9043 Background: One of the most burdensome complications of advanced cancer is the development of malignant ascites, impacting quality of life (QoL), gastrointestinal function, survival, and overall management costs. Recent studies have shown that malignant effusions arise in part from increased production and activity of vascular endothelial growth factors (VEGFs). VEGFs increase vascular permeability and establish an ideal environment for accumulation of malignant effusions. Methods: A pilot trial evaluating safety and efficacy of intraperitoneal administration of bevacizumab at 5 mg/kg monthly for as long as no disease progression or unacceptable toxicities are encountered. Patients with cytologically documented malignant ascites from any primary tumor refractory to standard therapy of diuretics, repeated paracentesis, and/or intraperitoneal chemotherapy were eligible. Patients were either off systemic therapy or had not had any changes in their systemic therapy for at least 4 weeks at the time of enrollment. Results: Between July 2006 and November 2006, 9 patients with refractory malignant ascites from colon cancer (3 pts), breast cancer (3 pts), uterine cancer (2 pts) and ovarian cancer (1 pt). Prior therapy included systemic chemotherapy and large volume paracentesis. Patients with ovarian and uterine cancer also received intraperitoneal cisplatin. All patients had rapid re-accumulation within 2 weeks of paracentesis before treatment. Patients were given intraperitoneal bevacizumab at 5 mg/kg monthly. Complications included grade I nausea in one patient, grade I abdominal pain in one patient, and partial small bowel obstruction in one patient that was managed conservatively. Malignant ascites resolved without reaccumulation or repeat paracentresis in 9/9 after a single intraperitoneal dose of bevacizumab over a median observation period of over two months. No objective tumor responses were observed. QoL assessment, pharmacokinetic studies of intraperitoneal Bevacizumab and pharmacodynamic studies on serum and ascites fluid VEGF are ongoing and will be reported. Conclusions: Intraperitoneal bevacizumab is a relatively safe and highly efficacious way to palliate the symptoms of refractory malignant ascites. No significant financial relationships to disclose.

Objective. The objective of this study was to explore the effectiveness of date palm pollen (DPP) in the prevention and treatment of oral mucositis induced by radiation and chemotherapy. Methods. Twenty subjects with varying head and neck cancers were enrolled. Ten subjects were treated with DPP administered orally (2 g daily for 42 days) as a swish and swallow suspension, and 10 control subjects received the facility standard of care. Objective oral assessments using the Oral Mucositis Assessment Scale (OMAS) were conducted at baseline and while the subjects were on treatment. Study subjects also evaluated the treatment impact by visual analog scales for severity of mouth pain and ability to swallow. Results. The results obtained demonstrate a statistically significant difference between the mean OMAS score in the DPP treatment group and the control group. Symptoms such as impairment of solid food intake observed with the control group were not observed in the DPP-treated group following the treatment. Reduction of mucositis severity of pain and ability to swallow were statistically significant in the DPP-treated group. Conclusion. DPP treatment reduced the incidence of mouth pain and oral ulcers that often require modifications to soft/liquid diet. The complex mixture of bioactive constituents contained in DPP may have protected the oral mucosa by blocking oxidative free radicals, preventing DNA damage, and neutralizing inflammatory reactions. Further randomized controlled studies are needed to validate DPP efficacy in the broader management of chemotherapy-and radiation-induced mucositis.

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Background: It is well established that mutations in the BRCA1 gene are a major risk factor for breast cancer. Induction of cancer cell death and inhibition of survival are the main principles of cancer therapy. In this context, autophagy may have dual roles in cancer, acting on the one hand as a tumor suppressor and on the other as a mechanism of cell survival that can promote the growth of established tumors. Therefore, understanding the role of autophagy in cancer treatment is critical. Moreover, defects in apoptosis, programmed cell death, may lead to increased resistance to chemotherapy. Purpose: The aim of the present study was to detect BRCA1 gene mutations in order to throw more light on their roles as risk factors for breast cancer in Egypt. Secondly the role of autophagy and apoptosis in determining response to a fluorouracil, doxorubicin, cyclophosphamide (FAC) regimen was investigated. Materials and Methods: Forty-five female breast cancer cases and thirty apparently healthy females were enrolled in the present study. Serum levels of autophagic biomarkers, Beclin 1 and LC3 as well as the serum levels of apoptosis biomarkers Bcl-2 and Caspase-3 were measured before and after chemotherapy. Results: BRCA1 mutations were found in 5 (16.7%) and 44 (99.8%) of the controls and cancer patients, the most frequent being 5382insC followed by C61G and 185 delAG. The results revealed that chemotherapy caused elevation in serum concentration levels of the autophagic biomarkers (Beclin 1 and LC3). This elevation was associated with a significant decrease in serum concentration levels of Bcl-2 and significant increase in caspase-3 concentration levels (apoptotic markers). Several factors may be responsible for the development of breast cancers, where they fall into modifiable and non-modifiable factors. Modifiable factors include; socioeconomic status, radiation exposure, modifiable hormonal factors such as hormone replacement therapy and lifestyle factors such as obesity and cigarette smoking. Non-modifiable risk factors include, age, reproductive factors, family history of breast disease and genetic predisposition (Lakshmi et al., 2013). However, genetic factors are thought to contribute to approximately 5% of all breast cancer cases, but to 25% of cases diagnosed before age 30 years. There are several breast cancer susceptibility genes that have been identified. These genes include in the first degree BRCA1 and BRCA2, and other tumor suppressor genes (TSGs) to a lesser extent, such as p53 (Tam 2010). Mutations of genes BRCA1 and BRCA2 involved in breast cancer susceptibility are Mohamed Ahmed Abdel-Mohsen et al

Background: Central neurocytoma (CN) is a rare tumor accounting for <0.5% of all intracranial tumors. Surgery ± radiotherapy is the mainstay treatment. This international multicentric study aims to evaluate the outcomes of CNs patients after multimodal therapies and identify predictive factors. Patients and methods: We retrospectively identified 33 patients with CN treated between 2005 and 2019. Treatment characteristics and outcomes were assessed. Results: All patients with CN underwent surgical resection. Radiotherapy was delivered in 19 patients. The median radiation dose was 54 Gy (range, 50–60 Gy). The median follow-up time was 56 months. The 5-year OS and 5-year PFS were 90% and 76%, respectively. Patients who received radiotherapy had a significantly longer PFS than patients without RT (p = 0.004) and a trend towards longer OS. In addition, complete response after treatments was associated with longer PFS (p = 0.07). Conclusions: Using RT seems to be associated with longer survival rates with an acceptable toxicity profile.