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4622 Background: The impact on survival of palliative second-line therapy in pancreatic cancer has not been clarified and clinical/molecular predictive factors are needed in order to decide which therapeutic regimens may be effective. Methods: Clinical records of 160 Gemcitabine resistant/refractory pancreatic cancer patients (pts) treated in 11 medical oncology departments in Italy and Switzerland were reviewed. All pts received a second line regimen from June 1997 to February 2006. There were 99 males, 61 females, median age 62 years (range 34–78) and median ECOG performance status (PS): 1 (range 0–2). 16 different salvage regimens were administered consisting of monotherapy with fluoropyrimidines in 59% of cases and combinations of platinum- salts/fluoropyrimidines in 36%. Fluoropyrimidines combinations with bevacizumab, irinotecan and mitomycin C were administered in the remaining 5%. ERCC-1 expression was examined by performing immunohistochemical staining in pts treated with platinum-salts. Results: Second line chemotherapy produced partial responses (PR) in 16 (10%) and stable disease (SD) in 40 pts (25%) by RECIST criteria. The median progression free survival (PFS) was 2.65 months. Multivariate analysis revealed that the most important prognostic factor for PFS was PS at the beginning of second line therapy (Second line PFS PS=0–1 vs PS=2: 78 days vs 48 days, p<0.05, log-rank test). Pts who had responded (PR) to first-line Gemcitabine were more likely to respond or attain stable disease after second-line treatment, with a PFS of 2.6 vs 1.6 months (p<0.05, log-rank test). The overall survival (OS) for all evaluable pts was 11.5 months and 1-year survival was 45%. Among 57 pts treated with platinum-containing doublets, a low ERCC1 level (28/57 pts) was highly predictive of longer survival (11.9 versus 9.9 months, p<0.05 log-rank test). Conclusions: These results suggest that fluoropyrimidine-based salvage regimens have marginal activity and should be considered only in pts with a good PS who have responded to first line chemotherapy. ERCC-1 expression should be further evaluated as a predictive test to select patients who may benefit from platinum/fluoropyrimidine salvage regimens. No significant financial relationships to disclose.

The interaction between platelets and endothelium in vivo is a complex phenomenon. Our aim was to develop an in vitro system that mimics the in vivo environment and investigate platelet function in a common pathological condition. Human umbilical vein endothelial cells were used and platelets from 28 type 2 diabetes patients were studied under shear stress conditions. Mean coefficient of variation of platelet aggregation was 10% in dynamic conditions in the presence of endothelium. Endothelial cells increased the concentration of inductor needed to achieve 50% platelet aggregation to adenosine diphosphate from 2.6 ± 1.3 in static conditions to 3.7 ± 1.3 µM in dynamic conditions. A similar pattern was observed when collagen was used for platelet activation. Incubation of endothelium with a nitric oxide inhibitor abolished this effect, indicating platelet inhibitory effect of endothelial cells is nitric oxide mediated. Platelet reactivity of healthy controls was less influenced by the presence of endothelial cells and displayed reduced basal platelet reactivity compared with platelets from diabetes patients. We show that platelet aggregation in diabetes as commonly reported in vitro may not fully reflect the in vivo pathophysiological process. Future studies are warranted to investigate other pathological conditions and analyse the effects of antiplatelet agents using this system.

The objective of this work is the elaboration of a methodology to develop STEAM projects (Science (S), Technology (T), Engineering (E), Art (A) and Mathematics (M)). The methodology proposed in this article is part of the results of the project ERASMUS+DART4City (2020-1-ES01-KA227-SCH-095545) “Empowering Arts and creativity for the cities of tomorrow”, whose objective is to design a methodology in order to develop STEAM projects from European curricula. The proposed methodology emerges after analysing, among others, the curricula from Spain, Italy, Cyprus, France, Finland and Germany, taking into account the international perspective of STEAM education, their priorities and problems. The proposal has two variants: “forward” and “backward”. Both variants begin with the analysis of the curriculum in which the contents are grouped by similarity, classified according to STEAM disciplines so that the thematic areas can be obtained. Subsequently, in the “forward” variant, the thematic areas with most connections are selected as areas of opportunity; for the development of the STEAM project, so from the “forward” methodology, the teacher will be able to select an area of opportunity and develop the project around it, so, the concept or project idea comes from an area of oportunity. The “backward” variant starts from a concept considered interesting for society or just for the teacher and which will become the main theme of the STEAM project and, from that concept, we will select the thematic areas of the curriculum that can be included in the project. The main difference bewteen both methodologies is that in the “forward” variant, the STEAM project concept comes from an area of oportunity detected in the curriculum meanwhile in the “backward” variant the concept of the STEAM project comes from the teacher, without taking into acount, initially, the curriculum. This article shows an example of application of each variant. From the “forward” variant, the STEAM project “Sustainable City” is shown for years 4, 5 and 6 of Primary Education, which has been carried out from the opportunity area “Sustainability”. From the “backward” variant, we develop the STEAM project, whose main theme is cooking, in which, based on this theme, 10 tests are developed, each of them related to different thematic areas of the Spanish curriculum.