of cancer. The radiation patterns are studied with numerical simulations in muscle tissue-equivalent model at 434 MHz. The relative performance of the applicators is compared in terms of reflection coefficient, current distribution, power deposition (SAR) pattern, effective field size in 2D and 3D tissue volumes, and penetration depth. One particular configuration generated the most uniform SAR pattern, with 25% SAR covering 84 % of the treatment volume extending to 1 cm depth under the aperture, while remaining above 58% coverage as deep as …

Celecoxib Inhibits Proliferation And Survival Of Chronic Myelogeous Leukemia (Cml) Cells Via Ampk-Dependent Regulation Of Β-Catenin And Mtorc1/2., Beatrice Riva, Marco De Dominici, Ilaria Gnemmi, Samanta A. Mariani, Alberto Minassi, Valentina Minieri, Paolo Salomoni, Pier Luigi Canonico, Armando A Genazzani, Bruno Calabretta, Fabrizio Condorelli

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

CML is effectively treated with tyrosine kinase inhibitors (TKIs). However, the efficacy of these drugs is confined to the chronic phase of the disease and development of resistance to TKIs remains a pressing issue. The anti-inflammatory COX2 inhibitor celecoxib has been utilized as anti-tumour drug due to its anti-proliferative activity. However, its effects in hematological malignancies, in particular CML, have not been investigated yet. Thus, we tested biological effects and mechanisms of action of celecoxib in Philadelphia-positive (Ph+) CML and ALL cells.We show here that celecoxib suppresses the growth of Ph+ cell lines by increasing G1-phase and apoptotic cells and …

Cd99 Triggering Induces Methuosis Of Ewing Sarcoma Cells Through Igf-1r/Ras/Rac1 Signaling., Maria Cristina Manara, Mario Terracciano, Caterina Mancarella, Marika Sciandra, Clara Guerzoni, Michela Pasello, Andrea Grilli, Nicoletta Zini, Piero Picci, Mario P. Colombo, Andrea Morrione, Katia Scotlandi

Department of Urology Faculty Papers

CD99 is a cell surface molecule that has emerged as a novel target for Ewing sarcoma (EWS), an aggressive pediatric bone cancer. This report provides the first evidence of methuosis in EWS, a non-apoptotic form of cell death induced by an antibody directed against the CD99 molecule. Upon mAb triggering, CD99 induces an IGF-1R/RAS/Rac1 complex, which is internalized into RAB5-positive endocytic vacuoles. This complex is then dissociated, with the IGF-1R recycling to the cell membrane while CD99 and RAS/Rac1 are sorted into immature LAMP-1-positive vacuoles, whose excessive accumulation provokes methuosis. This process, which is not detected in CD99-expressing normal mesenchymal …

Targeted And Controlled Anticancer Drug Delivery And Release With Magnetoelectric Nanoparticles, Alexandra Rodzinski

FIU Electronic Theses and Dissertations

A major challenge of cancer treatment is successful discrimination of cancer cells from healthy cells. Nanotechnology offers multiple venues for efficient cancer targeting. Magnetoelectric nanoparticles (MENs) are a novel, multifaceted, physics-based cancer treatment platform that enables high specificity cancer targeting and externally controlled loaded drug release. The unique magnetoelectric coupling of MENs allows them to convert externally applied magnetic fields into intrinsic electric signals, which allows MENs to both be drawn magnetically towards the cancer site and to electrically interface with cancer cells. Once internalized, the MEN payload release can be externally triggered with a magnetic field. MENs uniquely allow …

Exosome-Mediated Transfer Of Αvβ3 Integrin From Tumorigenic To Nontumorigenic Cells Promotes A Migratory Phenotype., Amrita Singh, Carmine Fedele, Huimin Lu, Marja T. Nevalainen, James H. Keen, Lucia R. Languino

Department of Cancer Biology Faculty Papers

The αvβ3 integrin is known to be highly upregulated during cancer progression and promotes a migratory and metastatic phenotype in many types of tumors. We hypothesized that the αvβ3 integrin is transferred through exosomes and, upon transfer, has the ability to support functional aberrations in recipient cells. Here, for the first time, it is demonstrated that αvβ3 is present in exosomes released from metastatic PC3 and CWR22Pc prostate cancer cells. Exosomal β3 is transferred as a protein from donor to nontumorigenic and tumorigenic cells as β3 protein or mRNA levels remain unaffected upon transcription or translation inhibition in recipient cells. …

Symptom Clusters., Andrea M. Barsevick

Department of Medical Oncology Faculty Papers

No abstract provided.

Processing Information After A Child's Cancer Diagnosis-How Parents Learn., Cheryl C. Rodgers, Kristin Stegenga, Janice S. Withycombe, Karen Sachse, Katherine Patterson Kelly

Manuscripts, Articles, Book Chapters and Other Papers

Parents of a child newly diagnosed with cancer must receive an extensive amount of information before their child's initial hospital discharge; however, little is known about best practices for providing this education. An interpretive descriptive study design was used to describe actual and preferred educational content, timing, and methods among parents of children newly diagnosed with cancer prior to their child's first hospital discharge. Twenty parents of children diagnosed with various malignancies participated in individual interviews 2 to 12 months after their child's diagnosis. Data were analyzed using constant comparative analysis. Education delivery occurred in a telling manner at diagnosis …

Association Between Prolonged Neutropenia And Reduced Relapse Risk In Pediatric Aml: A Report From The Children's Oncology Group., Lillian Sung, Richard Aplenc, Todd A. Alonzo, Robert B. Gerbing, Yi-Cheng Wang, Soheil Meshinchi, A S. Gamis

Manuscripts, Articles, Book Chapters and Other Papers

Objective was to describe the relationship between the number of sterile site infections and duration of neutropenia during the first four cycles of chemotherapy and the risk of recurrence and overall survival in children with newly diagnosed acute myeloid leukemia (AML). AAML0531 was a Children's Oncology Group randomized phase 3 clinical trial that included 1022 children with de novo AML. For this analysis, we focused on non-Down syndrome favorable and standard risk patients who completed at least 4 cycles of chemotherapy without recurrence or withdrawal during protocol therapy. Those receiving hematopoietic stem cell transplantation in first remission were excluded. Five …

Establishment Of Site Specific Multi Disciplinary Tumour Boards In Pakistan -Is It Really Necessary To Discuss All Cancer Cases In Multidisciplinary Tumour Board Meetings?, Ahmed Nadeem Abbasi

Department of Radiation Oncology

No abstract provided.

Shorter Remission Telomere Length Predicts Delayed Neutrophil Recovery After Acute Myeloid Leukemia Therapy: A Report From The Children's Oncology Group., Robert B. Gerbing, Todd A. Alonzo, Lillian Sung, Alan S. Gamis, Soheil Meshinchi, Sharon E. Plon, Alison A. Bertuch, Maria M. Gramatges

Manuscripts, Articles, Book Chapters and Other Papers

Purpose Suboptimal outcomes for children with acute myeloid leukemia (AML) necessitate maximally intensive therapy. Consequently, serious adverse events, such as prolonged periods of profound myelosuppression, contribute to AML treatment-related mortality. Telomeres, the repetitive DNA-protein structures at chromosome ends, influence cellular replicative capacity in that critically short telomeres can induce cell senescence or apoptosis. Our objective was to evaluate the impact of telomere length on duration of post-therapy neutropenia in a pediatric AML cohort. Patients and Methods Patients were diagnosed with de novo AML, enrolled in Children's Oncology Group study AAML0531, and included those with (n = 53) and without (n …

Oncolog, Volume 61, Number 11-12, November - December 2016, Brandon C. Strubberg, Sarah Bronson, Stephanie Deming, E Nielsen

OncoLog MD Anderson's Report to Physicians (All issues)

• Innovative Trial Investigates Molecular Drivers of Triple-Negative Breast Cancer: A new clinical trial focusing on molecular biomarkers of triple-negative breast cancer (TNBC) is attempting to advance targeted therapy against the deadly disease.
• Smac Mimetics Show Activity against Myelofibrosis: Not all cases of myelofibrosis respond well to ruxolitinib, the only drug approved for this disease. However, early studies indicate that a new class of drugs, Smac mimetics, can achieve a response in some patients with myelofibrosis.
• Urothelial Cancer Subtypes Predict Treatment Response: Subtypes of urothelial cancer identified through gene expression profiling predict which patients are most likely to respond to neoadjuvant …

Constitutively Activated Pi3k Accelerates Tumor Initiation And Modifies Histopathology Of Breast Cancer, M. R. Sheen, J. D. Marotti, M. J. Allegrezza, M. Rutkowski, J. R. Conejo-Garcia, S. Fiering

Dartmouth Scholarship

The gene encoding phosphatidylinositol 3-kinase catalytic subunit α-isoform (PIK3CA, p110α) is frequently activated by mutation in human cancers. Based on detection in some breast cancer precursors, PIK3CA mutations have been proposed to have a role in tumor initiation. To investigate this hypothesis, we generated a novel mouse model with a Cre-recombinase regulated allele of p110α (myristoylated-p110α, myr-p110α) along with p53fl/fl deletion and KrasG12D also regulated by Cre-recombinase. After instillation of adenovirus-expressing Cre-recombinase into mammary ducts, we found that myr-p110α accelerated breast tumor initiation in a copy number-dependent manner. Breast tumors induced by p53fl/fl;KrasG12D with no or one copy of myr-p110α …

Adaptive Styles And Coping Strategies Of Youth Diagnosed With Cancer: Relationship To Well-Being, Psychosocial And Educational Adjustment, And Parents’ Adaptive Styles, Renee Corbett

USF Tampa Graduate Theses and Dissertations

Although almost 16,000 children and adolescents are diagnosed with cancer each year, the incident rates have remained stable over recent years, and mortality has decreased consistently since 1975 (American Cancer Society, 2016). With increased survivorship, research and practice in pediatric oncology has focused more on the psychosocial well-being of patients during and after treatment. With research repeatedly indicating that patients and families appear to exhibit great resilience and adjustment, and low incidences of psychosocial difficulties (e.g., Kazak, 1994, Eiser et al. 2000), some researchers have examined adaptive style as a possible construct that may help explain the predominantly positive outcomes …