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Day 2 : May 7, 2019

Keynote Forum

Kunal Sharma

SRL Diagnostics, India

Keynote: Advances in diagnostics in lung cancer

Time : 10:00-10:40

Conference Series Global Cancer 2019 International Conference Keynote Speaker Kunal Sharma photo

Biography:

Kunal Sharma is currently working as a Consultant Oncopathologist, Molecular Pathologist & Section Head with SRL Diagnostics, India. He was in past working as Consultant Oncopathologist & Head of Quality Assurance at CORE Diagnostics Pvt. Ltd. He has been a guest faculty & presenter at numerous international and national conferences like Lymphoma & Myeloma Congress- New York, CAP-Chicago, The International Society of Paediatric Oncology (SIOP), Nigerian Medical Association, Dhaka Medical College & Bangladesh association of Hematologists, Indian Cancer Congress, ISMPOCON, YROC, ONCOCON etc. He was the faculty & mentor of the largest National hands on IHC workshop (D-I-Y) at JNMC, Belgavi. He has numerous international publications including first reported case of Cellular Ovarian Fibroma in India. He completed his MBBS with aggregate of 73% and received his Post-graduate training (DNB) in Oncopathology from HCG Cancer Hospital, Bangalore

Abstract:

Lung cancer remains the leading cause of cancer related deaths in most countries. Most (but not all) lung cancers are associated with tobacco smoking. Up until recent times, the diagnosis was in most cases based on histology and use of immunohistochemistry to classify lung epithelial tumors into small cell vs non- small cell (squamous and adeno) carcinomas. With the advent of better understanding of the biology of lung cancer, especially underlying oncogenic driver mutations, the hunt to develop targets to these mutations has increased manifold. This has led to the discovery of actionable mutations like EGFR, ALK and ROS-1. Current guidelines include testing for these driver mutations, aided primarily by clinical presentation and the histological subtype of tumor. There has also been a prominent focus on liquid biopsies in lung cancer given their innumerable advantages. We have thus witnessed a consequential change in the approach to treatment and survival of these patients. From an average survival of 2-4 months in 1990s, introduction of platinum-based combinations with third-generation agents and more specific cytotoxic drugs, significantly improved survival outcomes to 1-2 years. The newly developed targeted therapy in the appropriate patient population, may provide greater benefit than conventional chemotherapy and may further improve the survival rates in these patients.

Radiation Oncology | Cancer & Stem Cell Therapy | Surgical Oncology | Cancer Immunotherapy | Cancer Cell Biology and Genetics

Location: Meeting Room 1

Chair

Thomas W Kozlowski

Asia Pacific Regional Office Singapore, Singapore

Session Introduction

Kunal Sharma

SRL Diagnostics, India

Title: Paradigm shift towards molecular basis of cancer diagnosis and treatment- The hematolymphoid perspective

Time : 12:30-13:00

Biography:

Abstract:

Diagnosis of diseases especially neoplasms has witnessed a monumental change in its approach. Up until a few years back, the focus lied on histomorphological diagnosis and a blanket treatment was administered based on the disease. With careful understanding of difference in clinical course and treatment response in different patients suffering from the same disease, there arose a need to understand tumor biology to prognosticate and individualize treatment. Research on genetic basis of various neoplasms highlighted different tumor biology and actionable mutation targets in the same disease thus giving rise to the need for detecting these mutations and development of antibodies/molecules which can target them. Hematolymphoid malignancies were one of the earliest to be decoded for different tumor biology, prognosis, response to conventional treatment and need for different treatment strategies based on the underlying genetic mutation. We look into the paradigm shift in the diagnosis of these neoplasms, how the approach has progressively changed from diagnosis based on morphology to present times, classifying prognosis and personalizing treatment, based on the underlying genetic biology.

Baljeet Singh Talwar

Fight Cancer Global, India

Title: Application of microwave thermometry in early detection of Breast Cancer

Time : 14:00-14:30

Biography:

Baljeet Singh Talwar is a graduate from Moscow Power Engineering Institute (Technical University) with a passion of Microwave Technology and has a vast experience in International Business in healthcare(Pharmaceutical & Information Technology).He has the experience of handling scientific and technical development, management of research, interaction with medical consultants of the project. Organization of R & D, production of medical equipment, international scientific cooperation & publications.

Abstract:

Cancer mortality can be reduced if cases are detected and treated early. The lack of awareness, suboptimal medical infrastructure; less availability of screening and low doctor-patient ratio are the prime reasons for the scary statistics of increase in breast cancer load. Microwave Thermometry (MT) is used in risk estimation, the diagnosis of breast pathology and in assessing the effect of neo-adjuvant therapy for breast cancer treatment. It allows the evaluation of thermal changes both at the skin surface and inside the breast tissue. The device facilitates passive, painless, radiation-free and entirely noninvasive diagnostic procedures to pinpoint the changes in temperature that invariably precede structural changes in tissue. The temperature of a malignant tumor is a universal indicator of the growth rate of the tumor. Tumor temperature can be used as a prediction of the benefit of individual therapies and in monitoring the efficacy of breast cancer treatment. The device provides additional information about the severity of proliferative processes, manifested by thermal activity. This is the only device on a decentralized platform suitable for mass screening programs which will bring the Paradigm shift from reactive breast cancer care to care that is predictive, preventive, personalized and participatory.

Daniel Gandia

National University of Buenos Aires, Argentina

Title: The old and the new in medical Cancer therapy

Time : 14:30-15:00

Biography:

Daniel Gandia is a currently working as a Clinical Oncologist who has been involved in Cancer Medicine for many years and also in the guidance of clinical oncology trials in an important worldwide American CRO. He has published several papers in important journals and he also teaches Cellular and Molecular Biology at the School of Medicine in Buenos Aires.

Abstract:

Medical cancer treatment has evolved in a geometric manner since Gilman´s Mechlorethamine introduction into the bedside. Chemotherapy was born and rapidly proved its worth in different tumors and different clinical settings. Initially the bright results were seen in hematologic malignancies, namely complete remissions in some types of leukemias and lymphomas and posteriorly in solid tumors it changed the natural disease history in osteosarcoma, becoming adjuvant methotrexate the new overall survival drug in this malignancy. Many pediatric and young adults’ tumors comported complete remissions with chemotherapy, rendering them as curable diseases. As this, testicular cancer became the first example of a curable cancer model within advanced solid tumors (Cisplatin was the gladiator here). Even when the first clinical trial became from the sixties, during the seventies Oncologists became interested in the after surgery chemo in breast cancer. Two pivotal trials (US and Europe), continue showing that even nearly 40 years after, the overall survival benefit of adjuvant chemo in this disease is impressive. As many as with chemo, hormonotherapy proved and continue to prove its worth in postmenopausal breast cancer women. Adding to the before, two milestones in chemo history are the role of chemo in larynx organ preservation and its positive role in the colorectal cancer adjuvant setting. Taking as a profit chemo radio sensitizer power, the role of concomitant chemotherapy and radiotherapy came up to age: Head neck, rectal cancer, anal cancer only to mention some tumor topographies amenable to this combined approach with organ preservation objectives. As time passed, new techniques in molecular imaging created new magic little bullets named them small molecules and leading this to the creation of the target or directed cancer therapy. The druggable targets here are inner cellular membrane and cytosolic proteins, mainly tyrosine kinases and mutant DNA segments and/or mutant oncogenes. As some tumors to be treated with them, were historically chemo-insensible, the real benefit in renal cancer and melanoma became notorious. Tumor metastatic shrinkage became a reality in these before-mentioned malignancies. César Milstein Nature 1975 Letter (discovery of the Monoclonal Antibodies) was the road to the beautiful landscape that is Immune Oncology today. We treat patients with vaccine, leading this to impressive clinical results in melanoma, lung, kidney, lymphomas and so on. Cellular Immunology is weakened in cancer but there are some molecules that block T Lymphocytes surface, so they couldn’t go to the tumor target to eat them. This novel type of treatment, de-block the lazy lymphocytes. In the road of Immunology there are other-related-immune-novel compounds in trials and also new vaccines. In the future and not so far, we will cure still difficult-to-treat types of advanced cancer. Currently we have some tumor tissue complaints such as tumor heterogeneity that leads to cellular and clinical tumor resistance. Genomics and Proteomics are helping us with this and are currently at the bedside. In the meantime, at the bench side is Gene therapy. Cancer is mainly a DNA-disease and targeting what is correct can show us the long and winding road to a definite cure of this still deadly disease.

Prissadee Thanaphongdecha

Khonkaen University, Thailand

Title: Infection with CagA+ Helicobacter pylori induces epithelial to mesenchymal transition in human cholangiocytes

Time : 15:20-15:50

Biography:

Prissadee Thanaphongdecha has done Doctoral of philosophy in Pathobiology and Bachelor degree in Medical science. He is currently working in Faculty of medicine, Khonkaen university, Thailand

Abstract:

Recent reports suggest that the East Asian liver fluke Opisthorchis viverrini serves as a reservoir of Helicobacter pylori, which is implicated in pathogenesis of Opisthorchiasis-associated cholangiocarcinoma(CCA). The affected cholangiocyte lining intrahepatic biliary tract might be the origin of CCA. Here we investigated interaction of CagA+ve Helicobacter pylori and Helicobacter bilis with H69 cells, an immortalized form of human cholangiocyte. Exposure of H69 cells to increasing numbers of H. pylori at 0, 1, 10,100 bacteria per H69 cell for 24 hours induced morphological changes in cholangiocytes including the appearance of mesenchymal phenotype, profusion of thread-like filopodia and loss of cell-cell contact, in dose-dependent fashion. In parallel, changes in mRNA expression followed exposure to H. pylori, with increased expression of Epithelial to Mesenchymal Transition (EMT) associated-factors including snail, slug, vimentin, matrix metalloprotease, zinc finger E-boxbinding homeobox, and cancer stem cell marker CD44. Transcription levels encoding cell adhesion marker CD24 decreased. Analysis in real time using the xCELLigence approach revealed that exposure to 10 to 50 of H. pylori stimulated migration of H69 cells and CCLP1 cells, a derived form of human cholangiocarcinoma, and invasion through Matrigel extracellular matrix. Similarly, 10 bacteria of CagA+ve H. pylori but not H. bilis stimulated contact-independent colony establishment in soft agar. These findings support the hypothesis that infection with H. pylori contributes to the fibrogenesis and malignant transformation of the biliary epithelium.

Saeed Soroush

Guilan University School of Medicine, Iran

Title: Study of epigenomic changes (noncoding -tag.oncogene) in primary cells of cancer patients than biopsy cells from normal tissue

Time : 15:50-16:20

Biography:

Saeed Soroush began his education in 2013 in medicine in Gilan University of Medical Sciences, Rasht-IRAN. He has published more than 10 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

The epigenetic is a set of controlled reversible processes which causes inherited changes in the expression of genes Independent of the change in the nucleotide sequence of DNA. Changes in heterochromatin to yochromatin and vice versa. In DNA Methylation, Histone Modifications are considered as epigenetic mechanisms which regulates target genes in the transcription machine and On the other hand, the interaction of non-coding RNAs like Micro RNAs With target gene has identified their roles in the growth of differentiation and cell death. Therefore, epigenetic factors directly or indirectly change the expression of Micro RNAs in the cell. Certainly failure in these mechanisms leads to activating or inhibiting different messaging pathways and causing diseases such as cancer. As you know, the differentiation and survival of cells occur due to constant gene control patterns that also cancer is created as a result of a change in expression of the activity of carcinogenic genes or tumor suppressor genes. The expression of genes at the DNA and chromatin levels is regulated through epigenetic mechanisms. Of these, some small molecules and drugs that interact with specific sequences of DNA can be modified locally and allow the transcriptional machine to reach the target genes and, ultimately, to change the heterochromatin to the cochromatin,can be mentioned.

The epigenomic settings are considered in four ways:

1. Adjustment at the level of chromatin structure

2. Adjustment on the surface of Micro RNAs

3. Adjustment at the level of the histone structure

4. Adjustment at the level of DNA methylation

This hypothesis can be considered that in each replication of the somatic cells, the length of the telomeres is reduced, but in the cancer cells, the telomere length is fixed due to the telomerase activity and as drug compounds connect to the above structures valuable route in inhibiting telomeres and thus stopping the proliferation of cancer cells.

Mehrnaz Ajorloo

Shahid Beheshti University of Medical Sciences, Iran

Title: The role of genetic factors in the treatment and prognosis of cancer

Time : 16:20-16:50

Biography:

Mehrnaz Ajorloo is a Biotechnologist, and done her education from Shahid Beheshti University of Medical. She has published more than 10 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

Generally, cancer is caused by uncontrolled cell division due to the interference of environmental factors and genetic disorders. Among of the key genes involved in the guidance of cancer cells can be mentioned to Oncogenes, tumor suppressor genes, restorative genes and responsible for planned death. In recent pathologic studies that tumor size was calculated based on millimeters, Percentage of tubular body, mitosis and polymorphisms rates express that there is a direct correlation between tumor size and tissue grading with genetic factors. In this regard, some factors such as tumor size, tumor stage, type, estrogen and progesterone receptor status, P53 and HER2 have a more effective role in the prognosis of cancer. For example, the restorer gene BRCA-1 located on the chromosome 17q21 can produce proteins that have the power to correct defective genes. This protein contains Zink Finger, which in addition to controlling the expression of related genes, also has the ability to repair fractures of double strands of DNA. As a result, all genes in the cells naturally get damage by natural and metabolic factors that require restorative proteins. For this reason, prognosis that can be examined with genetic markers, in relation to the normal cells that go out of their standard pathway and become cancerous, it can be very helpful in the diagnosis process .

Precision Cancer Medicine & Oncology | Organ-Defined Cancers| Cancer Pharmacology | Cancer Awareness and Survival

Location: Meeting Room 1

Chair

Kunal Sharma

SRL Diagnostics, India

Session Introduction

Paulus S Wang

National Yang-Ming University, Taiwan

Title: Effect of prolactin on cell proliferation in non-small cell lung cancer cells

Time : 10:40-11:10

Biography:

Paulus S Wang worked as a Professor at the Department of Physiology, National Yang-Ming University (NYMU). He is currently working as a Chair-Professor and also the Director in the Medical Center of Aging Research, China Medical University Hospital (CMUH) and also Founder of both the Society of Adaptive Science in Taiwan (SAST) and also the Taiwan Society of Endocrinology and Metabolism (TSEM).

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Abstract:

It has been known that the concentration of Serum Prolactin (PRL) in lung cancer patients is higher than in healthy people. Recent reports point out that the PRL expression level of lung cancer tissues is related to patient’s survival rate. The lower survival rate occurs in patients who have higher PRL expression level. The aim of this study was to investigate the stimulatory mechanism of PRL in non-small cell lung cancer cells. We detected the effect of PRL on cell proliferation by MTT assay. The results show that cell proliferation was significantly increased after treatment with PRL by 50 nm for 24 hours. We also detected cell proliferation related signaling pathway JAK2/STAT3 and EMT (Epithelial–mesenchymal transition) marker by western blot. The protein levels of p-JAK2 and p-STAT3 were significantly increased after treatment with PRL. We also analyzed STAT3 regulated downstream gene VEGF mRNA level and protein level by qRT-PCR and western blot. VEGF mRNA and protein levels were significantly increased by PRL. The protein expressions of p-JAK2, p-STAT3 and VEGF were inhibited by JAK2 inhibitor AZD1480. AZD1480 treatment also led reduction of cell proliferation. Not only cell proliferation but also metastasis was led low survival rate in lung cancer patients. Results show that PRL also enhanced the protein levels of N-cadherin and vimentin. The protein expression of E-cadherin was decreased after treatment with PRL. We can conclude that these results suggested that PRL might promote NSCLC cells cell proliferation which was regulated through JAK2/STAT3 signaling pathway and EMT.

Joshua K S Ko

Hong Kong Baptist University, China

Title: Therapeutic potential of henryin in the treatment of pancreatic cancer

Time : 11:30-12:00

Biography:

Joshua K S Ko obtained his PhD degree in Pharmacology at the University of Hong Kong Medical School after completion of his undergraduate training at the University of Toronto, Canada with double specialists in Toxicology and Nutritional Sciences. He has been actively involved in many research projects, published over 100 papers in reputed journals and serving as an editorial board member of various journals including those of the Nature Publishing Group. He is currently member of the American Association for Cancer Research (AACR), European Association for Cancer Research (EACR) and International Union of Basic and Clinical Pharmacology (IUPHAR).

Abstract:

Pancreatic cancer is characterized by early metastasis and poor prognosis. Henryin, an Isodon diterpenoid, was suggested to exhibit anti-carcinogenic activity. For the first time, we have unveiled its anticancer potential in pancreatic cancer cells. Our results have shown that henryin (0.1-10 μM) induced growth inhibition in PANC-1 pancreatic cancer cells, which was most significant among other cancer cell types. The growth-inhibitory effect of henryin was more prominent among other ent-kaurane diterpenoids under the same dose range. Besides, it has also been noted that henryin reduced the number and size of cancer cell colonies and facilitated both autophagy and apoptotic cell death. The drug action of henryin (1 or 5 μM) in combination with the orthodox chemotherapeutic drug gemcitabine (10-500 nM) were also studied. Data indicate synergistic effects of henryin and gemcitabine on cell growth inhibition as proven by isobologram analysis. Following the tests on a combination of henryin-gemcitabine working concentrations, the optimal effect on the induction of apoptosis was found to be 1 μM of henryin and 100 nM of gemicitabine, even better than the use of gemcitabine at a higher concentration of 250 nM. Other than this, the henryin-gemcitabine combo also induced S-phase cell cycle arrest. S100A4 plays an important role in cancer invasion and metastasis. Our data here have revealed that henryin suppressed rS100A4-mediated migration of PANC1 cells through downregulation of pro-invasive and angiogenic factors. Findings in this study have exemplified that henryin could is a drug adjuvant that concomitantly increases the effectiveness of pancreatic cancer chemotherapic drugs.

Vinay Sharma

University of Witwatersrand, South Africa

Title: Conformal radiation therapy for breast cancer

Time : 12:00-12:30

Biography:

Vinay Sharma is currently working as Head of Department of Radiation Oncology at Charlotte Maxeke Johannesburg Academic Hospital, University of Witwatersrand. He has published over 150 papers in in national and international peer reviewed journals as well as book chapters. His main research interest is in breast cancers as well as gynecological malignancies

Abstract:

Conformal radiation therapy for breast cancer is being used as a standard radiation therapy technique in most centers in the world. The aim of the study was to document the doses to lung and heart (organs at risk) in addition to breast tumor volumes to correlate with treatment related toxicities. A total of 115 patients of cancer of breast underwent CT scans and planning procedure after decision at the multidisciplinary management meeting during 2016-17. Both right and left breast were almost equally affected right 62 patients (54%) and left 53 patients (46%). All patients had MUGA scans before RT planning. 43 patients (37%) had conservative breast surgery and 72 had mastectomies. 74 patients (64%) received 50 Gy in 25 fractions and 39 (34%) patients had 40.05 Gy in 15 fractions. The radiation therapy was delivered using 6 Mv photos with different fields. The patients with conservative surgery received a boost to the tumor bed following tangential field. The patients with locally advanced disease and nodal involvement received radiation to chest wall as well lymph drainage areas. 48% (56 patients) had radiation to chest wall and lymph drainage areas; 30 patients (26%) had tangential field and tumor bed boost. The lung constraints used were V20=≤30Gy, V8=35-40% and mean lung dose=<15 Gy. 106 patients (92%) achieved the lung constraints. The heart constraints used were V25 Gy=<10% and mean heart dose=<26 Gy. The heart constraints could be achieved in all except one patient both V25 as well as mean heart dose. Conformal radiation was able to achieve the aim of study and constraints were maintained in over 90 percent patients. There is no toxicity reported up till now on follow up and is increasingly being practiced.

Marilyn Parkin

International College of Medical Intuition, Canada Lunch Break

Title: Bio-Physical tendencies with applied methods of mind/body/soul techniques sound frequencies and including the art of intuition

Time : 12:30-13:00

Biography:

Parkin has been a practicing Medical Intuitive for several years. She earned her PhD in Energy Medicine through an innovative program designed by Dr. Norm Shealy and Dr. Caroline Myss. Dr. Parkin previously spent many years in nursing and holds a degree in Sociology and Psychology. She also teaches Health and Empowerment seminars worldwide and has founded the International College of Medical Intuition, Inc (2002) which has locations in Hawaii, Vancouver and NY.

Abstract:

The study was conducted to determine the effects of sound vibration on individuals with depression. The study also examined changes to the blood cell after the intervention of vibratory frequencies ranging from 120Hz to 10Hz throughout the magnetic field of the body. Variables introduced were time frame of one hour of control group listening to music and experimental group positioned on a sound vibrational treatment table to absorb the music vibrations. The random study was conducted on 60 subjects with inclusion of 25 to 45 years of age and >6 months maintenance dose of antidepressant drug, Paxil. Measurement was accomplished through evaluation of Live Blood Analysis and Hamilton Rating Scale for Depression. A blood draw process of Live Blood Analysis was obtained and examined for specific quality and level of visible clumping. Post blood analysis determined less clumping and healthier activity of the cell after intervention in the experimental group. The Live Blood Analysis of the control group remained unchanged. Hamilton Rating Scale for Depression indicated decreased levels of depression in experimental group. Hypothesis supports changes toward healthier cellular activity and appearance of less blood cell clumping and decreased level of depression with increased levels of frequency through sound vibrational treatment table. Application of this model has been applied within informal studies and observations on adults and children for various conditions with similar results.

Ola Osama Ahmed Hafez

Cairo University, Egypt

Title: Management and outcome of breast cancer patients with ipsilateral supraclavicular lymph nodes involvement at presentation retrospective study

Time : 14:00-14:30

Biography:

Ola Osama Ahmed Hafe is an Egyptian. He is a Physician young Oncology Specialist in Helwan University. He has completed his Master’s degree from Kasr Al Ainy School of Oncology, Cairo University. He is currently working as Specialist in governmental and private oncology centers. He is interested in research as well as clinical practice.

Abstract:

Breast cancer is the most common type of cancer and the most common cause of cancer-related mortality among women worldwide. About 4% have had ipsilateral Supraclavicular Lymph Nodes involvement (SCLNs). In spite this very low incidence, a big conflict occur in TNM staging and management. The current study was a retro prospective observational descriptive study. We re¬viewed the files of breast cancer patients with synchronized with ipsilateral SCLNs involvement without distant metastasis that were seen in the follow up clinic in the period (Feb 2016-August 2016) at NEMROCK oncology Department, Kasr Al Ainy School of Medicine. Clinic pathological data was described for 34 patients as age (median 50.5 years), menopausal status (pre-menopause were 47.1%), family history (positive in 23.5%), site of tumor (UOQ 67.6 %), side (Rt 52.9 %), hormonal receptors (positive in 58.8%), initial T (T3 and T4 70.6%). Treatment applied NAC was given to 73.5% and the response was regressive in 44% of patients, 64.7 % underwent mastectomy while 14.7 % gone for conservation, 41.1 % received adjuvant hormonal treatment, post-treatment pathological T (3,4) was 35.3 %. Local recurrence occur in 14.7%, systemic relapse occur in17.6%. We don't comment on overall survival because of selection bias. Although the incidence of patients with breast cancer who present with ipsilateral SCLNs involvement without distant spread at time of diagnosis is low. It seems reasonable to consider this selective patient group as a loco regional and thereby a potentially curable disease and should be treated with a curative rather than palliative intent. Nevertheless, one should keep in mind that patients presenting with supraclavicular disease are at high risk for harboring distant metastatic disease, even when clinically detectable metastases are not evident. Patients should be offered a combined-modality approach, including systemic therapy, surgery and radiotherapy.