Detecting Microsatellite Instability in Endometrial, Colon, and Stomach Cancers Using Targeted NGS.

PURPOSE: To develop a method for testing the MSI based on targeted NGS. METHODS: Based on the results of previous studies, 81 microsatellite loci with high variability in MSI-H tumors were selected, and a method for calculating the MSI score was developed. Using the MSI score, we defined the MSI status in endometral (162), colon (153), and stomach (190) cancers. Accuracy of the MSI scores was evaluated by comparison with MMR immunohistochemistry for 137 endometrium (63 dMMR and 74 pMMR), 76 colon (29 dMMR and 47 pMMR), and 81 stomach (8 dMMR and 73 pMMR) cancers. RESULTS: Classification of MSS and MSI-H tumors was performed with AUC (0.99), sensitivity (92%), and specificity (98%) for all tumors without division into types. The accuracy of MSI testing in endometrial cancer was lower than for stomach and colon cancer (0.98, 87%, and 100%, respectively). The use of 27 loci only, the most informative for endometrial cancer, increased the overall accuracy (1.00, 99%, and 99%). Comparison of MSI score values in 505 tumors showed that MSI score is significantly higher in colon (p < 10-5) and stomach (p = 0.008) cancer compared with endometrial cancer. CONCLUSION: The MSI score accurately determines MSI status for endometrial, colon, and stomach cancers and can be used to quantify the degree of MSI.

Rapid selection of BRCA1-proficient tumor cells during neoadjuvant therapy for ovarian cancer in BRCA1 mutation carriers.

Ovarian carcinomas (OC) often demonstrate rapid tumor shrinkage upon neoadjuvant chemotherapy (NACT). However, complete pathologic responses are very rare and the mechanisms underlying the emergence of residual tumor disease remain elusive. We hypothesized that the change of somatic BRCA1 status may contribute to this process. The loss-of-heterozygosity (LOH) at the BRCA1 locus was determined for 23 paired tumor samples obtained from BRCA1 germ-line mutation carriers before and after NACT. We observed a somatic loss of the wild-type BRCA1 allele in 74% (17/23) of OCs before NACT. However, a retention of the wild-type BRCA1 copy resulting in a reversion of LOH status was detected in 65% (11/17) of those patients after NACT. Furthermore, we tested 3 of these reversion samples for LOH at intragenic BRCA1 single nucleotide polymorphisms (SNPs) and confirmed a complete restoration of the SNP heterozygosity in all instances. The neoadjuvant chemotherapy for BRCA1-associated OC is accompanied by a rapid expansion of pre-existing BRCA1-proficient tumor clones suggesting that continuation of the same therapy after NACT and surgery may not be justified even in patients initially experiencing a rapid tumor regression.

Features of omental adipose tissue in endometrial cancer patients with 'standard' or 'metabolically healthy' obesity: associations with tumor process characteristics.

PURPOSE: Adipose tissue products may contribute to endometrial cancer (EC) initiation and further growth that encourages the analysis of this issue in patients with different obesity phenotypes. METHODS/PATIENTS: Omental fat depot characteristics were studied in EC patients (n = 57) with "standard" (SO) or "metabolically healthy" (MHO) obesity. Collected omental samples were evaluated by immunohistochemistry /IHC/ for brown fat marker UCP1, CYP19 (aromatase) and macrophage infiltration markers (CD68, CD163, crown-like structures/CLS) expression. Total RNA extracted from the same samples was investigated for UCP1, CYP19, PTEN and adipokine omentin mRNA. RESULTS: Immunohistochemistry data revealed a statistically significant increase in aromatase and CD68 expression and tendency to increase of UCP1 expression in SO patients' omental fat compared to samples obtained from MHO patients. Additionally, positive correlation of EC clinical stage with UCP1 protein and its mRNA content in omental fat was pronounced in MHO as well as SO group, while with omentin mRNA it was discovered only in patients with SO. An inclination to the correlation with better tumor differentiation was seen for UCP1 and CD68 protein expression in patients with MHO and with worse (high grade) differentiation-for CD68 expression in the group with SO. CONCLUSIONS: In aggregate, this suggests that obesity phenotype has significant impact on omental fat tissue characteristics which is related to the clinical course of EC and may have practical consequences.

BeHealthy Charities Aid Foundation Program, Russia: a Program Impact Pathways (PIP) analysis.

BACKGROUND: In 2007, the Charities Aid Foundation Branch in Russia, under the initiative of and with financial support from the Mondelez International Foundation and Mondelez International, launched the charitable BeHealthy Program. The program's main focus is the implementation of four interrelated activities: conducting lessons for schoolchildren on healthy nutrition, with an emphasis on breakfast; healthy cooking lessons with children; cultivating nutritional plants; and providing conditions to encourage children to engage in more physical activity. The program serves more than 13,000 children attending public schools in the Leningrad (Lomonosovskii District), Vladimir, and Novgorod regions. BeHealthy provides funding for schools and comprehensive educational materials to help schoolchildren develop habits of healthy nutrition and physical activity, as well as consulting and expert support for school staff and other key stakeholders. The program brings in experts on program implementation and training for teachers. Curriculum support also includes printed and Web-based healthy lifestyle educational materials on best practices and positive experience, as well as meetings and conferences with school representatives and local authorities. OBJECTIVE: One of the biggest challenges for program managers is to fully understand the complexities of the program, and why and how it is expected to induce changes in healthy lifestyle behaviors of the schoolchildren. For more comprehensive understanding, we performed a Program Impact Pathways (PIP) analysis to identify Critical Quality Control Points (CCPs) and a suite of core indicators of the program's impact on healthy lifestyles. The findings were presented at the Healthy Life-styles Program Evaluation Workshop held in Granada, Spain, 13-14 September 2013, under the auspices of the Mondelez International Foundation. METHODS: First, we developed an updated logic model based on how the program was executed. We then translated the logic model into a PIP diagram, where pathways that lead from one activity to the next were defined as the program processes. The PIP diagram is a road map to help ensure that the program inputs and activities lead to expected outcomes. Based on this road map, the program identifies and tracks its CCPs. RESULTS: Ensuring implementation of program activities and evaluating pre-post knowledge and behavior of participants were identified as CCPs. CONCLUSIONS: The PIP analysis was very useful for understanding realistic expectations for the potential of BeHealthy and its inputs. As a result, we now plan to evaluate the impact of the program and, on this basis, further improve the program's implementation and dissemination to other locations.