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Annals of Oncology<br />
between M2 macrophage density and patients outcome (P= 0.724) was found. In<br />
multivariate analysis M1/M2 was a positive independent predictor of survival (P=<br />
0.001; HR 0.420, CI95%: 0.22-0.78) whereas grading, histotype and TNM stage were<br />
not statistically significant.<br />
Conclusion: The M1 macrophage density and in particular M1/M2 ratio, as<br />
confirmed in multivariate analysis, is an independent factor that can predict patients<br />
survival time in gastric cancer after radical surgery. The role of macrophage<br />
phenotype in influencing <strong>the</strong> gastric cancer prognosis warrant fur<strong>the</strong>r investigation.<br />
Disclosure: All authors have declared no conflicts of interest.<br />
1682P ANTHRACYCLINE-INDUCED CARDIOTOXICITY IN MICE IS<br />
PREVENTED BY LATE INA INHIBITION WITH RANOLAZINE,<br />
WITH IMPROVEMENT IN HEART FUNCTION, FIBROSIS AND<br />
APOPTOSIS<br />
N. Maurea 1 , C. Coppola 1 , C. Quintavalle 2 ,D.Rea 3 , A. Barbieri 3 , G. Piscopo 4 ,<br />
R.V. Iaffaioli 4 , G. Condorelli 2 , C. Arra 3 , C.G. Tocchetti 1<br />
1 Cardiology, National Cancer Institute, Pascale Foundation, Naples, ITALY,<br />
2 Biology and Cellular and Molecular Pathology, Federico II University, Naples,<br />
ITALY, 3 Animal Experimental Research, National Cancer Institute, Pascale<br />
Foundation, Naples, ITALY, 4 Colorectal Oncology, National Cancer Institute,<br />
Pascale Foundation, Naples, ITALY<br />
Background: Doxorubicin (DOX) produces a well-known cardiomyopathy through<br />
multiple mechanisms, which include, among many, Ca2+ overload due to reduced<br />
SERCA2a activity and inappropriate opening of <strong>the</strong> RyR2, and impaired myocardial<br />
energetics. DOX generates Reactive Oxygen and Nitrogen Species (ROS and RNS),<br />
posing <strong>the</strong> heart at increased demand for oxygen, setting <strong>the</strong> stage for metabolic<br />
ischemia that also activates late INa, target of ranolazine (RAN). Here, we aim at<br />
assessing whe<strong>the</strong>r RAN, diminishing intracellular Ca2+ through inhibition of late<br />
I Na, and enhancing myocardial glucose utilization (and/or reverting impairment of<br />
glucose utilization caused by chemo<strong>the</strong>rapy) prevents DOX cardiotoxicity.<br />
Methods: We measured left ventricular (LV) function with fractional shortening (FS)<br />
by echocardiography in C57BL6 mice, 2-4 mo old, pretreated with RAN (370mg/kg/<br />
day, a dose comparable to <strong>the</strong> one used in humans) per os for 3 days. RAN was <strong>the</strong>n<br />
administered for additional 7 days, alone and toge<strong>the</strong>r with DOX (2.17mg/kg/day ip),<br />
according to our well established protocol. Hearts were <strong>the</strong>n excised, mRNA<br />
expression was analyzed by qRT- PCR, interstitial fibrosis with picrosirius red<br />
staining. By Western blotting, we measured <strong>the</strong> activation of <strong>the</strong> apoptotic pathway.<br />
Results: After 7 days with DOX, FS decreased to 50 ± 2%, p = .002 vs 60 ± 1%<br />
(sham). RAN alone did not change FS (59 ± 2%). Interestingly, in mice treated with<br />
RAN + DOX, <strong>the</strong> reduction in FS was milder: 57 ± 1%, p = 0.01 vs DOX alone.<br />
DOX-cardiotoxicity was accompanied by significant elevations in ANP (1000 folds),<br />
BNP (500 folds), CTGF (26 folds) and MMP2 (81 folds) mRNAs, while co-treatment<br />
with RAN significantly lowered <strong>the</strong>se same genes compared to DOX. The alterations<br />
in extracellular matrix remodeling were confirmed by an increase of interstitial<br />
collagen with DOX (3.66%), p = .004 vs 2.19% (sham), which was normal in hearts<br />
co-treated with RAN (2.02%, p = .0002 vs DOX). Finally, <strong>the</strong> levels of PARP and<br />
pro-Caspase 3 were significantly decreased in DOX (indicating activation of<br />
apoptosis) but not in RAN + DOX.<br />
Conclusions: In mice, RAN prevents DOX cardiotoxic effects. We plan to test RAN<br />
as a cardioprotective agent with o<strong>the</strong>r antineoplastic cardiotoxic drugs in mice, and<br />
to better characterize <strong>the</strong> cardioprotective mechanisms of RAN in <strong>the</strong>se settings.<br />
Disclosure: All authors have declared no conflicts of interest.<br />
1683P CATUMAXOMAB VERSUS CATUMAXOMAB PLUS<br />
PREDNISOLONE IN PATIENTS WITH MALIGNANT ASCITES<br />
DUE TO EPITHELIAL CANCER: RESULTS FROM THE<br />
CASIMAS STUDY<br />
J. Sehouli 1 , P. Wimberger 2 , I.B. Vergote 3 , P. Rosenberg 4 , A. Schneeweiss 5 ,<br />
C. Bokemeyer 6 , C. Salat 7 , G. Scambia 8 , D. Berton-Rigaud 9 , F. Lordick 10<br />
1 Department of Gynecology, Charite Medical University, Berlin, GERMANY,<br />
2 University of Duisburg-essen, AGO and Department of Gynecology and<br />
Obstetrics, Essen, GERMANY, 3 Obstetrics & Gynaecology, University Hospital<br />
Gasthuisberg, Leuven, BELGIUM, 4 Onkologiska Kliniken Universitetssjukhuset,<br />
University Hospital Linköping, Linköping, SWEDEN, 5 Heidelberg, National Center<br />
for Tumor Diseases, Heidelberg, GERMANY, 6 Head of The Department for<br />
Oncology, Haematology and Bone Marrow Transplantation, UKE II. Medizinische<br />
Klinik und PoliklinikMedizinische Klinik II., Hamburg-Eppendorf, GERMANY,<br />
7 Munich, Hematology Oncology Clinic, Munich, GERMANY, 8 Department of<br />
Gynecologic Oncology, Catholic University, Rome, ITALY, 9 Oncology, Centre<br />
René Gaducheau, Nantes, FRANCE, 10 Medizinische Klinik III, Staedtisches<br />
Klinikum Braunschweig, Braunschweig, GERMANY<br />
Purpose: This phase III b study compared catumaxomab with prednisolone (CP) to<br />
catumaxomab without prednisolone (C) as 3-hour intraperitoneal (i.p.) infusion in<br />
patients with malignant ascites from epi<strong>the</strong>lial cancers.<br />
Patients and methods: We randomised 219 patients to receive catumaxomab plus<br />
25 mg prednisolone as premedication (111 pts) or catumaxomab alone (108 pts).<br />
Primary endpoint of <strong>the</strong> study was <strong>the</strong> composite safety score (CSS) summarizing <strong>the</strong><br />
worst CTCAE grades for <strong>the</strong> main TEAEs (pyrexia, nausea, vomiting, and abdominal<br />
pain). A potential impact of prednisolone on efficacy was assessed by <strong>the</strong> co-primary<br />
endpoint puncture-free survival (PuFS). Fur<strong>the</strong>r parameters included overall survival<br />
(OS) and time to next <strong>the</strong>rapeutic puncture (TTPu).<br />
Results: The primary objective, to demonstrate superiority for safety of <strong>the</strong> CP arm<br />
was not met as <strong>the</strong> mean CSS was comparable for <strong>the</strong> two groups (CP: 4.1; C: 3.8<br />
for; p= 0.383). The median PuFS was slightly lower in CP (30 days) compared to C<br />
(37 days). However <strong>the</strong> hazard ratio (HR) for PuFS (HR: 1.130, p = 0.402) as well as<br />
<strong>the</strong> 75% quartiles (CP: 155 days, C: 92 days) were in favour of CP compared to<br />
C. The median TTPu was similar in both groups (CP: 78 days; C: 102 days, p=<br />
0.599). The majority of patients (123 pts) had no <strong>the</strong>rapeutic paracentesis prior to<br />
death (CP: 54.8%; C; 61.7%, p = 0.297). Median OS was longer for CP (CP: 124 days;<br />
C: 86 days, p= 0.186), but lacking statistical significance.<br />
Conclusions: The administration of 25mg prednisolone as premedication prior to<br />
catumaxomab infusion did not change <strong>the</strong> safety profile and did not negatively impact<br />
<strong>the</strong> efficacy of catumaxomab. The efficacy results of <strong>the</strong> CASIMAS study are in<br />
concordance with <strong>the</strong> data of <strong>the</strong> pivotal study and thus confirm <strong>the</strong> robustness of <strong>the</strong><br />
treatment effect of catumaxomab in malignant ascites. The composite safety score after<br />
3-hour infusion time was comparable to that seen in <strong>the</strong> pivotal study using 6 hours.<br />
Disclosure: J. Sehouli: consultant for Fresenius Biotech GmbH. P. Wimberger:<br />
consultant for Fresenius Biotech GmbH. I.B. Vergote: consultant for Fresenius<br />
Biotech GmbH. P. Rosenberg: financial support for clinical studies from Fresenius<br />
Biotech GmbH. A. Schneeweiss: financial support for clinical studies from Fresenius<br />
Biotech GmbH. C. Bokemeyer: consultant for Fresenius Biotech GmbH. C. Salat:<br />
financial support for clinical studies from Fresenius Biotech GmbH. G. Scambia:<br />
financial support for clinical studies from Fresenius Biotech GmbH.<br />
D. Berton-Rigaud: financial support for clinical studies from Fresenius Biotech<br />
GmbH. F. Lordick: consultant for Fresenius Biotech GmbH<br />
1684P CHARACTERISATION OF A NOVEL ROLE OF MST2 IN<br />
CANCER CELL MIGRATION IN THE CONTEXT OF HEAD AND<br />
NECK CANCER<br />
C. Escriu, F. Watt<br />
Medical Oncology, Li Ka Shing Centre, Cancer Research UK, Cambridge<br />
Research Institute Addenbrooke’s Hospital, Cambridge, UNITED KINGDOM<br />
MST2 has so far been considered a tumour suppressor, however, its expression<br />
correlates with poor prognosis in several cancer types. We aimed to understand <strong>the</strong><br />
unknown mechanism by which <strong>the</strong>se tumours appear more aggressive in <strong>the</strong> context of<br />
head and neck cancers, where MST2 is highly expressed. We tested <strong>the</strong> role of MST2 in<br />
cell migration in automated boyden chambers and scratch wound assays in several early<br />
passage oral squamous cell cancer cell lines. Interestingly, cancer cell migration was<br />
significantly reduced in knock down cells using short hairpin and short interfering RNA<br />
knock down systems. Fur<strong>the</strong>rmore, overexpression of wild type MST2 promoted cell<br />
migration, whereas overexpression of kinase dead MST2 had a dominant negative effect.<br />
In 3D confocal microscopy quantification of inverted matrigel invasion assays MST2<br />
knock down also showed reduced invasion. Trying to characterise this effect fur<strong>the</strong>r we<br />
quantified cell attachment using confocal microscopy and image analysis in different<br />
laminin substrate concentrations. MST2 knock down cells showed a reduced cell<br />
number attachement and impaired cell spreading ability. Fur<strong>the</strong>r image analysis of<br />
migrating cells revealed, in keeping with <strong>the</strong> attachment defect, that MST2 knock down<br />
cells had larger focal adhesions with lower proportional surface of paxillin<br />
phosphorylation than control cells. MST2 knock down cells also required a longer time<br />
for actin cytoskeleton recovery after cytochalasin D treatment, suggesting a role in actin<br />
polymerisation that could explain <strong>the</strong> cell-spreading defect. Fur<strong>the</strong>rmore, using<br />
automated boyden chamber assays, Akt inhibition reduced cell migration over time in a<br />
directly proportional manner to cell MST2 expression levels. We are currently testing<br />
<strong>the</strong> effect of MST2 modulation in time to metastasis and survival using a tongue<br />
injection xenograft model. We describe here a novel role for MST2 in cell migration,<br />
explained by focal adhesion architecture and activity change, and by modulating actin<br />
polymerisation. Akt inhibirors can reverse this migration effect, which may lead to<br />
MST2 potentially becoming a predictor marker of response to biological <strong>the</strong>rapies in<br />
head and neck cancers.<br />
Disclosure: All authors have declared no conflicts of interest.<br />
1685P PROSTATE CANCER STEM CELLS DISPLAY LOWERED<br />
ACTIVITY OF THE MTOR PATHWAY AND RESISTANCE<br />
AGAINST MTOR INHIBITION CAUSED BY ELEVATED<br />
HYPOXIC SIGNALING<br />
M. Marhold 1 , E. Tomasich 1 , A. Haschemi 2 , G. Hofbauer 3 , A. Spittler 3 ,<br />
M. Krainer 1 , P. Horak 1<br />
1 Department of Internal Medicine I, Medical University of Vienna, Vienna,<br />
AUSTRIA, 2 Department of Laboratory Medicine, Medical University of Vienna,<br />
Vienna, AUSTRIA, 3 ASCTR Core Facility Flow Cytometry, Medical University of<br />
Vienna, Vienna, AUSTRIA<br />
Tumor-initiating subpopulations of cancer cells, also known as cancer stem cells<br />
(CSCs), were recently identified and characterized in Prostate cancer (PCa). We<br />
Volume 23 | Supplement 9 | September <strong>2012</strong> doi:10.1093/annonc/mds417 | ix539